Is your hospital prepared for a DSH Examination?

If your hospital underwent a DSH examination, how confident is your team with its current financial reporting?

Each year, federal law requires that state Medicaid programs make Disproportionate Share Hospital (DSH) payments to qualifying hospitals that serve a large number of Medicaid and uninsured individuals. States are required by federal law to submit an independent certified audit and an annual report to the Centers for Medicare and Medicaid Services (CMS) describing the DSH payments made to each DSH hospital. 

States will begin sending out the upcoming DSH Examination surveys to fulfill the federal requirements in the coming months. Below are some tips on how to start preparing now to ensure a timely and accurate submission.

• Look at your current staffing capabilities and upcoming PTO/vacation requests to ensure you have the work force to complete the survey.

• Review prior year results. Was the hospital overpaid or close to being overpaid? If so, was all eligible patient accounts included in the exhibits?

• We all know the data request can sometimes take a long time, is your IT department ready for the request and have appropriate staff to complete the request? Schedule a meeting with your IT department and start the data request as soon as possible. 

• Start gathering other needed financial documents such as the working trial balance used to complete the Medicare cost report. Also, ensure that you have a copy of the most recently submitted cost report

• Don’t wait till you get the survey letter from the State, or Myers & Stauffer, you can start preparing now to ensure you are in compliance and able to submit a timely survey.

 A big change with this coming DSH examination is the reinstatement of CMS’ FAQs 33 & 34. For all services furnished on or after June 2, 2017, third party payments will be included in the uncompensated care costs calculation. If you were overpaid in prior years or close to being overpaid, it’s important now to make sure you are including all eligible accounts to ensure you are capturing all allowable DSH costs.

This month, The Rybar Group’s Medicaid Reimbursement Manager Brooke Yowell, led a webinar discussing the specific Medicaid requirements, how to prepare for a DSH examination, reinstatement of CMS FAQs 33 & 34, and the Consolidated Appropriations Act of 2021. 

We've uploaded resources from the webinar including:

• A recording of the webinar 

• PDF of the presentation slides

 We hope you find the information useful and encourage you to share this with colleagues and others who may benefit from the content. If you would like more information or would like to set up a time to further discuss how The Rybar Group can assist your hospital, please contact us at any time.