Chuck Grassley

United States Senator from Iowa

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Finance Committee Releases Report on Medicaid Supplemental Payments

Apr 30, 2019

WASHINGTON – The Senate Finance Committee today released a report finding Medicaid’s supplemental payments, totaling approximately $50 billion in federal spending annually, often lack basic transparency and largely lack auditing tools to ensure taxpayer dollars are being spent appropriately or effectively.

The report was released by Chairman Chuck Grassley of Iowa and Sens. Mike Crapo of Idaho, Pat Roberts of Kansas, Michael B. Enzi of Wyoming, John Cornyn of Texas, John Thune of South Dakota, Rob Portman of Ohio, Patrick J. Toomey of Pennsylvania, Tim Scott of South Carolina, Bill Cassidy of Louisiana, James Lankford of Oklahoma, Steve Daines of Montana, and Todd Young of Indiana.

“This report seeks to increase educational understanding of Medicaid supplemental payments, as well as outline the reporting mechanisms for these payments to ensure adequate stewardship of taxpayer dollars,” the report states. “It is imperative that Congress, and the public, better understand the complex nature of Medicaid payment structures. Whether by the reporting requirements under current law, the differences between the types of supplemental payments, how states raise their share of supplemental payments, or the different interactions between fee-for-service and managed care with supplemental payments, this report offers a clearer lens into one of the most opaque areas of health care financing. The ultimate conclusion, that non-DSH supplemental payment data at the provider level would improve efficiencies and transparency to better inform policy decisions, brings the Medicaid program into the 21st century.”

“Transparency in government spending should always be the default and shouldn’t be a partisan issue,” Grassley said. “It’s against the law for Medicaid to overpay providers, but right now in many cases there’s no way of knowing if the law is being followed. CMS should explore regulatory options to add transparency to this opaque system, and states should do their part, too, to safeguard taxpayer dollars. This Congress, I’ve been focused on lowering prescription drug prices for patients and taxpayers, but there are other places to lower health care costs, including in federal Medicaid supplemental spending, which deserves more scrutiny. To give a sense of the scope of this spending, non-DSH supplemental Medicaid payments roughly equal the total amount spent by Medicaid annually on prescription drugs, at about $30 billion each. These are massive expenditures, and taxpayers have the right to know their tax dollars are being well-spent.”

The full report can be viewed HERE.

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