Medicaid Disproportionate Share Hospital (DSH)
- Letter to the Clerk of the U.S. Court of Appeals for the Eighth Circuit regarding revised DSH audits (March 2019)
- MHA Membership Update on Medicaid DSH Audits (January 2019)
- DSH Basics — Talking Points (members only)
- Communicating About DSH Audits (January 2016)
- Treatment of Third Party Payers in Calculating Uncompensated Care Costs (August 2016)
- CMS Embarks on Audits of Hospital DSH Payments (March 2010)
Federal Reimbursement Allowance (FRA)
Missouri’s Federal Reimbursement Allowance program directly benefits Missouri’s economic and health care infrastructure. This highly successful public/private partnership serves as a model of vision, creativity and cooperation.
In 1991, Missouri’s health care and governmental leaders were facing significant budgetary challenges. In response, the FRA program began as a voluntary program; it was expanded and enacted into law as a provider tax in 1992. Hospitals provide funds to the state, and Missouri’s Medicaid program (now called MO HealthNet) uses these funds to earn federal matching dollars.
The FRA program has evolved to maximize federal matching dollars and reduce the burden of MO HealthNet on state general revenue. The FRA is a major source of revenue to the state, surpassing all but the two largest sources of general revenue. Today, it is a major funding stream for MO HealthNet. This releases traditional general revenue to be used for other state priorities.
MHA developed an FRA Tutorial to help its members better understand how the FRA funds are used and the role of MHA Management Services Corporation in the process. This resource only is available to MHA members.
For information on the MO HealthNet Managed Care Program, visit the Missouri Department of Social Services’ Managed Care Program web page.