This document is scheduled to be published in the

Federal Register on 07/26/2013 and available online at

http://federalregister.gov/a/2013-17965, and on FDsys.gov

DEPARTMENT OF HEALTH AND HUMAN SERVICES 

Centers for Medicare & Medicaid Services 

[CMS-2342-N] 

RIN 0938-AR91 

Medicaid Program; Disproportionate Share Hospital Allotments and Institutions 

for Mental Diseases Disproportionate Share Hospital Limits for FY 2012, and 

Preliminary FY 2013 Disproportionate Share Hospital Allotments and Limits 

AGENCY: Centers for Medicare & Medicaid Services (CMS), HHS. 

ACTION: Notice.

SUMMARY: This notice announces the final federal share disproportionate share 

hospital (DSH) allotments for federal fiscal year (FY) 2012 and the preliminary federal 

share DSH allotments for FY 2013. This notice also announces the final FY 2012 and 

the preliminary FY 2013 limits on aggregate DSH payments that states may make to 

institutions for mental diseases (IMDs) and other mental health facilities. This notice 

also includes background information describing the methodology for determining the 

amounts of states' FY DSH allotments and IMD DSH limits. 

EFFECTIVE DATE: This notice is effective on [Insert date 30 days after date of 

publication in the Federal Register]. The final allotments and limitations set forth in 

this notice are effective for the fiscal years specified. 

FOR FURTHER INFORMATION CONTACT: 

Richard Strauss, (410) 786-2019. 

SUPPLEMENTARY INFORMATION: 
CMS-2342-N 2 

I. Background 

In general, in accordance with the methodology specified under section 1923(f)(3) 

of the Social Security Act (the Act), a state's federal fiscal year (FY) disproportionate 

share hospital (DSH) allotment is calculated by increasing the amount of its DSH 

allotment for the preceding FY by the percentage change in the Consumer Price Index for 

all Urban Consumers (CPI-U) for the previous FY. Also in accordance with section 

1923(f)(3) of the Act, a state's DSH allotment for a FY is subject to the limitation that an 

increase to a state's DSH allotment for a FY cannot result in the DSH allotment 

exceeding the greater of the state's DSH allotment for the previous FY or 12 percent of 

the state's total medical assistance expenditures for the allotment year (this is referred to 

as the 12 percent limit). 

Furthermore, under section 1923(h) of the Act, federal financial participation 

(FFP) for DSH payments to institutions for mental diseases (IMDs) and other mental 

health facilities is limited to state-specific aggregate amounts determined in accordance 

with the methodology specified under such section. Under this provision, the aggregate 

limit for DSH payments to IMDs and other mental health facilities is the lesser of a state's 

FY 1995 total computable (state and federal share) IMD and other mental health facility 

DSH expenditures applicable to the state's FY 1995 DSH allotment (as reported on the 

Form CMS-64 as of January 1, 1997), or the amount equal to the product of the state's 

current year total computable DSH allotment and the applicable percentage specified in 

section 1902(h) of the Act (the applicable percentage is the IMD share of DSH total 

computable expenditures as of FY 1995). 
CMS-2342-N 3 

In general, we determine states' DSH allotments and IMD DSH limits for a FY 

using the most recent available estimates of or actual medical assistance expenditures, 

including DSH expenditures in their Medicaid programs and the most recent available 

change in the CPI-U used for the FY in accordance with the methodology prescribed in 

statute. The indicated estimated or actual expenditures are obtained from states for each 

relevant FY from the most recent available quarterly Medicaid budget reports (Form 

CMS-37) or quarterly Medicaid expenditure reports (Form CMS-64), respectively, 

submitted by the states. For example, as part of the initial determination of a state's FY 

DSH allotment (referred to as the preliminary DSH allotments) that is determined before 

the beginning of the FY for which the DSH allotments and IMD DSH limits are being 

determined, we use estimated expenditures for the FY obtained from the August 

submission of the CMS-37 submitted by states prior to the beginning of the FY; such 

estimated expenditures are subject to update and revision during the FY before such 

actual expenditure data become available. We also use the most recent available 

estimated CPI-U percentage change that is available before the beginning of the FY for 

determining the states’ preliminary FY DSH allotments; such estimated CPI-U 

percentage change is subject to update and revision during the FY before the actual 

