State Proposals
Guidance for state submission of a demonstration proposal, including capitated, managed fee-for-service (FFS), and alternative models.
Final
Issued by: Centers for Medicare & Medicaid Services (CMS)
Issue Date: February 11, 2020
A total of 26 states submitted proposals by the deadline of May 31, 2012, and those with active proposals are listed below. Submission of a demonstration proposal is an important step - but not the final step - toward demonstration approval. The proposals below include capitated, managed fee-for-service (FFS), and alternative models.
States interested in the new financial alignment opportunities were required to submit a letter of intent by October 1, 2011.
When a state meets the standards and conditions for the Financial Alignment Initiative, the Centers for Medicare & Medicaid Services (CMS) and a state will develop a memorandum of understanding (MOU) to establish the parameters of the initiative.
To access the signed MOUs, click on the dates listed in the chart below, under the column labeled "MOU Signed."
| State | 2012 Proposal | Model Proposed | MOU Signed |
| California | Capitated | 3/27/2013 (PDF) | |
| Colorado | State Proposal (PDF) | FFS | 2/28/14 (PDF) |
| Hawaii | State Proposal (PDF) | Capitated | |
| Illinois | State Proposal (PDF) | Capitated | 2/22/2013 (PDF) |
| Massachusetts | Capitated | 8/22/2012 (PDF) | |
| Michigan | State Proposal (PDF) | Capitated | 4/3/2014 (PDF) |
| Minnesota | State Proposal (PDF) | Alternative | 9/12/2013 (PDF) |
| New York | Capitated Two Models | ||
| Ohio | Capitated | 12/11/2012 (PDF) | |
| Oklahoma | State Proposal (PDF) | FFS | |
| Rhode Island | State Proposal (PDF) | Capitated | 07/28/2015 (PDF) |
| South Carolina | Capitated | 10/25/2013 (PDF) | |
| Texas | Capitated | 5/23/2014 (PDF) | |
| Virginia | Capitated | 5/21/2013 (PDF) | |
| Washington | FFS | FFS: 10/24/2012 (PDF) |
Standards and Conditions
As indicated in the State Medicaid Director (SMD) letter, demonstration proposals are evaluated against standards and conditions that CMS is requiring of all states seeking to participate in the demonstration.
Public Comments
As part of the proposal review process, CMS hosted a public comment period for each proposal. These periods have closed, but interested parties can still review the proposals above and read the public comments submitted to CMS.
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