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Section 1923(a)(2)(D) of the Social Security Act (the Act) requires States to submit an annual report to the Secretary describing disproportionate share hospital (DSH) payments made to each hospital. Section 1001(d) of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) added Section 1923(j) of the Act specifying that in order to received federal financial participation for DSH payments, States must submit not only an annual report but also an independent certified audit. The report must include identification of each disproportionate share hospital that received a DSH payment adjustment and provide other information as the Secretary determines necessary to ensure the appropriateness of the amount of such payment adjustment. The annual certified independent audit includes specific verifications to assure the appropriateness of all DSH payments. On December 18, 2008, CMS published a final rule to implement this provision, specifying the elements for the required report and the verifications required for the audit. CMS also developed a General DSH Audit and Reporting Protocol and the DSH Report Format to assist States in fulfilling the statutory and regulatory requirements.
Page Last Modified: 06/15/2009 3:04:22 PM
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