This presentation provides a closer analysis of upper payment limit (UPL) supplemental payments to hospitals and the federal parameters that the Centers for Medicare & Medicaid Services (CMS) currently uses to oversee them. It follows up on the review of all types of Medicaid-based and supplemental payments presented at the January 2018 Commission meeting that was the starting point for the Commission’s long-term work on hospital payment.
The presentation contains findings from MACPAC’s review of state-level UPL data provided by CMS and provides an update on the status of prior UPL recommendations made by MACPAC, the U.S. Government Accountability Office, and the U.S. Department of Health and Human Services Office of Inspector General.