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Diane Publishing Books
Medicaid: CMS Oversight of Provider Payments Is Hampered by Limited Data and Unclear Policy
Katherine M. Iritani (au)
Under Medicaid, a joint federal-state program, states pay health care providers and receive federal matching funds for their payments. States may have incentives to make excessive Medicaid payments to certain institutional providers such as hospitals operated by local governments. Medicaid payments are not limited to providersäó» costs, but federal law requires that they be economical and efficient. Large payments that exceed costs raise questions as to whether the payments are for Medicaid purposes. This report examined (1) in selected states, how state Medicaid payments to government hospitals compare to those made to private hospitals, and, for selected hospitals, to their Medicaid costs and total hospital operating costs; and (2) CMS oversight. Tables and figures. This is a print on demand report.
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