CPI-U percentage change becomes available. In determining the final DSH allotments 

and IMD DSH limits for a FY we use the actual expenditures for the FY and actual CPIU percentage change for the previous FY. 
CMS-2342-N 4 

II. Provisions of the Notice 

A. Calculation of the Final FY 2012 Federal Share State DSH Allotments, and the 

Preliminary FY 2013 Federal Share State DSH Allotments

1. Final FY 2012 Federal Share State DSH Allotments 

Chart 1 of the Addendum to this notice provides the states' final FY 2012 DSH 

allotments determined in accordance with section 1923(f)(3) of the Act. As described in 

the background section, in general, the DSH allotment for a FY is calculated by 

increasing the FY DSH allotment for the preceding FY by the CPI-U increase for the 

previous fiscal year. For purposes of calculating the states' final FY 2012 DSH 

allotments, the preceding final fiscal year DSH allotments (for FY 2011) were contained 

in the Federal Register published on July 24, 2012 (77 FR 43301). For purposes of 

calculating the states' final FY 2012 DSH allotments we are using the actual Medicaid 

expenditures for FY 2012. Finally, for purposes of calculating the states' final FY 2012 

DSH allotments, the applicable historical percentage change in the CPI-U for the 

previous FY (FY 2011) was 2.6 percent; we note that this is an increase from the 

estimated 2.4 percentage change in the CPI-U for FY 2011 that was available and used in 

the calculation of the preliminary FY 2012 DSH allotments which were published in the 

July 24, 2012 Federal Register (77 FR 43301). 

2. Calculation of the Preliminary FY 2013 Federal Share State DSH Allotments. 

Chart 2 of the Addendum to this notice provides the preliminary FY 2013 DSH 

allotments determined in accordance with section 1923(f)(3) of the Act. The preliminary 

FY 2013 DSH allotments contained in this notice were determined based on the most 

recent available estimates from states of their FY 2013 total computable Medicaid 
CMS-2342-N 5 

expenditures. Also, the preliminary FY 2013 allotments contained in this notice were 

determined by increasing the final FY 2012 DSH allotments as contained in this notice 

(and described in section II.A.1. above) by 2.4 percent, representing the most recent 

available estimate of the percentage increase in the CPI-U for FY 2012 (the previous FY 

to FY 2013). In this regard, we note that in September of 2012 for purposes of 

calculating preliminary FY 2013 DSH allotments for states (which at that time was prior 

to the beginning FY 2013), we calculated such preliminary FY 2013 allotments by 

increasing states' preliminary FY 2012 allotments by 2.5 percent, representing the 

estimate of the percentage change in the CPI-U for FY 2012 available at that time. 

Again, we note that the preliminary FY 2013 allotments contained in this notice were 

determined using the final FY 2012 DSH allotments contained in this notice, the most 

recent available estimates of FY 2013 Medicaid expenditures, and the most recent 

available estimate of the percentage change in the CPI-U for FY 2012. 

States' s final FY 2013 DSH allotments will be published in future rulemaking 

based on the states' four quarterly Medicaid expenditure reports (Form CMS-64) for FY 

2013 available following the end of FY 2013 and the actual change in the CPI-U for FY 

2012. 

B. Calculation of the Final FY 2012 and the Preliminary FY 2013 IMD DSH Limits

Section 1923(h) of the Act specifies the methodology to be used to establish the 

limits on the amount of DSH payments that a state can make to IMDs and other mental 

health facilities. FFP is not available for IMD or DSH payments that exceed the IMD 

limits. In this notice, we are publishing the final FY 2012 and the preliminary FY 2013 

IMD DSH Limits determined in accordance with the provisions discussed above. 
CMS-2342-N 6 

Charts 3 and 4 of the “Addendum” to this notice detail each state's final FY 2012 

and preliminary FY 2013 IMD DSH Limit, respectively, determined in accordance with 

section 1923(h) of the Act

III. Collection of Information Requirements 

This notice does not impose any new or revised information collection or 

recordkeeping requirements. The requirements and burden associated with Form CMS37 (OMB No. 0938-0101), and Form CMS-64 (OMB No. 0938-0067) are unaffected by 

this notice. Consequently, this notice, the Form CMS-37, and Form CMS-64 are not 

subject to Office of Management and Budget review under the authority of the 

Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.). 

