The Government Accountability Office and the federal advisory panel on Medicaid are pressing states to better document and report the extra payments to providers that fall outside the federal disproportionate-share hospital programs.

The GAO says weak documentation limits the Feds’ ability to make sure that the payments are efficient and  directly support Medicaid beneficiaries. Modern Healthcare reported that ”in one analysis, the agency found that supplemental payments to about 500 hospitals in 39 states exceeded the costs of caring for Medicaid patients by $2.7 billion. ”

The publication reported the GAO worried that states “are increasingly relying on collecting assessments from providers and local governments to draw federal matching dollars and create funding for enhanced Medicaid payments.”