Instructions for requests covering reporting periods prior to December 8, 2004.

Providers who wish to obtain the data used to calculate their DSH rates may request this data under 65 Federal Regulation 50548-01 (August 18, 2000). CMS data may be obtained upon meeting both CMS's data release requirements and Privacy Act of 1974 disclosure provisions.

Requests for DSH data files must include the following:

• Letter of Request
  • Cover letter on Provider letterhead, formally requesting CMS data, years of data and purpose for obtaining data. A Federal Express or UPS billing number is required for the shipment of the data.
• DSH Data Use Agreement
  • Agreement between CMS and Provider that stipulates responsibilities regarding use of data. Instructions on how to complete the DUA are provided.
• Privacy Protected Data Disclaimer

Please note there is a predetermined amount for the data which can be found on Page 4 of the DSH Data Use Agreement. Make company check or money order payable to: Centers for Medicare & Medicaid Services-DSH or CMS-DSH .Send payment and request paperwork to the addresses below:

Mailing address if using U.S. Postal Services:

Centers for Medicare & Medicaid Services
Public Use Files
Accounting Division
P.O. Box 7520
Baltimore, MD 21244-1850

Mailing address if using Express Mail

Centers for Medicare & Medicaid Services
OFM/Division of Accounting/PUF
7500 Security Boulevard
Mailstop: C3-07-11
Baltimore, MD 21244-1850

Disproportionate Share Hospital (DSH) Rate Data

Instructions for requests covering cost reporting periods that end or after December 8, 2004.

ALERT: DISPROPORTIONATE SHARE HOSPITAL MEDPAR-SSI DATA, YEARS 2005, AND 2006

The Release of these data has been delayed until further notice. The data for the 2005 file needs to be rerun to update the data. The 2006 data is delayed due to a systems change. As such, we are not accepting data requests at this time.

Please continue to check this website for further updates.

In the FY 2006 IPPS Final Rule, CMS stated that, beginning with cost reporting periods that include December 8, 2004, the agency will no longer require that a hospital have a properly pending appeal relating to DSH payments in order to process a hospital's request for the data used to compute the Medicare fraction of the hospital's DSH patient percentage (the "MedPAR-SSI data"). See 70 Fed. Reg. 47,278, 47,439 (Aug. 12, 2005). This implements Section 951 of the Medicare Modernization Act. There will be no charge for this data. However, a Data Use Agreement must be signed by the requesting provider and by any subcontractor that will have access to the data.

CMS will make this MedPAR-SSI data available beginning in August 2006. CMS will continue to release up to two years of MedPAR-SSI data that cover the provider's cost report year.

Beginning in December 2005, CMS will accept Data Use Agreements for provider cost report years that include December 8, 2004. These agreements will be effective for a maximum of 5 years. The required Data Use Agreement form will be available on the Medicare DSH webpage on the CMS website in December 2005. Please note that there is a different Data Use Agreement for cost reporting periods prior to those spanning December 8, 2004.

Cost report years including the date, December 8, 2004, cover federal fiscal years 2004 and 2005. Therefore, these requests will require that CMS provide both the 2004 and 2005 MedPAR-SSI data (unless the provider's fiscal year is the federal fiscal year).

The MedPAR-SSI data file that is used to calculate the provider's Medicare fraction for the DSH patient percentage is produced by CMS in August of the year following the conclusion of the calendar year. For example, the MedPAR-SSI file used for 2005 will be created in August 2006. CMS will begin processing providers' requests for MedPAR-SSI data in August 2006.

Requests for DSH data files must include the following:

• Letter of Request
  • Cover letter on Provider letterhead, formally requesting CMS data, years of data and purpose for obtaining data.
• DSH Data Use Agreement for cost reporting periods after December 8, 2004.
  • Agreement between CMS and Provider that stipulates responsibilities regarding use of data. Instructions on how to complete the DUA are provided.
• Privacy Protected Data Disclaimer

Mailing address:

Centers for Medicare & Medicaid Services
Director, Division of Business Analysis & Operations
Mailstop: N1-15-03
7500 Security Blvd.
Baltimore, MD 21244-1850

Downloads
DSH Data Use Agreement for reporting periods PRIOR to December 8, 2004 [PDF, 81KB] DSH DUA for Requests Covering Cost Reporting Periods that End or After December 8, 2004 [PDF, 81KB] Privacy Protected Data Disclaimer [PDF, 45KB]
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Page Last Modified: 07/31/2008 11:29:31 AM
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