How many hospitals get DSH payments?

Although 3,109 hospitals receive this adjustment, Medicare DSH payments are highly concentrated. Ninety-three percent of total DSH payments go to large hospitals in urban areas, and teaching hospitals receive about 65 percent of all DSH payments.

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 DSH Medicare?

The DSH patient percentage is equal to the sum of the percentage of Medicare inpatient days attributable to patients eligible for both Medicare Part A and Supplemental Security Income (SSI), and the percentage of total inpatient days attributable to patients eligible for Medicaid by not Medicare Part A.

Who is eligible for 340B pricing?

In order to be eligible, the patient must receive health care services other than drugs from the 340B covered entity (although a sole exception exists for patients that are part of an AIDS drug purchasing assistance program that has ties to the government).

How is 340B pricing determined?

The 340B ceiling price is calculated by taking the Average Manufacturer Price (“AMP”) and subtracting the Unit Rebate Amount (“URA”). Manufacturers submit the AMP and URA amount to the Center for Medicare and Medicaid Services (“CMS”). The HRSA then uses that data to calculate the ceiling prices.

How does a critical access hospital get paid?

However, CAH payments are based on each CAH’s costs and the share of those costs that are allocated to Medicare patients. CAHs receive cost based reimbursement for inpatient and outpatient services provided to Medicare patients (and Medicaid patients depending on policy of the state in which they are located).

Can a critical access hospital have an ICU?

Context: Although critical access hospitals (CAHs) have limitations on number of acute care beds and average length of stay, some of them provide intensive care unit (ICU) services. ICUs are also used for postsurgical recovery.