The report proposes three recommendations responding to Medicaid disproportionate share hospital allotment reductions and responds to concerns about the accuracy and completeness of available upper payment limit data.

The brief reviews each type of Medicaid hospital payment, information on payment goals, and state-level data on fiscal year 2016 supplemental payments to hospitals.

GAO found that CMS lacks adequate data to conduct provider-level oversight of Medicaid payments to ensure payments are used for Medicaid patients in an economical and efficient manner.

MACPAC recommended that HHS collect and make publicly available provider-level Medicaid UPL payment data. MACPAC said this would help standardize the reporting process, enhancing transparency and enabling data analysis.

MACPAC commissioners voted to increase standardization and transparency around UPL payments.

Clarifies the Outpatient Clinic and Hospital Facility Services definition, Upper Payment Limit.

Letter to state Medicaid directors details federal-state efforts to strengthen program integrity