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Disproportionate Share Hospitals

Overview

Federal law requires Medicaid programs to make special payments to hospitals that serve a disproportionately large number of Medicaid and low-income patients. These hospitals are called disproportionate share hospitals (DSH) and receive DSH funding. DSH funds are different from most other Medicaid payments because they are not tied to specific services for Medicaid-eligible patients.

Methodology / Rules

The Hospital Services program rules are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 354, SubChapter A, Division 6, Rules 1071-1073, 1075, and 1077.

Reimbursement rules applicable to Hospitals are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, SubChapter J, Division 4, Rules 8052, 8054, 8056, 8061, 8063, 8064, 8065, 8067, 8069, and 8071.

Condition of Participation

In accordance with Texas Administrative Code §355.8065, beginning FFY 2024, all hospitals, except for state-owned and rural hospitals, are required to enroll, participate in, and comply with requirements for voluntary supplemental Medicaid or directed Medicaid programs for which the hospital is eligible within the State of Texas to participate in DSH.  Details on this requirement can be found in §355.8065 (e)(9).  A list of the required programs to satisfy this condition of participation is available for viewing here.

DSH Audit Information

View the DSH Audit information

DSH Qualification

View the Revised FFY 2023 Qualification File (.xlsx) (Updated 05/30/2023)

DSH Payment Files

Federal Fiscal Year (FFY) 2024

View the FFY 2023 Qualification File with Adopted Rule used for the Advances (.xlsx) (Updated 09/29/2023) 

View the FFY 2024 DSH Advanced Payment 1 (.xlsx) (Updated 9/29/2023)

View the FFY 2024 DSH Advanced Payment 2 (.xlsx) (Updated 02/09/2024)

Federal Fiscal Year (FFY) 2023

View the FFY 2023 DSH Advanced Payment 1 (.xlsx) (Updated 09/20/2022)

View the FFY 2023 DSH Advanced Payment 2 (.xlsx) (Updated 10/14/2022)

View the FFY 2023 DSH Advanced Payment 3 (.xlsx) (Updated 02/14/2023)

View the Revised FFY 2023 DSH Final Payment (.xlsx) (Updated 05/31/2023)

View FFY 2023 DSH Pass 3 Payment (.xlsx) (Updated 06/12/2023)

DSH Payment Redistribution & IGT Call

View the 2020 DSH Redistribution File (.xlsx) (Updated 07/14/2022)

View the 2021 DSH Redistribution File (.xlsx) (Updated 07/21/2023)

DSH Payment Information

View Proposed DSH Timeline for Payments (.pdf)

View DSH 2023 Payments (.pdf)

View DSH 2022 Payments (.pdf) 

View DSH 2021 Payments (.pdf)

View DSH 2020 Payments (.pdf)

View DSH 2019 Payments (.pdf)

View DSH 2018 Payments (.pdf)

View DSH 2017 Payments (.pdf)

View DSH 2016 Payments (.pdf)

View DSH 2015 Payments (.pdf)

View DSH 2014 Payments (.pdf)

View DSH 2013 Payments (.pdf)

View DSH 2012 Payments (.pdf)

Methodology / Rules

The Hospital Services program rules are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 354, SubChapter A, Division 6, Rules 1071-1073, 1075, and 1077.

Reimbursement rules applicable to Hospitals are located at Title 1 of the Texas Administrative Code, Part 15, Chapter 355, SubChapter J, Division 4, Rules 8052, 8054, 8056, 8061, 8063, 8064, 8065, 8067, 8069, and 8071.