In the Consolidated Appropriations Act of 2021 (CAA), Congress enacted a provision requiring the Department of Human Services (HHS) to establish a mechanism for reporting on Medicaid supplemental payments. The reporting requirements will apply to supplemental payments in Medicaid fee-for-service (excluding DSH) and pursuant to Medicaid waivers. The reporting requirements outlined by Congress are narrower than those proposed by the Centers for Medicare & Medicaid Services in its now withdrawn Medicaid Fiscal Accountability Regulation. HHS has until October 1, 2021 to implement the CAA’s required reporting system.