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HHS/CMS RIN: 0938-AS92 Publication ID: Fall 2016 
Title: ●Disproportionate Share Hospital (DSH) Payments: Treatment of Third Party Payers in Calculating Uncompensated Costs (CMS-2399-F) 

This final rule addresses the hospital-specific limitation on Medicaid DSH payments and annual DSH audits required under the Social Security Act (the Act) by clarifying that only uncompensated cost can be included in the calculation of the hospital-specific DSH limit. Specifically, this rule codifies an existing policy that all payments received by hospitals by or on behalf of Medicaid eligible individuals, including Medicare and third party payments, must be included in the calculation of uncompensated care cost.

Agency: Department of Health and Human Services(HHS)  Priority: Other Significant 
RIN Status: First time published in the Unified Agenda Agenda Stage of Rulemaking: Final Rule Stage 
Major: No  Unfunded Mandates: No 
CFR Citation: 42 CFR 447   
Legal Authority: 42 U.S.C. 1396r–4   
Legal Deadline:  None
Action Date FR Cite
NPRM  08/15/2016  81 FR 53980   
NPRM Comment Period End  09/14/2016 
Final Action  02/00/2017 
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 
Agency Contact:
Wendy Harrison
Health Insurance Specialist
Department of Health and Human Services
Centers for Medicare & Medicaid Services
Center for Medicaid and CHIP Services, MS: S3-14-18, 7500 Security Boulevard,
Baltimore, MD 21244
Phone:410 786-2075