What is Medicaid DSH?

What is Medicaid DSH?

Medicaid disproportionate share hospital (DSH) payments are statutorily required payments intended to offset hospitals’ uncompensated care costs to improve access for Medicaid and uninsured patients as well as the financial stability of safety-net hospitals.

What is DSH pricing?

The 340B Drug Pricing Program allows certain hospitals and other health care providers (“covered entities”) to obtain discounted prices on “covered outpatient drugs” (prescription drugs and biologics other than vaccines) from drug manufacturers.

What is a UPL payment?

IGT UPL Payment means any “upper payment limit” (as defined by CMS or Medicaid regulations) payment received or accrued by an IGT Hospital in connection with an IGT Facility or an IGT Transaction.

What is DSH UPL?

These additional payments fall into two categories: disproportionate share hospital (DSH) payments, which help offset hospital uncompensated care costs, and UPL (upper payment limit) supplemental payments, which are intended to make the difference between fee-for-service payments and the amount that Medicare would have …

How do you qualify for DSH?

To be eligible the hospital must have a LIUR in excess of twenty five percent with a MUR of at least one percent, or a MUR of at least one standard deviation above the statewide mean. DSH payments are calculated for eligible hospitals and are disbursed in cycles throughout the state’s fiscal year.

What is the upper payment limit?

The Upper Payment Limit (UPL) is a federal limit placed on fee-for-service reimbursement of Medicaid providers. Specifically, the Upper Payment Limit is the maximum a given State Medicaid program may pay a type of provider in the aggregate, statewide in Medicaid fee-for-service.

What are Medicaid supplemental payments?

Supplemental Payments are Medicaid payments to health care providers that are separate from and in addition to base payments. Supplemental payments give additional funding to certain health care providers, like hospitals. The payments may be made in a lump sum.

What is an upper payment limit?

 Upper Payment Limit (UPL) is a federal limit placed. on a fee-for-service reimbursement for Medicaid. providers.  UPL is the maximum a state may pay a group of. providers in the aggregate, statewide for Medicaid fee-

What is meant by upper payment limit?

Is DSH the same as 340B?

Disproportionate share hospitals (DSH) are eligible to participate in 340B if their DSH adjustment–a measure that identifies hospitals that treat a disproportionate share of low income Medicare or Medicaid patients–is above 11.75%.