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GAO-06-705 Medicaid Financial Management: Steps Taken to Improve Federal Oversight but Other Actions Needed to Sustain Efforts
Examining the social, political and economic factors that have shaped Medicaid, the author of The Political Economy of Aging: The State, Private Power, and Social Welfare helps readers understand the powerful interests that cause costs to swell and hold elected officials hostage.
The financing of the $299 billion Medicaid program is shared between the fed. gov¿t. and states. States pay qualified providers for covered Medicaid services and receive fed. matching funds for expenditures authorized in their state Medicaid plans. In addition to these standard Medicaid payments, most states make supplemental payments to certain providers, which are also matched by fed. funds. This report provides info. about Medicaid supplemental payments and examines: (1) what info. states report about supplemental payments on Medicaid expenditure reports; and (2) in selected states, how much was distributed as supplemental payments, to what types of providers, and for what purposes. Includes recommendations. Illustrations.
In addition to standard Medicaid payments, hospitals receive supplemental payments for uncompensated costs of care provided to uninsured and Medicaid patients. These supplemental payments are referred to as disproportionate share hospital (DSH) payments. In FY 2006, DSH payments totaled about $17 billion and non-DSH supplemental payments exceeded $6 billion. Hospitals' DSH payments are limited to their uncompensated care costs, that is, their costs for covered care less Medicaid and other payments. This report examined: (1) how state DSH payments in 2006 compared to DSH payment limits; and (2) certain aspects of states' calculations of 2006 DSH payment limits. Charts and tables.