IV. Regulatory Impact Statement 

We have examined the impact of this notice as required by Executive Order 

12866 on Regulatory Planning and Review (September 1993), the Regulatory Flexibility 

Act (RFA) (September 19, 1980, Pub. L. 96-354), section 1102(b) of the Act, section 202 

of the Unfunded Mandates Reform Act of 1995 (March 22, 1995; Pub. L. 104-4), 

Executive Order 13132 on Federalism (August 4, 1999) and the Congressional Review 

Act (5 U.S.C. 804(2)). 

Executive Order 12866 directs agencies to assess all costs and benefits of 

available regulatory alternatives and, if regulation is necessary, to select regulatory 

approaches that maximize net benefits (including potential economic, environmental, 

public health and safety effects, distributive impacts, and equity). A regulatory impact 

analysis (RIA) must be prepared for major rules with economically significant effects 

($100 million or more in any 1 year). This notice reaches the $100 million economic 
CMS-2342-N 7 

threshold and thus is considered a major rule under the Congressional Review Act. 

The final FY 2012 DSH allotments being published in this notice are 

approximately $20 million more than the preliminary FY 2012 DSH allotments published 

in the July 24, 2012 Federal Register (77 FR 43301). The increase in the final FY 2012 

DSH allotments is due to the difference between the actual percentage change in the CPIU for FY 2011 used in the calculation of the final FY 2012 allotments [2.6 percent) as 

compared to the estimated percentage change in the CPI-U for FY 2011 used in the 

calculation of the preliminary FY 2012 allotments (2.4 percent). The final FY 2012 IMD 

DSH limits being published in this notice are approximately $1 million more than the 

preliminary FY 2012 IMD DSH limits published in the July 24, 2012 Federal Register

(77 FR 43301). The increases in the IMD DSH limits are because the DSH allotment for 

a FY is a factor in the determination of the IMD DSH limit for the FY. Since the final 

FY 2012 DSH allotments were increased as compared to the preliminary FY 2012 DSH 

allotments, the associated FY 2012 IMD DSH limits for some states were also increased. 

The preliminary FY 2013 DSH allotments being published in this notice are about 

$182 million more than the final FY 2012 DSH allotments being published in this notice. 

The increase in the DSH allotments is due to the application of the statutory formula for 

calculating DSH allotments under which the prior fiscal year allotments are increased by 

the percentage increase in the CPI-U for the prior fiscal year. The preliminary FY 2013 

IMD DSH limits being published in this notice are about $13 million more than the final 

FY 2012 IMD DSH limits being published in this notice. The increase in the IMD DSH 

limits is because the DSH allotment for a FY is a factor in the determination of the IMD 

DSH limit for the FY. Since the preliminary FY 2013 DSH allotments are greater than 
CMS-2342-N 8 

the final FY 2012 DSH allotments, the associated preliminary FY 2013 IMD DSH limits 

for some states also increased. 

The RFA requires agencies to analyze options for regulatory relief of small 

businesses, if a rule has a significant impact on a substantial number of small entities. 

For purposes of the RFA, small entities include small businesses, nonprofit organizations, 

and small governmental jurisdictions. Most hospitals and most other providers and 

suppliers are small entities, either by nonprofit status or by having revenues of less than 

$7.0 million to $34.5 million in any one year. Individuals and states are not included in 

the definition of a small entity. We are not preparing an analysis for the RFA because the 

Secretary has determined that this notice will not have significant economic impact on a 

substantial number of small entities. Specifically, any impact on providers is due to the 

effect of the various controlling statutes; providers are not impacted as a result of the 

independent regulatory action in publishing this notice. The purpose of the notice is to 

announce the latest distributions as required by the statute. 

In addition, section 1102(b) of the Act requires us to prepare a regulatory impact 

analysis if a rule may have a significant impact on the operations of a substantial number 

of small rural hospitals. This analysis must conform to the provisions of section 604 of 

the RFA. For purposes of section 1102(b) of the Act, we define a small rural hospital as 

a hospital that is located outside of a Core-Based Statistical Area for Medicaid payment 

regulations and has fewer than 100 beds. We are not preparing analysis for section 

1102(b) of the Act because the Secretary has determined that this notice will not have a 

significant impact on the operations of a substantial number of small rural hospitals. 

