(THIS SPREADSHEET
SHOULD NOT BE USED TO CONFIRM 340B PARTICIPATION)
Disproportionate
Share Hospitals & Their Disproportionate Share Adjustment Percentage
(Excel)
In
accordance with CMS guidance, as of May 5, 2008, allowing hospitals to submit
cost reports using either FY 2006 or FY 2005 SSI (Supplemental Security Income)
ratios, the OPA is posting DSH List with two worksheets provided by CMS showing
disproportionate share adjustment percentages using either fiscal year’s data.
Please use the two tabs at the bottom of the spreadsheet to select the
worksheet. Once 2007 SSI ratios are published and CMS provides this list to
OPA, the OPA will return to posting one spreadsheet. For more information,
please see CMS website at:
http://www.cms.hhs.gov/AcuteInpatientPPS/05_dsh.asp#TopOfPage
The
spreadsheet is provided to the Office of Pharmacy Affairs (OPA) by the Centers
for Medicare and Medicaid Services (CMS) and is the official source used to
verify a hospital’s DSH adjustment percentage. Hospitals appearing on the list
with a DSH adjustment percentage of greater than 11.75% meet the adjustment
percentage requirement to participate in the 340B program. However, there are
other qualifying criteria that must also be met. For-profit hospitals are not
eligible to participate in the 340B program.
Hospitals not appearing on the list and hospitals that appear on the
list but have a DSH adjustment percentage less than 11.75% are ineligible to
participate in the 340B program. If you wish to challenge the DSH adjustment
percentage reported by CMS, please provide to OPA a copy of Worksheet E, Part
A, line 4.03 from your most recently filed Medicare cost reporting period that
indicates a disproportionate share adjustment percentage of greater than
11.75%. This Worksheet should be accompanied by a signed letter from the
hospital’s Chief Financial Officer certifying the accuracy of the DSH
adjustment percentage as reflected on Worksheet E. OPA will make a
determination on eligibility based on a review of the information submitted.
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