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Diane Publishing Books
Medicaid: More Transparency of and Accountability for Supplemental Payment Are Needed
Katherine Iritani (au)
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 disproportionate share hospital (DSH) payments, for uncompensated care costs experienced by hospitals serving large numbers of low-income and Medicaid patients. States also make other supplemental payments (non-DSH payments) to hospitals and other providers who, for ex., serve high-cost Medicaid beneficiaries. Past 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. The Centers for Medicare & Medicaid Services (CMS) has required states to submit annual audits and reports on DSH payments since 2010. This report reviewed federal oversight of supplemental payments and examined (1) how information in DSH audits and reports facilitates CMSäó»s oversight of DSH payments; and (2) the extent to which similar information exists for non-DSH payments. Tables and figures. This is a print on demand report.
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