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HEHS-96-74R 1 (1995-12-15)

handle is hein.gao/gaobaclag0001 and id is 1 raw text is: United States GAO General Accounting Office Washington, D.C. 20548 Health, Education and Human Services Division B-270670 December 15, 1995 Senator Daniel K. Akaka United States Senate Senator Daniel K. Inouye United States Senate The Honorable Patsy T. Mink House of Representatives The Honorable Neil Abercrombie House of Representatives In your letter dated November 28, 1995, you expressed concern that Hawaii's Medicaid spending for fiscal year 1995 may have been understated in tables that we produced at the direction of the Senate Finance committee. More specifically, you were concerned that the base year funding amount used in these tables was obtained by subtracting federal allotments for Disproportionate Share Hospital (DSH) payments from the state's estimated fiscal year 1995 Medicaid spending. Because Hawaii's Director of the Department of Human Services reported that the state will not use any of the DSH allotment, you asked if the Senate Medicaid base year amounts and the subsequent November 15 budget reconciliation calculations accurately reflected that situation. In brief, we are unable to determine if Hawaii's funding under the November 15 conference agreement accurately reflects Hawaii's DSH payments because the conference agreement makes no reference to a base year spending amount. Rather, the conferees agreed to specific funding amounts for each state for fiscal year 1996 and did not explicitly link the fiscal year 1996 grant to prior spending. With respect to the provisions as passed by the Senate, the determination of the base year federal funding amount involved choosing the largest of the adjusted federal funding amounts for the 3 fiscal years 1993 to 1995 as reported by the Health Care Financing Administration (HCFA). For 1995, the legislation required HCFA to exclude any federal payments under the DSH program from the total GAO/HEHS-96-74R Medigrant: Hawaii's Base Year Funding

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