Almost all states provide supplemental payments through their Medicaid programs over and above actual payments for their services provided. Some of these are additional payments to make up for cost shortfalls that are incurred when treating Medicaid patients, while other are for supporting initiatives outside of actual services being provided.

The supplemental payments for services being provided can be used to ensure that identified groups of hospitals are receiving the maximum allowable payment based on the extent of their upper payment limit. The upper payment limit is the amount of payment that would be provided to that group in the aggregate if Medicare were paying for comparable services.

  • In selected states SCA will examine various hospital supplemental payment programs that access federal funds to identify additional payment opportunities either within the existing programs or through new programs
  • SCA will coordinate with various hospitals or hospital groups to analyze such new opportunities and determine the best approaches for seeking the related funding
  • SCA will participate with hospitals or hospital groups to approach their state Medicaid agency or state hospital association to present such federal funding options