U S Government Accountability Office

Medicaid U S Government Accountability Office

" In 2011, states reported making $43 billion in Medicaid supplemental payments-payments above regular payments for Medicaid services-to certain providers, mainly hospitals. The federal government shares in the cost of these payments. By law, states make certain supplemental payments, known as DSH payments, for uncompensated care costs experienced by hospitals serving large numbers of low-income and Medicaid patients. States also make other supplemental payments-referred to here as non-DSH payments-to hospitals and other providers who, for example, serve high-cost Medicaid beneficiaries. Past GAO reports have found gaps in federal oversight of these high-risk payments: a lack of information on the providers receiving them, inaccurate payment calculation methods, and a lack of assurances the payments were used for Medicaid purposes. CMS has required states to submit annual audits and reports on DSH payments since 2010. GAO was asked to review federal oversight of supplemental payments and examined (1) how information in DSH audits and reports facilitates CMS's oversight of DSH payments, and (2) the extent to which similar information exists for non-DSH payments. GAO analyzed 2010 DSH audits and reports and interviewed CMS officials. "