The Medicaid statute specifies the methodology for determining the amounts of 
CMS-2342-N 9 

states' DSH allotments and IMD DSH limits; and as described previously, the application 

of the methodology specified in statute results in the decreases or increases in states' DSH 

allotments and IMD DSH limits for the applicable FYs. The statute applicable to these 

allotments and limits does not apply to the determination of the amounts of DSH 

payments made to specific DSH hospitals; rather, these allotments and limits represent an 

overall limit on the total of such DSH payments. In this regard, we do not believe that 

this notice will have a significant economic impact on a substantial number of small 

entities. 

Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that 

agencies assess anticipated costs and benefits before issuing any rule whose mandates 

require spending in any 1 year of $100 million in 1995 dollars, updated annually for 

inflation. In 2013, that threshold is approximately $141 million. This notice will have no 

consequential effect on state, local, or tribal governments, in the aggregate, or on the 

private sector. 

Executive Order 13132 establishes certain requirements that an agency must meet 

when it promulgates a proposed rule (and subsequent final rule) that imposes substantial 

direct requirement costs on state and local governments, preempts state law, or otherwise 

has Federalism implications. Since this notice does not impose any costs on state or local 

governments, the requirements of E.O. 13132 are not applicable. 

Alternatives Considered

The methodologies for determining the states’ fiscal year DSH allotments and 

IMD DSH Limits, as reflected in this notice, were established in accordance with the 

methodologies and formula for determining states' allotments as specified in statute. This 
CMS-2342-N 10 

notice does not put forward any further discretionary administrative policies for 

determining such allotments. 

Accounting Statement

As required by OMB Circular A-4 (available at 

http://www.whitehouse.gov/omb/circulars/a004/a-4.pdf), in the Table 1, we have 

prepared an accounting statement showing the classification of the estimated 

expenditures associated with the provisions of this notice. Table 1 provides our best 

estimate of the change (decrease) in the federal share of states’ Medicaid DSH payments 

resulting from the application of the provisions of the Medicaid statute relating to the 

calculation of states’ FY DSH allotments and the increase in the FY DSH allotments 

from FY 2012 to FY 2013. 

Table 1 -- Accounting Statement: Classification of Estimated Expenditures, 

from the FY 2012 to FY 2013 (in Millions) 

Category TRANSFERS 

Annualized Monetized Transfers $182 

From Whom To Whom? Federal Government to States 

Congressional Review Act

This proposed regulation is subject to the Congressional Review Act provisions of 

the Small Business Regulatory Enforcement Fairness Act of 1996 (5 U.S.C. 801 et seq.) 

and has been transmitted to the Congress and the Comptroller General for review. 

In accordance with the provisions of Executive Order 12866, this notice was 

reviewed by the Office of Management and Budget.
CMS-2342-N 

(Catalog of Federal Domestic Assistance Program No. 93.778, Medical Assistance 

Program) 

Dated: June 20, 2013.

 

________________________________ 

Marilyn Tavenner,

Administrator,

Centers for Medicare & Medicaid

Services. 

Dated: July 19, 2013______________________

 ________________________________ 

Kathleen Sebelius, 

Secretary.

Department of Health and Human Services.

BILLING CODE 4120-01-P
CMS-2342-N 12 

Addendum

This addendum contains the charts 1 through 4 (preceded by associated keys) that are referred to in the 

preamble of this notice.

Key to Chart 1. Final DSH Allotments for FY 2012. 
CMS-2342-N 13 

Key to Chart 1.— FINAL DSH ALLOTMENTS FOR FISCAL YEAR: 2012 

The Final FY 2012 DSH Allotments for the NON-Low DSH States are 

presented in the top section of this chart, and the 

Final FY 2012 DSH Allotments for the Low-DSH States are presented in the 

bottom section of this chart. 

 

Column Description 

Column A State. 

Column B FY 2012 FMAPs. 

 This column contains the states’ FY 2012 Federal Medical 

Assistance Percentages. 

Column C Prior FY (2011) DSH Allotments. 

 This column contains the states’ prior FY 2011 DSH Allotments as 

would be determined without the application of section 5002 of 

ARRA. 

