Sen. Charles Grassley (R-Iowa) has urged the Centers for Medicare & Medicaid Services to better track states’ supplemental payments to hospitals, stating a concern that those facilities are not meeting their obligations to the public despite their extra Medicaid funding. Grassley would like CMS to adopt recommendations included in a Government Accountability Office report he released June 30. The report found that states are not reporting all of the supplemental payments they make to hospitals and recommended that CMS finalize reporting requirements for the states, as well as conduct a review of the supplemental payment programs available in each state. Under the Medicaid payment system, most states make supplemental payments to certain hospitals, which are then matched by the federal government. GAO said in its report that the supplemental payments can be used by states to improperly increase the flow of federal dollars. A spokeswoman for the National Association of Public Hospitals and Health Systems has said the organization is reviewing the report. The report added that CMS has begun updating its requirements in order to collect better information about supplemental payments, including finalizing a 2005 proposed rule (70 Fed. Reg. 50262, 8/26/05) that would require states to provide more detailed information about their DSH payments. For the GAO report and Grassley’s statement, see e and prg063008GAO.pdf.