On May 22, 2026, the Centers for Medicare and Medicaid Services (CMS) released a proposed rule concerning state-directed payment (SDP) arrangements in Medicaid programsopens in new window that utilize a managed care system. While hospitals typically receive the bulk of this funding, states also often rely on these arrangements to bring in more behavioral health providers willing to participate in their Medicaid program.
American Psychological Association. (2026, October 19). Proposed federal regulations would limit state authority to expand the behavioral health workforce in Medicaid programs. https://www.apaservices.org/advocacy/news/limit-authority-behavioral-health-medicaid
Election 2026 APA Services Voter Guide
Many issues affecting psychologists and their communities are on the ballot this November, and your engagement in the upcoming election can impact the future of your work and the well-being of society. Use the 2026 APA Services Voter Guide to learn how you can engage in the upcoming election and educate candidates and communities about the importance of psychology and the issues that matter to you.
While Congress made some targeted adjustments to the program in last summer’s One Big Beautiful Bill Act (H.R. 1)opens in new window, the proposed rule makes broad changes to SDP arrangements. For example, while H.R. 1 imposed SDP payment limitations on specific kinds of entities, the proposed rule extends these constraints to all providers and entities receiving SDPs. On July 17, 2026, APA Services filed a response to the proposed rule (PDF, 197KB)opens in new window highlighting the ways in which CMS exceeded its authority, their impact on access to behavioral health care, and the effect the new guidelines will have on existing and future SDP arrangements.
For more information, email Andrew Strickland.