NAPH submitted comments that expressed appreciation with CMS for acknowledging that the 2008 definition of the uninsured excludes costs of medically necessary services, which would significantly limit hospitals’ funding. NAPH urged CMS to finalize the proposal to change the definition of the uninsured to a service-specific definition, which includes the costs of their care in the DSH limit calculation.

The Centers for Medicare & Medicaid Services (CMS) on Jan. 13 issued a rule proposing to adopt the recommendations made by NAPH and other stakeholders to allow states to include costs for the underinsured as well as the uninsured in disproportionate share hospital (DSH) limits.

The state-specific annual DSH reports and audits can be found on CMS' website.

(March 2011) In December 2008, the federal Centers for Medicare & Medicaid Services (CMS) issued a final DSH audit and reporting rule. Unfortunately, the rule goes beyond congressional intent by making substantive DSH policy changes that go beyond the scope of the rule-making process and congressional intent. NAPH urges the Administration to limit the scope of the rule to increasing transparency through greater auditing and reporting.

NAPH sent a letter to the Secretary of the Dept. of Health and Human Services (HHS), Kathleen Sebelius, urging the Secretary to reevaluate damaging policy changes implemented through the Medicaid Disproportionate Share Hospital (DSH) Audit and Reporting Rule.

On December 19, 2008, the Centers for Medicare and Medicaid Services (CMS) published the long-anticipated Final Rule establishing new Medicaid disproportionate share hospital (DSH) reporting and audit requirements which were mandated by Section 1001(d) of the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA). The rule finalizes a proposal issued August 26, 2005. This memorandum provides a summary of the Final Rule.

NAPH submitted comments to CMS on Proposed Rule CMS-2198-P: Medicaid Program; Disproportionate Share Hospital Payments on Oct. 25, 2005.