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HHS/CMS RIN: 0938-AQ37 Publication ID: Fall 2011 
Title: Medicaid Disproportionate Share Hospital Payments Uninsured Definition (CMS-2315-P) 
Abstract: This proposed rule addresses the hospital-specific limitation on Medicaid disproportionate share hospital (DSH) payments under section 1923(g)(1)(A) of the Social Security Act. Under this limitation, DSH payments to a hospital cannot exceed the uncompensated costs of furnishing hospital services by the hospital to individuals who are Medicaid-eligible or "have no health insurance (or other source of third party coverage) for the services furnished during the year." This rule would provide that the quoted phrase would refer in context to a lack of coverage on a service-specific basis, so that the calculation of uncompensated care for purposes of the hospital-specific Medicaid Disproportionate Share Hospital (DSH) limit would include the cost of each service furnished to an individual who had no health insurance or other source of third party coverage for that service. 
Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: No  Unfunded Mandates: No 
CFR Citation: 42 CFR 447   
Legal Authority: 1923(g) of the Social Security Act   
Legal Deadline:  None
Timetable:
Action Date FR Cite
NPRM  01/00/2012    
Regulatory Flexibility Analysis Required: No  Government Levels Affected: State 
Small Entities Affected: Businesses, Governmental Jurisdictions  Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Agency Contact:
Rory Howe
Health Insurance Specialist
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Mail Stop S3-13-11, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-8533
Email: rory.howe@cms.hhs.gov