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
Mississippi
Uniform increase established by the state for ground emergency ambulance services for the rating period covering July 1, 2022 through June 30, 2023, incorporated in the capitation rates through a separate payment term of up to $14,740,472.00.
Approval Date:
July 26, 2023
Effective Date:
July 1, 2022
Links:
State Rating Period:
July 1, 2022
-
June 30, 2023
Payment Type:
Fee schedule
Review Type:
New
Approval Period:
Single Rating Period
Provider Class:
Other
New Jersey
Uniform dollar increase for inpatient hospital services provided by hospitals in Essex 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 $240,495,335.
Approval Date:
July 26, 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
Rhode Island
Uniform increase established by the state for personal care and combined personal care/ homemaker services for the rating period covering July 1, 2022 through June 30, 2023, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 25, 2023
Effective Date:
July 1, 2023
Links:
State Rating Period:
July 1, 2022
-
June 30, 2023
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
HCBS/personal care services
Florida
Uniform increase established by the state for inpatient and outpatient hospital exemption payments for the rating period covering October 1, 2020 through September 30, 2021, incorporated in the capitation rates through a separate payment term up to $240,107,394.00
Approval Date:
July 18, 2023
Effective Date:
October 1, 2020
Links:
State Rating Period:
October 1, 2020
-
September 30, 2021
Payment Type:
Fee schedule
Review Type:
Amendment
Approval Period:
Single Rating Period
Provider Class:
Dental services
Massachusetts
Uniform increase for behavioral health outpatient services, behavioral health diversionary services, and early intervention services established by the state for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 14, 2023
Effective Date:
January 1, 2022
Links:
State Rating Period:
January 1, 2022
-
December 31, 2022
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Other
Massachusetts
Minimum fee scheduled established by the State for outpatient behavioral health services and behavioral health diversionary services for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 14, 2023
Effective Date:
January 1, 2022
Links:
State Rating Period:
January 1, 2022
-
December 31, 2022
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Other
Massachusetts
Uniform increase for DMH-licensed Psychiatric Hospitals and all units with DMH-licensed beds within acute inpatient hospitals and all units that have DMH-licensed beds within applicable Chronic Disease and Rehabilitation Hospitals for the rating period covering January 1, 2022 through December 31, 2022, incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 13, 2023
Effective Date:
January 1, 2022
Links:
State Rating Period:
January 1, 2022
-
December 31, 2022
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health inpatient service
New York
Uniform dollar increase for inpatient and outpatient services delivered by qualifying financially distressed hospitals for the rating period covering April 1, 2023 through March 31, 2024, incorporated in the capitation rates through a separate payment term of up to $1,559,329,241.
Approval Date:
July 13, 2023
Effective Date:
April 1, 2023
Links:
State Rating Period:
April 1, 2023
-
March 31, 2024
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Behavioral health outpatient services
Inpatient hospital service
Outpatient hospital service
New York
A value-based payment arrangement for hospitals providing labor and delivery services for the rating periods covering April 1, 2023 through March 31, 2025, incorporated in the capitation rates through a separate payment term of up to $14 million for the April 1, 2023 – March 31, 2024 rating period and up to $24 million for the April 1, 2024 – March 31, 2025 rating period.
Approval Date:
July 13, 2023
Effective Date:
April 1, 2023
Links:
State Rating Period:
April 1, 2023
-
March 31, 2025
Payment Type:
Value-based payment
Review Type:
New
Approval Period:
Multiple Rating Period
Provider Class:
Inpatient hospital service
Florida
Minimum fee schedule established by the state for primary care services and specialty physician services for the rating period covering October 1, 2022 through September 30, 2023 incorporated in the capitation rates through a risk-based rate adjustment.
Approval Date:
July 7, 2023
Effective Date:
October 1, 2022
Links:
State Rating Period:
October 1, 2022
-
September 30, 2023
Payment Type:
Fee schedule
Review Type:
Renewal
Approval Period:
Single Rating Period
Provider Class:
Primary care services
Specialty physician services