The Centers for Medicare & Medicaid Services (CMS) Medicaid managed care regulations at 42 C.F.R. § 438 govern how states may direct plan expenditures in connection with implementing delivery system and provider payment initiatives under Medicaid managed care contracts. CMS began reviews of state directed payment arrangements beginning with contract rating periods on or after July 1, 2017. For more information on state directed payments, please visit our Guidance Page. Persons with disabilities having problems accessing the Preprint PDF files may call 410-786-0429 for assistance.
Approved State Directed Payment Preprints
New Hampshire
Uniform dollar increase for community mental health programs including Assertive Community Treatment (ACT), New Hampshire Hospital (NHH) Discharges/Same-day Access and Follow-up, Timely Prescriber Services Following Intake, Illness Management and Recovery Services (IMR), and Specialty Residential Service Payment Enhancement for Individuals with Co-occurring Developmental Disabilities Discharged from Hospital for the rating period covering July 1, 2023 through August 31, 2024, incorporated into the capitation rates through a separate payment term of up to $5,833,333.
Approval Date:
November 27, 2023
Effective Date:
July 1, 2023
Links:
Oklahoma
Uniform dollar increase for Oklahoma Universities Affiliated Physicians established by the state for the rating period covering April 1, 2024 through June 30, 2025, incorporated int the capitation rates through separate payment term of up to $127,410,566.
Approval Date:
November 27, 2023
Effective Date:
April 1, 2024
Links:
Hawaii
Uniform percentage increase established by the state for nursing facility services, community care foster homes (CCFH), and expanded adult residential care homes (E-ARCHs) for the rating period of July 1, 2022 to December 31, 2022, incorporated into the capitation rates through a separate payment term of up to $47,694,753.
Approval Date:
November 22, 2023
Effective Date:
July 1, 2022
Links:
Utah
Uniform percentage increase for outpatient hospital services for privately owned hospitals for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $227,855,207.
Approval Date:
November 17, 2023
Effective Date:
July 1, 2023
Links:
Utah
Uniform percentage increase for outpatient hospital services for state teaching hospitals for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $80,821,068.
Approval Date:
November 17, 2023
Effective Date:
July 1, 2023
Links:
Utah
Uniform percentage increase for outpatient hospital services for privately owned hospitals for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $24,833,227.
Approval Date:
November 17, 2023
Effective Date:
July 1, 2023
Links:
Utah
Uniform percentage increase for outpatient hospital services for state teaching hospitals for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $3,066,737.
Approval Date:
November 17, 2023
Effective Date:
July 1, 2023
Links:
Utah
Uniform percentage increase for outpatient hospital services for privately owned hospitals for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $89,272,072.
Approval Date:
November 17, 2023
Effective Date:
July 1, 2023
Links:
Utah
Uniform percentage increase for outpatient hospital services for state teaching hospitals for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $38,146,652.
Approval Date:
November 17, 2023
Effective Date:
July 1, 2023
Links:
Utah
Uniform percentage increase for professional services at an academic medical center for state teaching hospitals for the rating period covering July 1, 2023 through June 30, 2024, incorporated in the capitation rates through a separate payment term of up to $48,050,958.
Approval Date:
November 17, 2023
Effective Date:
July 1, 2023
Links: