States spent $9 billion more on supplemental Medicaid payments in 2010 than it did four years previously, according to a government investigation requested by Congress.

In fiscal 2010, the federal government spent $383 billion on the state-federal Medicaid program, but a Government Accountability Office audit found that states reported $32 billion in Medicaid supplemental payments during fiscal year 2010.

According to the GAO, the supplemental payments included $17.6 billion in disproportionate share hospital (DSH) funding and $14.4 billion in non-DSH supplemental payments.

Disproportionate share hospital funding payments are intended to offset the uncompensated costs of care provided to uninsured individuals and Medicaid beneficiaries. These payments can also constitute a large portion of states’ expenditures for particular categories of services, such as inpatient or outpatient hospital or nursing facility services, according to the GAO.

Federal spending on Medicaid, the primary payer for long-term care, remains under scrutiny as states decide whether to participate in the Affordable Care Act’s expansion of the program.

Click here to read the report.