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HHS/CMS RIN: 0938-AS63 Publication ID: Fall 2016 
Title: Medicaid Disproportionate Share Hospital (DSH) Allotment Reductions (CMS-2394-P) 

The Affordable Care Act amends the Social Security Act by requiring aggregate reductions to state Medicaid DSH allotments from FY 2014 through FY 2020.  CMS published a final rule in October 2013 that delineated a methodology to implement the annual reductions only for FY 2014 and FY 2015.  Subsequent legislation delayed the start of the reductions until FY 2018.  Since the earlier final rule was only limited to FY 2014 and FY 2015, this rule proposes a methodology to reduce the allotments for FY 2018-2024.

Agency: Department of Health and Human Services(HHS)  Priority: Economically Significant 
RIN Status: Previously published in the Unified Agenda Agenda Stage of Rulemaking: Proposed Rule Stage 
Major: Yes  Unfunded Mandates: No 
CFR Citation: 42 CFR 447   
Legal Authority: Pub. L. 111-148, sec 1203    Pub. L. 114-10, sec 412   
Legal Deadline:
Action Source Description Date
Final  Statutory  MACRA section 412  10/01/2017 

Overall Description of Deadline: The statutory deadline was originally October 1, 2014, but was delayed by subsequent legislation until October 1, 2017.

Action Date FR Cite
NPRM  01/00/2017 
Regulatory Flexibility Analysis Required: No  Government Levels Affected: State 
Small Entities Affected: No  Federalism: No 
Included in the Regulatory Plan: No 
RIN Data Printed in the FR: No 
Related RINs: Related to 0938-AR31 
Agency Contact:
Rory Howe
Director, Financial Management Group
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicaid and CHIP Services, MS: S3-14-28, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-4878