CMS released states' preliminary disproportionate share hospital allotments for fiscal years 2020 and 2021 as well as final disproportionate share hospital allotments for fiscal years 2018 and 2019.
The DSH payments, first given to the states, are then passed on to hospitals that serve a large number of low-income patients. The total amount of these payments to hospitals is limited by this annual allotment. DSH payments to a hospital also cannot exceed the total amount of uncompensated care reported by the hospital.
The report shows that in fiscal 2018, CMS provided $12.3 billion in DSH payments to states, and in 2019 CMS provided $12.6 billion in DSH allotments to states. For 2020, states' allotments total $22.5 billion, and in 2021 state allotments total $22.8 billion. States that don't use all of the money must return it.
The preliminary allotments for fiscal 2020 and 2021 factor in adjustments from the American Rescue Plan Act, including the temporary increase in federal medical assistance, according to the March 15 notice.
These allotments are determined annually and are generally equal to the prior year's amount but adjusted for inflation.
DSH allotments were slated to be reduced under law, but in 2021 Congress further pushed off the reductions until fiscal year 2024. The reductions are slated for fiscal years 2024-27 at a rate of $8 billion per year.
The allotments announced are effective April 15, according to the notice.