CMS issues preliminary guidance on Medicaid state-directed payments as part of OBBBA implementation

Sep 09, 2025 - 04:54 PM
CMS-APM-QPP-update

The Centers for Medicare & Medicaid Services Sept. 9 issued preliminary guidance regarding the implementation of certain state-directed payment provisions in Section 71116 of the One Big Beautiful Bill Act. 

CMS sent a letter to stakeholders with information regarding “applicable rating period criteria,” preprint status criteria, the definition of a “completed preprint,” the definition of “good faith effort” and limits for grandfathered SDPs. CMS said it is issuing the guidance now to allow states additional time to plan their efforts to meet the requirements laid out in the OBBBA. CMS is proceeding with preparing a notice of proposed rulemaking as required by Section 71116.   

The AHA is reviewing CMS’ guidance. AHA members will receive an Advisory with more details. 

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