Disproportionate
Share Hospitals & Their Disproportionate
Share Adjustment Percentage (Excel)
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
equal to or 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 the following:
A copy of Worksheet E, Part A
from your most recently filed Medicare
cost reporting period that indicates
a DSH adjustment percentage of greater
than 11.75% and
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. Please
note that in the future, the spreadsheet
will no longer identify those hospitals
that have submitted the appropriate
information to verify their DSH
adjustment percentage as greater
than 11.75%.
