DSH Documentation for Audit/Review Purposes
As part of the audit of a hospital s Medicare cost report, WPS may choose to review the documentation a hospital maintains to support its disproportionate share (DSH) payment, including the support for the number of Medicaid days included in the numerator of the DSH Medicaid day fraction. We are asking you to have available complete documentation for these days and all other components of its DSH payment at the time we start the desk review of your cost report.
Below is a list (not exhaustive) of things pertaining to the DSH payment that we may ask you to document at audit.
- The patient was eligible for Medicaid
- The patient was not entitled to Medicare Part A
- The patient received services in an area of the hospital subject to the inpatient prospective payment system
- The total number of patient days included in the denominator of the DSH Medicaid day fraction
- The available bed day count
If the documentation we request is not available by the deadline we set at the audit pre-exit conference, we will make any necessary adjustments to the DSH payment. While we will accept DSH documentation after this deadline, we will not consider this documentation in the initial Notice of Amount of Program Reimbursement (NPR). The documentation may be considered later if we decide to reopen the cost report or if you appeal the NPR.
If you have any questions regarding this subject, please contact the Field Audit Manager who handles your cost report audit. Refer to our Field Office Contacts.
This publication was also issued in our June 15, 2004 Newsletter.
Page Last Updated: Wednesday, 31-Dec-2008 10:49:03 CST
