Archive for March, 2014

It’s Time for DSH Audits in Texas

Wednesday, March 26th, 2014

Texas Health and Human Services Commission recently sent letters to Texas hospitals informing them that they have initiated an audit of the DSH program for fiscal year 2011 in accordance with the federal regulations regarding disproportionate share hospital (DSH) payments issued by CMS on December 19, 2008 (See Federal Register Vol. 73, No. 245, December 19, 2008, rules and regulations). HHSC has contracted with Myers and Stauffer LC, a certified public accounting firm, to perform the mandated audits.

The regulation mandates auditing and reporting requirements for DSH payments under state Medicaid programs. The certified audit report, along with other required data elements, must be submitted by the Medicaid program to CMS by December 31, 2014. Texas’ DSH year corresponds with the federal fiscal year; therefore, the DSH year under audit covers the time period from October 1, 2010 through September 30, 2011. If your hospital received Medicaid DSH payments during this time period, it is subject to the DSH program audit and must identify its actual Medicaid and uninsured costs incurred during the DSH year in question. To fulfill the other reporting requirements, several additional data elements will need to be reported by your hospital.

It is important to the Texas Medicaid program that all hospitals that received DSH payments during these time periods provide the information needed in order to complete the required federal audit. Once your completed surveys (and other required documents) are received by Myers and Stauffer, HHSC will contact you to address any questions they may have and to schedule a detailed examination of your survey responses if considered necessary. Per 1 TAC 355.8065(o)(1)(D) “A hospital that fails to provide requested information or to otherwise comply with the independent certified audit requirements may be subject to a withholding of Medicaid disproportionate share payments or other appropriate sanctions.”

Webinars with Myers and Stauffer have been scheduled to assist hospitals in the completion of the survey. The webinar will discuss the CMS requirements, known issues in data collection and review, and provide a detailed description of the survey document including answering any questions hospitals might have. The webinar is intended for the hospital personnel that will be responsible for actual completion of the survey and will run two to three hours in length. Each webinar will be limited to 100 call-in lines. After the first 100 callers have joined the conference the website and phone lines will be locked and you will be asked to participate in a webinar scheduled at a later date.

There are four scheduled opportunities to participate; three live webinars and one in-person seminar at the Texas Hospital Association. All four of these events will cover the same material. Participation in more than one session will not be necessary. The sessions will take place on Thursday, March 27 at 1:30 pm, Wednesday, April 2 at 9:00 am, Friday, April 4 at 9:00 am and in-person at THA on Wednesday, April 9 at 9:00am. To register, go to The webinar telephone is 888-506-9354 and the participant code is 9793484.

We would encourage you to participate in one of these sessions if necessary. However, if your hospital cannot attend, a link to the presentation materials (including frequently asked questions (FAQs) and responses) will be made available following the conclusion of the webinars.