State Plan Amendment (SPA) 18-0015 Disproportionate Share Hospital (DSH) Payments has been submitted to update the hospital DSH program effective October 1, 2018:
1. To clarify:
a) The treatment of hospital assessments on hospital cost reports according to the entire Section 2122 of the Medicare Provider Reimbursement Manual 15-1,
b) Medicaid costs include Graduate Medical Education (GME) approved program costs in DSH calculations,
c) Medicaid costs do not include costs associated with services covered by another third-party payer, including Medicare. When Medicaid eligible patients have access to coverage from another party, payments may be used as a proxy for cost offsets when calculating the Medicaid payment shortage or overage,
d) The DSH payment period is from October 1 through September 30. The determination of a hospital DSH status is made annually for hospitals that meet the DSH requirements as of October 1, and
2. Add Section 5-6, Revised Allotments, which describes the treatment of revised DSH allotments.
For more information, read the submitted draft pages.
