I 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE; TABLE OF CONTENTS. 

4 This Act may be cited as the ‘‘Improving Oversight 

5 and Accountability in Medicaid Non-DSH Supplemental 

6 Payments Act’’. 


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1 SEC. 2. IMPROVING CALCULATION, OVERSIGHT, AND AC2 COUNTABILITY OF NON-DSH SUPPLEMENTAL 

3 PAYMENTS UNDER THE MEDICAID PROGRAM. 

4 (a) GUIDANCE FOR STATES ON NON-DSH SUPPLE5 MENTAL PAYMENTS; STATE REPORTING AND AUDITING

6 REQUIREMENTS.—Section 1903 of the Social Security Act 

7 (42 U.S.C. 1396b) is amended by adding at the end the 

8 following new subsection: 

9 ‘‘(aa)(1) Not later than 180 days after the date of 

10 the enactment of this subsection, the Secretary shall— 

11 ‘‘(A) issue guidance to States that identifies 

12 permissible methods for calculation of non-DSH sup13 plemental payments to providers to ensure such pay14 ments are consistent with section 1902(a)(30)(A) 

15 (including any regulations issued under such section 

16 such as the regulations specifying upper payment 

17 limits under the State plan in part 447 of title 42, 

18 Code of Federal Regulations (or any successor regu19 lations)); 

20 ‘‘(B) establish annual reporting requirements 

21 for States making non-DSH supplemental payments 

22 that include— 

23 ‘‘(i) with respect to a provider that is a 

24 hospital, nursing facility, intermediate care fa25 cility for the mentally retarded, or an institu26 tion for mental diseases, or any other instituVerDate Sep 11 2014 03:09 Jan 27, 2017 Jkt 069200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\H541.IH H541

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1 tion, an identification of each provider that re2 ceived a non-DSH supplemental payment for 

3 the preceding fiscal year, the type of ownership 

4 or operating authority of each such provider, 

5 and the aggregate amount of such payments re6 ceived by each provider for the preceding fiscal 

7 year broken out by category of service; 

8 ‘‘(ii) with respect a provider that is not de9 scribed in clause (i), any information specified 

10 in the preceding paragraph, as determined ap11 propriate by the Secretary; and 

12 ‘‘(iii) such other information as the Sec13 retary determines to be necessary to ensure 

14 that non-DSH supplemental payments made to 

15 providers under this section are consistent with 

16 section 1902(a)(30)(A); and 

17 ‘‘(C) establish requirements for States making 

18 non-DSH supplemental payments to conduct and 

19 submit to the Secretary an annual independent cer20 tified audit that verifies— 

21 ‘‘(i) the extent to which non-DSH supple22 mental payments made in the preceding fiscal 

23 year are consistent with the guidance issued 

24 under subparagraph (A); 


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1 ‘‘(ii) that payments made under the State 

2 plan (or under a waiver of the plan) are only 

3 for the provision of covered services to eligible 

4 individuals under the State plan (or under a 

5 waiver of the plan); and 

6 ‘‘(iii) any other information the Secretary 

7 determines is necessary to ensure non-DSH 

8 supplemental payments are consistent with ap9 plicable Federal laws and regulations. 

10 ‘‘(2) For purposes of this subsection, the term ‘non11 DSH supplemental payment’ means a payment, other 

12 than a payment under section 1923, that— 

13 ‘‘(A) is identified by the Secretary through 

14 guidance described in paragraph (1)(A); 

15 ‘‘(B) is made by a State to a provider under the 

16 State plan (or under a waiver of the plan) for an 

17 item or service furnished to an individual eligible for 

18 medical assistance under the State plan (or under a 

19 waiver of the plan); and 

20 ‘‘(C) is in addition to any base or standard pay21 ments made to a provider under the State plan (or 

22 under a waiver of the plan) for such an item or serv23 ice, including any additional payments made to such 

24 provider that are not more than any limits imposed 

25 pursuant to section 1902(a)(30)(A) (including the 


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1 regulations specifying upper payment limits under 

2 the State plan in part 447 of title 42, Code of Fed3 eral Regulations (or any successor regulations)).’’. 

4 (b) STATE REPORTING AND AUDITING OF NON-DSH 

5 SUPPLEMENTAL PAYMENTS.—Section 1903(i) of the So6 cial Security Act (42 U.S.C. 1396b(i)) is amended— 

7 (1) in paragraph (26), by striking ‘‘or’’ at the 

8 end; 

9 (2) by redesignating paragraph (27) as para10 graph (28); and 

11 (3) by inserting after paragraph (26) the fol12 lowing new paragraph: 

13 ‘‘(27) with respect to amounts expended to 

14 make any non-DSH supplemental payment (as de15 fined in subsection (aa)(2)), unless the State com16 plies with the reporting and auditing requirements 

17 under subparagraphs (B) and (C) of subsection 

18 (aa)(1); or’’. 

Æ 


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