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The Social Security Act requires States to have methods and procedures in place to ensure Medicaid payments are consistent with efficiency, economy, and quality of care. This proposed rule would set forth additional requirements to ensure supplemental payments made for all Medicaid services are economic and efficient. Specifically, this rule would require all supplemental payments be distributed proportional to the volume or cost of services delivered or be tied to meeting performance benchmarks, place a time limit on all supplemental payments, and require States to report additional details regarding supplemental payments when submitting claims of State Medicaid expenditures for Federal Financial Participation to provide a consistent and comprehensive data source by which the benefit or the value added to the Medicaid program can be assessed.