Disproportionate Share Hospitals


Disproportionate Share Hospitals serve a significantly disproportionate number of low-income patients and receive payments from the Centers for Medicaid and Medicare Services to cover the costs of providing care to uninsured patients. Disproportionate share hospitals are defined in Section 1886(d)(1)(B) of the Social Security Act. For more information, see the disproportionate share hospitals fact sheet (PDF - 1.1 MB).

To be eligible to participate in the 340B Drug Pricing Program, disproportionate share hospitals must meet the requirements of 42 USC 256b(a)(4)(L).

Disproportionate share hospitals may also register their outpatient clinics.


  1. Know your eligibility. Only nonprofit organizations with specific federal designations and/or funding are eligible to register with and be approved to purchase discounted drugs through the 340B Drug Pricing Program.
  2. Be aware of the latest registration dates and deadlines. The current registration periods are listed on the top right corner of this page, along with a link to the OPA database and registration forms. The registration forms are open only during the registration periods.
  3. Identify your Authorizing Official. This individual must be someone who can legally bind the organization to a contract, such as a CEO, COO, or CFO. This is the only person who may submit the 340B online registration. You may designate another employee (not a consultant or contractor) to serve as the primary contact.
  4. Identify your Government Official. If you are submitting a parent hospital registration, please review step 2 of the Hospital Registration Instructions for instructions on additional information that will be required during the online registration process.
  5. Prepare to complete registration in one session. You must complete the online registration in one session. Registrations left uncompleted will become inactive and close automatically. If this occurs you will need to start at the beginning of the process.
  6. Collect required information. Have all the necessary information on hand to ensure your Hospital registration will be accepted.
  7. Submit required documentation immediately upon completion of your registration.

If the information received from CMS is current and correct, submission of worksheets and trial balances is not required. If a more recently filed cost report is available, or the hospital otherwise submits changes to the pre-identified information, the required documents must be submitted on the same day the registration is submitted. For details, please refer to the Hospital Registration Instructions (PDF - 267 KB).


Hospital Registration Review Process


Date Last Reviewed:  September 2017

Registration Now

Register Start Date
January 1-15 April 1
April 1-15 July 1
July 1-15 October 1
October 1-15 January 1


Eligible in Multiple Categories

Hospitals that are eligible to participate in the 340B Drug Pricing Program in more than one category may select one. For example, a hospital that is both as a Disproportionate Share Hospital and a Sole Community Hospital may choose either type of eligibility and must abide by requirements and guidelines for that type of eligible organization/covered entity once enrolled.