Reimbursement Unit
In-Patient Hospital Resources
For questions, contact
801-538-6149
Utah Medicaid DRG Calculators:
Download
MS-DRG Calculator (version 29) for discharges on or after October 1, 2011 (The calculator is now named to coinside with the MS-DRG version. No calculator version exist between 17 and 28.)
- Includes SFY2012 adjustments.
- SFY2012 Claim Add-On DSH Factors
removed
Download MS-DRG Calculator (version 16) for discharges between October 1, 2009 and September 30, 2011
Download DRG Calculator (version 13) for discharges between
October 1, 2001 and September 30, 2009.
Download DRG Calculator (version 3) for discharges prior to
October 1, 2001.
Utah Medicaid DRG Factors:
Current and historical DRG base rates, overall outlier and hospital specific outlier payment factors can be found here.
Disproportionate Share (DSH) Expenditures
Disproportionate Share (DSH) Expenditures by Year
Medicaid Disproportionate Share (DSH) Expenditures spent by Federal Fiscal
Year.
FFY 2011
FFY 2010
FFY 2009
DSH Uncompensated Care Cost Survey
Government hospitals can download an Excel version of the
Hospital Uncompensated Care Cost Survey to be used in determining
qualification for Disproportionate Share (DSH) hospital payments.
Rural Hospitals
Frontier Hospitals
State Teaching Hospital
DSH Add-On Survey (FFY 12)
Hospital DSH Survey 2009
As required by CMS, DSH audits are required of all hospitals that
received Medicaid Disproportionate Share dollars for federal fiscal
year 2009.
Download
Survey
DSH Audit Reports
DSH Audit Report (2005).pdf
DSH Audit Report (2006).pdf
DSH Audit Report (2007).pdf
DSH Audit Report (2008).pdf
Federal Regulations
Each DSH payment is funded by State and Federal funds with Federal funds being the largest share (about 70 Percent for State fiscal year 2012). The references below outline the federal requirements, which must be met:
Electronic Code of Federal Regulations (http://ecfr.gpoaccess.gov)
42 CFR 447.299 - Reporting Requirements
42 CFR 455.300 - Independent Certified Audit of State Disproportionate Share Payment Adjustments (Purpose)
42 CFR 455.301 - Independent Certified Audit of State Disproportionate Share Payment Adjustments (Definitions)
42 CFR 455.304 - Condition for Federal financial participation (FFP)
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