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FY 2025 List of Hospitals Excepted from Section 203 DSH Limit Available

September 30, 2024
Julie Kozminski

The Centers for Medicare & Medicaid Services (CMS) has released the fiscal year 2025 list of hospitals excepted from a policy that excludes the costs of care for dually eligible patients from a hospital’s Medicaid disproportionate share hospital (DSH) limit.

The policy, which CMS published in a February final rule for Section 203 of the Consolidated Appropriations Act, 2021 (CAA), effectively lowered the ceiling for Medicaid DSH payments by changing how the DSH uncompensated care limit accounts for costs and payments related to Medicare and other dually eligible patients. However, the CAA made an exception for hospitals at or above the 97th percentile for all hospitals with respect to either of two measures, based on the most recent cost reporting period:

  • Percentage of total inpatient days for patients entitled to Medicare Part A and supplemental security income benefits
  • Number of inpatient days for such patients

Hospitals qualifying for the 97th percentile exception will have a DSH limit equal to the higher of the limit prescribed in Section 203 or the previous regulatory limit, which included costs and payments for dually eligible patients.

Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.

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