Column D Prior Fiscal Year (FY 2011) Allotment x (100% + Percentage 

Increase in CPI-U): 102.6%. 

This column contains the amount in Column D increased by 1 plus 

the percentage increase in the CPI-U for the prior FY (2.6 percent). 

Column E FY 2012 TC MAP Exp. Including DSH. 

This column contains the amount of the states’ FY 2012 total 

computable (TC) medical assistance expenditures including DSH 

expenditures. 

Column F FY 2012 TC DSH Expenditures. 

 This column contains the amount of the states’ FY 2012 total 

computable DSH expenditures. 

Column G FY 2012 TC MAP Exp. Net of DSH. 

This column contains the amount of the states’ projected FY 2012 

total computable medical assistance expenditures net of DSH 

expenditures, calculated as the amount in Column 

E minus the amount in Column F. 

Column H 12% Amount. 

 This column contains the amount of the “12 percent limit” in federal 

share for the fiscal year, determined in accordance with the 

provisions of section 1923(f)(3) of the Act. 
CMS-2342-N 14 

Column I Greater of FY 2011 Allotment or 12% Limit. 

 This column contains the greater of the state’s prior FY (FY 2011) 

DSH allotment or the amount of the 12% Limit, determined as the 

maximum of the amount in Column C or Column I. 

Column J FY 2012 DSH Allotment. 

 This column contains the states’ final FY 2012 DSH allotments, 

determined as the minimum of the amount in Column I or Column 

D. 

For states with "na" in Columns I or D, refer to the footnotes in the 

chart. 
CMS-2342-N 15 

CHART 1 - FINAL DSH ALLOTMENTS FOR FISCAL YEAR: 2012 

 A B C D E F G H 

 FY 2012 Prior FY (2011) Prior Fiscal Year FY 2012 FY 2012 FY 2012 "12% Amount" 

 STATE FMAPs Allotments (FY 2011) Allotment (Col C) x TC MAP Exp. TC DSH TC MAP Exp. =Col G x 

100% + Pct Increase in CPIU: Including DSH Expenditures Net of DSH .12/(1-.12/COL B)* 

102.6% Col E - F (In FS) 

ALABAMA 68.62% $307,525,116 $315,520,769 $4,980,627,414 $458,470,904 $4,522,156,510 $657,669,473 ARIZONA 67.30% $101,258,270 $103,890,985 $7,902,936,657 $194,651,219 $7,708,285,438 $1,125,716,333 CALIFORNIA 50.00% $1,096,339,537 $1,124,844,365 $48,965,395,434 $2,101,502,957 $46,863,892,477 $7,399,561,970 COLORADO 50.00% $92,507,555 $94,912,751 $4,686,399,553 $189,455,472 $4,496,944,081 $710,043,802 CONNECTICUT 50.00% $200,016,335 $205,216,760 $6,463,271,670 $478,109,955 $5,985,161,715 $945,025,534 DISTRICT OF COLUMBIA 70.00% $61,255,002 $62,847,632 $2,099,098,380 $61,103,120 $2,037,995,260 $295,157,934 FLORIDA 56.04% $200,016,335 $205,216,760 $17,794,004,730 $365,483,097 $17,428,521,633 $2,661,292,513 GEORGIA 66.16% $268,771,950 $275,760,021 $8,299,066,366 $415,817,421 $7,883,248,945 $1,155,588,811 HAWAII /1 na na na na na na na ILLINOIS 50.00% $215,017,560 $220,608,017 $13,216,199,698 $443,954,241 $12,772,245,457 $2,016,670,335 INDIANA 66.96% $213,767,459 $219,325,413 $7,450,053,558 -$1,293,679 $7,451,347,237 $1,089,393,474 KANSAS 56.91% $41,253,369 $42,325,957 $2,633,525,501 $74,168,771 $2,559,356,730 $389,186,350 KENTUCKY 71.18% $145,011,843 $148,782,151 $5,564,881,723 $208,470,796 $5,356,410,927 $773,104,420 LOUISIANA /2 na na na na na na na MAINE 63.27% $105,008,576 $107,738,799 $2,369,701,164 $41,241,661 $2,328,459,503 $344,813,652 MARYLAND 50.00% $76,256,228 $78,238,890 $7,564,182,204 $36,324,863 $7,527,857,341 $1,188,609,054 MASSACHUSETTS 50.00% $305,024,911 $312,955,559 $12,660,753,340 $0 $12,660,753,340 $1,999,066,317 MICHIGAN 66.14% $265,021,644 $271,912,207 $12,377,302,267 $276,022,328 $12,101,279,939 $1,774,019,923 MISSISSIPPI 74.18% $152,512,455 $156,477,779 $4,432,068,902 $210,532,157 $4,221,536,745 $604,349,172 MISSOURI 63.45% $473,788,694 $486,107,200 $8,620,708,926 $755,588,598 $7,865,120,328 $1,163,946,087 NEVADA 56.20% $46,253,777 $47,456,375 $1,730,509,323 $85,540,193 $1,644,969,130 $250,988,050 NEW HAMPSHIRE 50.00% $160,111,598 $164,274,500 $1,174,440,051 $41,992,778 $1,132,447,273 $178,807,464 NEW JERSEY 50.00% $643,802,579 $660,541,446 $10,263,014,973 $1,242,812,460 $9,020,202,513 $1,424,242,502 NEW YORK 50.00% $1,606,381,192 $1,648,147,103 $51,477,488,275 $3,250,438,690 $48,227,049,585 $7,614,797,303 NORTH CAROLINA 65.28% $295,024,095 $302,694,721 $12,074,012,547 $310,365,066 $11,763,647,481 $1,729,574,116 OHIO 64.15% $406,283,181 $416,846,544 $16,241,807,775 $544,474,576 $15,697,333,199 $2,317,125,042 PENNSYLVANIA 55.07% $561,295,840 $575,889,532 $20,215,741,634 $1,161,609,171 $19,054,132,463 $2,923,550,707 
CMS-2342-N 16 

