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 Jersey
The uniform dollar increase for inpatient hospital services provided by general acute care hospitals and freestanding psychiatric hospitals in Camden County 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 $134,768,687.
Approval Date:
August 10, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Inpatient hospital service
New Jersey
A uniform dollar increase for inpatient hospital services provided by Hudson County 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 $72,753,656.
Approval Date:
August 9, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Inpatient hospital service
New Jersey
The uniform dollar increase for inpatient hospital services provided by participating hospitals in Ocean County 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 $63,498,231.
Approval Date:
August 8, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Inpatient hospital service
New Jersey
The uniform dollar increase for inpatient hospital services provided by general acute care hospitals and non-general acute care hospitals in Burlington County 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 $60,600,614.
Approval Date:
August 8, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Inpatient hospital service
New Jersey
The uniform dollar increase for inpatient hospital services provided by public and private acute care hospitals and freestanding psychiatric hospitals in Bergen County 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 $311,194,527.
Approval Date:
August 4, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2023
-
June 30, 2024
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Inpatient hospital service
Texas
Behavioral Health Services (BHS) directed payment program for the rating period covering September 1, 2023 through August 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 31, 2023
Effective Date:
September 1, 2023
Links:
State Rating Period:
September 1, 2023
-
August 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
Texas
Rural Access to Primary and Preventative Services (RAPPS) for the rating period covering September 1, 2023 through August 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 31, 2023
Effective Date:
September 1, 2023
Links:
State Rating Period:
September 1, 2023
-
August 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Other
Texas
Texas Incentives for Physicians and Professional Services (TIPPS) program for the rating period covering September 1, 2023 through August 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 31, 2023
Effective Date:
September 1, 2023
Links:
State Rating Period:
September 1, 2023
-
August 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Primary care services
Professional services at an academic medical center
Specialty physician services
Texas
Comprehensive Hospital Increase Reimbursement Program (CHIRP) directed payment for the rating period covering September 1, 2023 through August 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 31, 2023
Effective Date:
September 1, 2023
Links:
State Rating Period:
September 1, 2023
-
August 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
Inpatient hospital service
Outpatient hospital service
Texas
Quality Improvement Payment Program (QIPP) for the rating period covering September 1, 2023 through August 31, 2024, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 31, 2023
Effective Date:
September 1, 2023
Links:
State Rating Period:
September 1, 2023
-
August 31, 2024
Payment Type:
Value-based payment
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Nursing facility services