Proposed Changes to Medicaid State Directed Payments and Targeted Practitioner Payments
May 28, 2026
On May 20, 2026, the Centers for Medicare & Medicaid Services (CMS) released the Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments Proposed Rule.
This proposed regulation outlines critical updates to Medicaid provider reimbursement, directly addressing federal mandates from the One Big Beautiful Bill Act (the Working Families Tax Cut legislation enacted on July 4, 2025). Notably, the rule extends payment limitations to additional healthcare providers operating under both Medicaid managed care models and fee-for-service (FFS) delivery systems.
To help healthcare organizations, state agencies, and health plans navigate these complex regulatory shifts, Health Management Associates (HMA) experts have developed a comprehensive compliance and impact overview.
The proposed changes to Medicaid state directed payments are highly complex. The HMA consulting team is actively analyzing the regulatory text and stands ready to assist organizations with impact evaluations, policy interpretation, and strategic response planning.
Don’t Miss Our Upcoming Webinar: The Future of Medicaid State Directed Payments
Wednesday, June 10, 2026 | 12:00 PM ET
As federal regulators move to reshape the Medicaid landscape, states, providers, and insurers face intense pressure to adapt. Join HMA subject matter experts as they deliver timely, up-to-the-moment analysis on federal guidance, waiver activity, and litigation shaping the operational environment.
👉 Register for the webinar to secure your spot and gain actionable insights for your organization.
