CMS Issues Preliminary Guidance For Medicaid Managed Care State-Directed Payments

On September 9, 2025, the Centers for Medicare & Medicaid Services (CMS) issued preliminary guidance to states about how to implement new federal payment limits for state-directed payments (SDPs) in Medicaid managed care. For SDPs submitted or approved before July 4, some may qualify for temporary grandfathering until the January 1, 2028 rating period. The preliminary guidance defines in detail how CMS will interpret whether an SDP will qualify for grandfathering.;

For rating periods beginning on or after July 4, 2025, SDPs for four services (inpatient and outpatient hospital services, nursing facility services, and qualified practitioner services at . . .