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CMS Issues New Medicaid DSH Reporting and Auditing Guidance

The Centers for Medicare & Medicaid Services (CMS) has released Additional Information on the DSH Reporting and Audit Requirements – Part 2. This new guidance applies to the requirement that states  submit an independent certified audit and an annual report on Medicaid disproportionate share hospital (DSH) payments made to each DSH hospital in the state.

The new guidance provides information to help states prepare for the end of the transition period that was established in 2008 to give stakeholders time to develop and refine DSH reporting and auditing techniques. In the guidance, CMS specifically outlines the requirements independent auditors must follow when conducting annual DSH audits and provides information to help states calculate uncompensated care costs. The guidance also notes that for state plan rate year (SPRY) 2011, states will begin reporting the three new data elements outlined in CMS’ final Medicaid DSH rule, published Sept. 18, 2013.

CMS also reminded states, starting in SPRY 2011, DSH payments exceeding hospital-specific DSH limits will be regarded as overpayments to providers.

Please contact Shahid Zaman, JD, policy analyst, at szaman@essentialhospitals.org or 202.585.0124 with questions.

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About the Author

Shahid Zaman is a senior policy analyst at America's Essential Hospitals.

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