CMS Issues Additional Guidance on State Directed Payments in Medicaid Managed Care


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Today, the Centers for Medicare & Medicaid Services (CMS) is releasing a State Medicaid Director Letter (SMDL) that provides guidance to states on the standards and documentation for Medicaid managed care state directed payments, which will reduce state administrative burden, enhance federal oversight of Medicaid managed care, and improve fiscal and program integrity. 

This guidance also offers additional information on the types of contractual payment requirements that are considered state directed payments, standards for reimbursement analyses, requirements for incorporating state directed payments into rate certifications, and ties to the quality strategy.

CMS is also releasing a revised preprint form. This form has been revised to include more information in tables and check-box formats to make completing the preprint easier and clearer. Additionally, by including more information in the revised preprint, CMS hopes to reduce processing time.