CMS-2449-P recasts Medicaid State Directed Payments & FFS targeted practitioner supplements @ the Medicare benchmark, kills the ACR ceiling, bans uniform increases & projects $774.8B in 10yr savings

CMS just proposed a rule that could cut Medicaid spending by $774.8B over ten years. It targets State Directed Payments, a financing mechanism most people outside Medicaid policy have never heard of. Here is why it matters.

SDPs grew from 4 preprints across 2 states in 2016 to 366 preprints across 41 states by 2024. Total spending: $97.8B in FY2024. CMS …