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HHS/CMS RIN: 0938-AV69 Publication ID: 2026 
Title: Medicaid Managed Care State Directed Payments and Medicaid Fee-For-Service Targeted Medicaid Practitioner Payments (CMS-2449) 
Abstract:

This rule would propose to modify the limit on the total payment rate and other requirements for state directed payments in Medicaid Managed Care. CMS would propose these changes to comply with Section 71116 of the One Big Beautiful Bill Act, known as the Working Families Tax Cut (WFTC) legislation, as well as the Presidential Memorandum, "Eliminating Waste, Fraud, and Abuse in Medicaid” issued June 6, 2025. This rule also proposes to set a limit for certain targeted Medicaid practitioner payments in Medicaid fee-for-service.

 
Agency: Department of Health and Human Services(HHS)  Priority: Economically Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: Yes  Unfunded Mandates: No 
EO 14192 Designation: Other 
CFR Citation: 42 CFR 438   
Legal Authority: 42 U.S.C. 1302    Pub. L. 119-21, Sec 71116   
Legal Deadline:  None
Timetable:
Action Date FR Cite
NPRM  07/00/2026 
Regulatory Flexibility Analysis Required: Undetermined  Government Levels Affected: Federal, State 
Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
John Giles
Director, Managed Care Group
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicaid and CHIP Services, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-1255
Email: john.giles1@cms.hhs.gov