Medicaid Managed Care State Directed Payments and FFS Targeted Medicaid Practitioner Payments Proposed Rule Summary

On May 22, 2026, CMS, Department of Health and Human Services, published in the Federal Register (91 FR 30400) the proposed rule entitled “Medicaid Program; Medicaid Managed Care State Directed Payments and Medicaid Fee For-Service Targeted Medicaid Practitioner Payments.” The proposed rule includes proposals to implement the provisions of section 71116 of Public Law 119-21 (referred to as the “Working Families Tax Cut” legislation), which modify the limit on the total payment rate and other requirements for State directed payments (SDPs) in Medicaid managed care with respect to certain service types and SDPs. The proposed rule also includes proposals to expand application of the modified limit to all SDPs and all service types and to set a limit for certain targeted Medicaid payments in Medicaid fee-for-service.

Comments on the proposed rule are due by July 21, 2026.