 A B C D E F G H 

 FY 2012 Prior FY (2011) Prior Fiscal Year FY 2012 FY 2012 FY 2012 "12% Amount" 

 STATE FMAPs Allotments (FY 2011) Allotment (Col C) x TC MAP Exp. TC DSH TC MAP Exp. =Col G x 

100% + Pct Increase in CPIU: Including DSH Expenditures Net of DSH .12/(1-.12/COL B)* 

102.6% Col E - F (In FS) 

RHODE ISLAND 52.12% $65,005,309 $66,695,447 $1,841,508,177 $127,714,099 $1,713,794,078 $267,167,340 SOUTH CAROLINA 70.24% $327,526,749 $336,042,444 $4,611,047,760 $457,157,861 $4,153,889,899 $601,172,857 TENNESSEE /1 na na na na na na na TEXAS 58.22% $956,328,103 $981,192,634 $27,523,481,436 $1,515,965,665 $26,007,515,771 $3,931,174,993 VERMONT 57.58% $22,501,838 $23,086,886 $1,332,991,907 $37,448,781 $1,295,543,126 $196,395,015 VIRGINIA 50.00% $87,614,730 $89,892,713 $6,806,627,571 $214,541,182 $6,592,086,389 $1,040,855,746 WASHINGTON 50.00% $185,015,110 $189,825,503 $7,452,641,090 $392,480,601 $7,060,160,489 $1,114,762,182 WEST VIRGINIA 72.62% $67,505,513 $69,260,656 $2,772,398,537 $75,461,531 $2,696,937,006 $387,696,929 TOTAL $9,751,002,453 $10,004,528,517 $343,597,888,543 $15,767,606,535 $327,830,282,008 $50,271,525,401 

