Medicaid Monitor
Policy Intelligence
Medicaid Monitor
Policy Intelligence
Updated 7:40 AM MT
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Managed Care·July 21, 2026

MACPAC Comments on CMS Proposed Rule for State Directed Payments and Targeted Practitioner Payments

The Medicaid and CHIP Payment and Access Commission submitted comments to CMS Administrator Dr. Mehmet Oz on a proposed rule governing state directed payments in managed care and targeted practitioner payments in fee-for-service. MACPAC supports CMS efforts to align Medicaid payments with statutory requirements for economy and efficiency. The comment letter addresses proposed changes to how states can direct managed care organizations to make specific payments to providers and how states structure targeted payments in FFS arrangements. The proposed rule affects state Medicaid agencies' flexibility to use payment strategies that support provider rates and access while meeting federal oversight requirements.

Why it matters

State directed payments have become a primary mechanism for states to supplement MCO provider payments and support safety-net providers — CMS rule changes will directly affect state financing strategies and MCO actuarial soundness demonstrations.

Managed Care · Finance

Read the full article at macpac.gov

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