Update on DSH Surveys and FAQs 33 and 34
Monday, March 18, 2019 11:59 AM
In correspondence dated December 31, 2018, in light of four recent
appellate court decisions, the Centers for Medicare and Medicaid Services
(CMS) is withdrawing questions 33 & 34 from the Medicaid
Disproportionate Share Hospital (DSH) guidance that was issued in January
2010 titled, “Additional Information on the DSH Reporting and Audit
Requirements,” available at:
As a result, frequently asked questions (FAQs) 33 and 34 are no longer operative, which means
payments received from third-party payors on claims for Medicaid eligible
patients will no longer be offset in determining Uncompensated Care.
CMS will accept revised DSH audits that cover hospitals' services furnished
before June 2, 2017. CMS has not yet given up arguing their case for the
periods subsequent to that date.
At the last Technical Advisory Committee (TAC) meeting the Kentucky
Cabinet for Health and Family Services (CHFS) announced that it plans to re-work the SFY 2011 thru 2015 in terms of eliminating the
offsets in those surveys.
KHA has now received recent correspondence for SYE 2016 as well:
“Due to recent Centers for Medicare and Medicaid Services (CMS) guidance
provided on December 31, 2018, to withdraw FAQs 33 and 34, the Department
for Medicaid Services (DMS) has asked Myers and Stauffer LC not to factor
Medicare and Private Insurance payments into the uncompensated care costs
(UCC) calculation for the SFY 2016 DSH Examination. DMS has asked Myers and
Stauffer LC to continue collecting and reporting these payments on the
Medicaid DSH survey for informational purposes only, in case further
analysis or CMS requests are needed. When the SFY 2016 DSH Examination
results are delivered to each facility, the adjusted total UCC will not include Medicare and Private Insurance payment offsets
when comparing to each facility's DSH payment.”
There has not been any determination as to how DSH surveys will be handled
subsequent to the SFY 2016.