LOW DSH STATES 

ALASKA 50.00% $20,371,357 $20,901,012 $1,323,188,957 $19,859,459 $1,303,329,498 $205,788,868 ARKANSAS 70.71% $43,141,306 $44,262,980 $4,105,082,591 $61,447,395 $4,043,635,196 $584,415,830 DELAWARE 54.17% $9,053,936 $9,289,338 $1,484,381,209 $12,647,971 $1,471,733,238 $226,863,997 IDAHO 70.23% $16,438,844 $16,866,254 $1,420,520,599 $23,407,154 $1,397,113,445 $202,203,559 IOWA 60.71% $39,384,356 $40,408,349 $3,416,666,341 $51,985,041 $3,364,681,300 $503,230,881 MINNESOTA 50.00% $74,694,976 $76,637,045 $8,661,424,765 $47,645,449 $8,613,779,316 $1,360,070,418 MONTANA 66.11% $11,351,703 $11,646,847 $965,777,404 $17,086,812 $948,690,592 $139,089,858 NEBRASKA 56.64% $28,300,533 $29,036,347 $1,675,943,349 $41,928,603 $1,634,014,746 $248,791,923 NEW MEXICO 69.36% $20,371,357 $20,901,012 $3,420,434,313 $56,394,276 $3,364,040,037 $488,137,692 NORTH DAKOTA 55.40% $9,552,761 $9,801,133 $732,046,343 $1,163,524 $730,882,819 $111,956,428 OKLAHOMA 63.88% $36,215,744 $37,157,353 $4,397,686,300 $36,151,183 $4,361,535,117 $644,444,557 OREGON 62.91% $45,269,681 $46,446,693 $4,542,895,184 $69,278,705 $4,473,616,479 $663,371,155 SOUTH DAKOTA 59.13% $11,045,549 $11,332,733 $740,258,203 $751,299 $739,506,904 $111,335,565 UTAH 70.99% $19,619,586 $20,129,695 $1,870,691,982 $32,876,938 $1,837,815,044 $265,400,556 WISCONSIN 60.53% $94,540,543 $96,998,597 $6,978,470,509 $101,257 $6,978,369,252 $1,044,469,048 WYOMING 50.00% $226,348 $232,233 $518,211,253 $452,696 $517,758,557 $81,751,351 
CMS-2342-N 17 

 A B C D E F G H 

 FY 2012 Prior FY (2011) Prior Fiscal Year FY 2012 FY 2012 FY 2012 "12% Amount" 

 STATE FMAPs Allotments (FY 2011) Allotment (Col C) x TC MAP Exp. TC DSH TC MAP Exp. =Col G x 

100% + Pct Increase in CPIU: Including DSH Expenditures Net of DSH .12/(1-.12/COL B)* 

102.6% Col E - F (In FS) 

TOTAL LOW DSH STATES $479,578,580 $492,047,623 $46,253,679,302 $473,177,762 $45,780,501,540 $6,881,321,686 TOTAL $10,230,581,033 $10,496,576,140 $389,851,567,845 $16,240,784,297 $373,610,783,548 $57,152,847,088 FOOTNOTES: /1 Hawaii and Tennessee DSH allotments are determined under section 1923(f)(6) of the Act. Under this provision, for FY 2012, Tennessee's DSH payments are limited to $70,108,895 and Hawaii’s DSH allotment is limited to $1/2 FY 2012 DSH allotment for Louisiana determined under the provisions of section 1903(f)(3)(C) and (D) of the Act. 
CMS-2342-N 18 

Key to Chart 2. Preliminary DSH Allotments for FY 2013. 

Key to Chart 2.— PRELIMINARY DSH ALLOTMENTS FOR FISCAL 

YEAR: 2013 

The Preliminary FY 2013 DSH Allotments for the NON-Low DSH States are 

presented in the top section of this chart, and the 

Preliminary FY 2013 DSH Allotments for the Low-DSH States are presented in 

the bottom section of this chart. 

 

Column Description 

Column A State. 

Column B FY 2013 FMAPs. 

 This column contains the States’ FY 2013 Federal Medical 

Assistance Percentages. 

Column C Prior FY (2012) DSH Allotments 

 This column contains the States’ prior FY 2012 DSH Allotments. 

Column D Prior FY (2012) DSH Allotments (Col C) x (100% + Percentage 

Increase in CPIU): 102.4%. 

This column contains the amount in Column D increased by 1 plus 

the estimated percentage increase in the CPI-U for the prior FY 

(102.4 percent). 

Column E FY 2013 TC MAP Exp. Including DSH. 

This column contains the amount of the States’ projected FY 2013 

total computable (TC) medical assistance expenditures including 

DSH expenditures. 

Column F FY 2013 TC DSH Expenditures. 

 This column contains the amount of the States’ projected FY 2013 

total computable DSH expenditures. 

Column G FY 2013 TC MAP Exp. Net of DSH. 

This column contains the amount of the States’ projected FY 2013 

total computable medical assistance expenditures net of DSH 

expenditures, calculated as the amount in Column E minus the 

amount in Column F. 

