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 re-
ferred 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 Representa-
tives 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’’. 
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SEC. 2. IMPROVING CALCULATION, OVERSIGHT, AND AC-
COUNTABILITY OF NON-DSH SUPPLEMENTAL 
PAYMENTS UNDER THE MEDICAID PROGRAM. 
(a) GUIDANCE FOR STATES ON NON-DSH SUPPLE-
MENTAL 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 sup-
plemental payments to providers to ensure such pay-
ments 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 regu-
lations)); 
‘‘(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 fa-
cility for the mentally retarded, or an institu-
tion for mental diseases, or any other institu-
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tion, an identification of each provider that re-
ceived 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 re-
ceived by each provider for the preceding fiscal 
year broken out by category of service; 
‘‘(ii) with respect a provider that is not de-
scribed in clause (i), any information specified 
in the preceding paragraph, as determined ap-
propriate by the Secretary; and 
‘‘(iii) such other information as the Sec-
retary 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 cer-
tified audit that verifies— 
‘‘(i) the extent to which non-DSH supple-
mental payments made in the preceding fiscal 
year are consistent with the guidance issued 
under subparagraph (A); 
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‘‘(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 ap-
plicable 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 pay-
ments made to a provider under the State plan (or 
under a waiver of the plan) for such an item or serv-
ice, 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 
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regulations specifying upper payment limits under 
the State plan in part 447 of title 42, Code of Fed-
eral Regulations (or any successor regulations)).’’. 
(b) STATE REPORTING AND AUDITING OF NON-DSH 
SUPPLEMENTAL PAYMENTS.—Section 1903(i) of the So-
cial 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 para-
graph (28); and 
(3) by inserting after paragraph (26) the fol-
lowing new paragraph: 
‘‘(27) with respect to amounts expended to 
make any non-DSH supplemental payment (as de-
fined in subsection (aa)(2)), unless the State com-
plies with the reporting and auditing requirements 
under subparagraphs (B) and (C) of subsection 
(aa)(1); or’’. 
Æ 
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