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Medicaid Nursing Facility Supplemental Payments

CMS has approved Medicaid nursing facility upper payment limit (UPL) supplemental payment programs in several States. In these States, nursing facilities may be eligible for supplemental payments that, when combined with a base payment, may not exceed a reasonable estimate of the amount that Medicare would pay for the services. Under the UPL supplemental payment programs, a State may use a variety of financing mechanisms to fund that State's share of supplemental payments. We will determine whether payments States claimed under their Medicaid supplemental payment programs complied with Federal and State requirements, and describe how those payments were distributed and used.

Announced or Revised Agency Title Component Report Number(s) Expected Issue Date (FY)
April 2024 Centers for Medicare and Medicaid Services Medicaid Nursing Facility Supplemental Payments Office of Audit Services WA-24-0038 (W-00-24-31579) 2025