Issue Brief 10-19
May 6, 2010

The American Recovery and Reinvestment Act of 2009 (ARRA, P.L. 111-5) increased ceilings for disproportionate share hospital (DSH) payments in fiscal years (FYs) 2009-2010. Specifically, the law increased FY 2009 ceilings by 2.5%. FY 2010 ceilings were increased by 2.5% over the new FY 2009 levels, but only for states whose ceilings would grow more slowly than 2.5%.

On April 23, 2010, the Centers for Medicare and Medicaid Services (CMS) published a notice in the Federal Register that provides revised preliminary FY 2009 and preliminary FY 2010 DSH allotments, which reflect the ARRA provisions. The notice also provides final FY 2008 DSH celings. Separate limits are included for DSH payments to institutions for mental disease (IMDs) and other mental health facilities.