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Disproportionate Share Data (DSH)

Refer to our "What's New" page regarding the use of digital signatures on DUA forms.   

Effective February 1, 2013, CMS no longer requires a DUA for DSH file data releases.  However, the process for requesting DSH data continues to be the same as provided below.  Going forward, CMS will only create a DSH DUA when the size of the file is too large for distribution to the requestor via e-mail and therefore, an alternate method of distribution is required via a physical media device, which is typically a DVD.  Shipment of the DVD will occur via the postal or a commercial carrier service.

Effective June 1, 2012, all DUA request submissions must follow the e-mail Subject line instructions located on the DUA-Forms page (use the link in the left hand menu).

Effective January 1, 2012, all DUA requests must be submitted to CMS via e-mail with any required documentation signed and attached to the e-mail.  This includes all new requests for DSH data.  The signed and scanned documentation may be attached to the e-mails as .pdf .jpg .tif or bitmap images. 

Use the "What's New" link on the left to view previous announcements.

Disproportionate Share Data (DSH) Availability - All years through FY 2009.  The revised SSI ratios for the Medicare DSH calculation for FY 2006, FY 2007, FY 2008, and FY 2009 are available as of March 16, 2012.  These SSI ratios include Medicare Advantage (MA) patient days and are calculated in the manner prescribed by CMS-1498-R.  Please visit the Acute Patient PPS web page for these ratios and information regarding the MedPAR claims run out and the Supplemental Security Income (SSI) eligibility file used to calculate them.

Providers who are interested in obtaining the data used to calculate their FY 2006–FY 2009 ratios are required to submit a request per the instructions below.  These data will display MA patients days separately.  Providers that submitted a request when CMS was not accepting requests because these data were not available must submit a new request.

In the FY 2006 IPPS Final Rule, CMS stated that, beginning with cost reporting periods that include December 8, 2004, the agency will no longer require that a hospital have a properly pending appeal relating to DSH payments in order to process a hospital's request for the data used to compute the Medicare fraction of the hospital's DSH patient percentage (the "MedPAR-SSI data"). See 70 Fed. Reg. 47,278, 47,439 (Aug. 12, 2005). This implements Section 951 of the Medicare Modernization Act. There will be no charge for this data. However, a Data Use Agreement must be submitted, per the instructions below.

Cost report years including the date, December 8, 2004, cover federal fiscal years 2004 and 2005. Therefore, these requests will require that CMS provide both the 2004 and 2005 MedPAR-SSI data (unless the provider's fiscal year is the same as the federal fiscal year).

Requests for DSH Data

CMS data may be obtained upon meeting CMS' data release requirements as mandated by the Privacy Act of 1974 disclosure provisions.  The following forms are fillable on-line:

DSH DUA Cost Reporting Periods Prior to those that include December 8, 2004

DSH DUA Cost Reporting Periods that include December 8, 2004 and Thereafter

In Section 16 of the form to the right of the Custodian's name, include the carrier type (e.g. FedEX, UPS) and carrier account #.   Once the form is completed, print, sign, scan and include as an e-mail attachment and send to  The request will be forwarded to the CMS staff responsible for shipment of the data.  The data will be shipped to the Requestor in approximately 6-8 weeks. 

If applicable, you will be provided with payment instructions.  Effective March 1, 2010, CMS is requiring all Providers requesting DSH rate data to submit their payments via provides secure electronic payments to Federal Agencies.

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