Improving Oversight and Accountability in Medicaid Non-DSH Supplemental Payments Act

Improving Oversight and Accountability in Medicaid Non-DSH Supplemental Payments Act

This bill amends title XIX (Medicaid) of the Social Security Act to direct the Centers for Medicare & Medicaid Services to: (1) issue guidance to states that identifies permissible methods for calculating certain supplemental payments, excluding disproportionate-share payments, made by state Medicaid programs to providers; and (2) establish annual reporting and auditing requirements for states making such supplemental payments. Federal payment with respect to such supplemental payments shall be conditioned upon a state's compliance with these reporting and auditing requirements.

[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H.R. 541 Introduced in House (IH)]

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115th CONGRESS
  1st Session
                                H. R. 541

     To amend title XIX of the Social Security Act to improve the 
  calculation, oversight, and accountability of non-DSH supplemental 
      payments under the Medicaid program, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                            January 13, 2017

  Mr. Collins of New York (for himself, Mr. Mullin, Mr. Guthrie, Mr. 
   Bucshon, and Mr. Flores) introduced the following bill; which was 
            referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
     To amend title XIX of the Social Security Act to improve the 
  calculation, oversight, and accountability of non-DSH supplemental 
      payments under the Medicaid program, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    This Act may be cited as the ``Improving Oversight and 
Accountability in Medicaid Non-DSH Supplemental Payments Act''.

SEC. 2. IMPROVING CALCULATION, OVERSIGHT, AND ACCOUNTABILITY OF NON-DSH 
              SUPPLEMENTAL PAYMENTS UNDER THE MEDICAID PROGRAM.

    (a) Guidance for States on Non-DSH Supplemental Payments; State 
Reporting and Auditing Requirements.--Section 1903 of the Social 
Security Act (42 U.S.C. 1396b) is amended by adding at the end the 
following new subsection:
    ``(aa)(1) Not later than 180 days after the date of the enactment 
of this subsection, the Secretary shall--
            ``(A) issue guidance to States that identifies permissible 
        methods for calculation of non-DSH supplemental payments to 
        providers to ensure such payments are consistent with section 
        1902(a)(30)(A) (including any regulations issued under such 
        section such as the regulations specifying upper payment limits 
        under the State plan in part 447 of title 42, Code of Federal 
        Regulations (or any successor regulations));
            ``(B) establish annual reporting requirements for States 
        making non-DSH supplemental payments that include--
                    ``(i) with respect to a provider that is a 
                hospital, nursing facility, intermediate care facility 
                for the mentally retarded, or an institution for mental 
                diseases, or any other institution, an identification 
                of each provider that received a non-DSH supplemental 
                payment for the preceding fiscal year, the type of 
                ownership or operating authority of each such provider, 
                and the aggregate amount of such payments received by 
                each provider for the preceding fiscal year broken out 
                by category of service;
                    ``(ii) with respect a provider that is not 
                described in clause (i), any information specified in 
                the preceding paragraph, as determined appropriate by 
                the Secretary; and
                    ``(iii) such other information as the Secretary 
                determines to be necessary to ensure that non-DSH 
                supplemental payments made to providers under this 
                section are consistent with section 1902(a)(30)(A); and
            ``(C) establish requirements for States making non-DSH 
        supplemental payments to conduct and submit to the Secretary an 
        annual independent certified audit that verifies--
                    ``(i) the extent to which non-DSH supplemental 
                payments made in the preceding fiscal year are 
                consistent with the guidance issued under subparagraph 
                (A);
                    ``(ii) that payments made under the State plan (or 
                under a waiver of the plan) are only for the provision 
                of covered services to eligible individuals under the 
                State plan (or under a waiver of the plan); and
                    ``(iii) any other information the Secretary 
                determines is necessary to ensure non-DSH supplemental 
                payments are consistent with applicable Federal laws 
                and regulations.
    ``(2) For purposes of this subsection, the term `non-DSH 
supplemental payment' means a payment, other than a payment under 
section 1923, that--
            ``(A) is identified by the Secretary through guidance 
        described in paragraph (1)(A);
            ``(B) is made by a State to a provider under the State plan 
        (or under a waiver of the plan) for an item or service 
        furnished to an individual eligible for medical assistance 
        under the State plan (or under a waiver of the plan); and
            ``(C) is in addition to any base or standard payments made 
        to a provider under the State plan (or under a waiver of the 
        plan) for such an item or service, including any additional 
        payments made to such provider that are not more than any 
        limits imposed pursuant to section 1902(a)(30)(A) (including 
        the regulations specifying upper payment limits under the State 
        plan in part 447 of title 42, Code of Federal Regulations (or 
        any successor regulations)).''.
    (b) State Reporting and Auditing of Non-DSH Supplemental 
Payments.--Section 1903(i) of the Social Security Act (42 U.S.C. 
1396b(i)) is amended--
            (1) in paragraph (26), by striking ``or'' at the end;
            (2) by redesignating paragraph (27) as paragraph (28); and
            (3) by inserting after paragraph (26) the following new 
        paragraph:
            ``(27) with respect to amounts expended to make any non-DSH 
        supplemental payment (as defined in subsection (aa)(2)), unless 
        the State complies with the reporting and auditing requirements 
        under subparagraphs (B) and (C) of subsection (aa)(1); or''.
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