medicaid · Centers for Medicare and Medicaid Services · Rule · Published 2014-12-03 · Effective 2014-12-31 · 79 FR 71679
Document
Document number
2014-28424
Federal Register citation
79 FR 71679
CFR reference
42 CFR 447
Type
Rule
Action
Final rule.
Category
medicaid
Sub-agency
Centers for Medicare and Medicaid Services
Publication date
2014-12-03
Effective date
2014-12-31
Abstract
This final rule addresses the hospital-specific limitation on Medicaid disproportionate share hospital (DSH) payments under the Social Security Act (the 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 provides that, in auditing DSH payments, the quoted test will be applied on a service- specific basis; so that the calculation of uncompensated care for purposes of the hospital-specific DSH limit will include the cost of each service furnished to an individual by that hospital for which the individual had no health insurance or other source of third party coverage.