Column H 12% Amount. 

 This column contains the amount of the “12 percent limit” in Federal 

share, determined in accordance with the provisions of section 

1923(f)(3) of the Act. 

Column I Greater of FY 2012 Allotment or 12% Limit. 

 This column contains the greater of the State’s prior FY (FY 2012) 
CMS-2342-N 19 

Key to Chart 2.— PRELIMINARY DSH ALLOTMENTS FOR FISCAL 

YEAR: 2013 

The Preliminary FY 2013 DSH Allotments for the NON-Low DSH States are 

presented in the top section of this chart, and the 

Preliminary FY 2013 DSH Allotments for the Low-DSH States are presented in 

the bottom section of this chart. 

 

Column Description 

DSH allotment or the amount of the 12% Limit, determined as the 

maximum of the amount in Column C or Column H 

Column J FY 2013 DSH Allotment. 

 This column contains the States’ preliminary FY 2013 DSH 

allotments, determined as the minimum of the amount in Column I 

or Column D. 

For states with "na" in Columns I or D, refer to the footnotes in the 

chart. 

 

 

 
CMS-2342-N 20 

CHART 2 - PRELIMINARY DSH ALLOTMENTS FOR FISCAL YEAR: 2013 

 

 A B C D E F G H 

 FY 2013 Prior FY (2012) Prior FY (2012) FY 2013 FY 2013 FY 2013 "12% Amount" 

 STATE FMAPs DSH Allotments DSH Allotment (Col C) x TC MAP Exp. TC DSH TC MAP EXP. =Col G x 

100% + Pct Increase in CPIU: Including DSH Expenditures Net Of DSH .12/(1-.12/Col B)* 

102.4% Col E - F (In FS) 

ALABAMA 68.53% $315,520,769 $323,093,267 $5,329,850,000 $471,003,000 $4,858,847,000 $706,832,022 ARIZONA 65.68% $103,890,985 $106,384,369 $8,671,536,000 $213,742,000 $8,457,794,000 $1,241,820,961 CALIFORNIA 50.00% $1,124,844,365 $1,151,840,630 $66,298,257,000 $919,513,000 $65,378,744,000 $10,322,959,579 COLORADO 50.00% $94,912,751 $97,190,657 $5,051,411,000 $192,614,000 $4,858,797,000 $767,178,474 CONNECTICUT 50.00% $205,216,760 $210,141,962 $6,431,510,000 $290,445,000 $6,141,065,000 $969,641,842 DISTRICT OF COLUMBIA 70.00% $62,847,632 $64,355,975 $2,263,613,000 $57,226,000 $2,206,387,000 $319,545,703 FLORIDA 58.08% $205,216,760 $210,141,962 $19,230,077,000 $383,399,000 $18,846,678,000 $2,850,560,048 GEORGIA 65.56% $275,760,021 $282,378,262 $8,369,129,000 $415,995,000 $7,953,134,000 $1,168,201,938 ILLINOIS 50.00% $220,608,017 $225,902,609 $15,891,835,000 $492,771,000 $15,399,064,000 $2,431,431,158 INDIANA 67.16% $219,325,413 $224,589,223 $8,205,160,000 $296,676,000 $7,908,484,000 $1,155,475,965 KANSAS 56.51% $42,325,957 $43,341,780 $2,631,311,000 $75,425,000 $2,555,886,000 $389,395,061 KENTUCKY 70.55% $148,782,151 $152,352,923 $6,003,011,000 $207,429,000 $5,795,582,000 $838,008,492 LOUISIANA /3 na na na na na na na MAINE 62.57% $107,738,799 $110,324,530 $2,411,890,000 $38,474,000 $2,373,416,000 $352,393,844 MARYLAND 50.00% $78,238,890 $80,116,623 $7,990,885,000 $28,789,000 $7,962,096,000 $1,257,173,053 MASSACHUSETTS 50.00% $312,955,559 $320,466,492 $14,457,969,000 $0 $14,457,969,000 $2,282,837,211 MICHIGAN 66.39% $271,912,207 $278,438,100 $13,054,597,000 $489,458,000 $12,565,139,000 $1,840,484,453 MISSISSIPPI 73.43% $156,477,779 $160,233,246 $4,938,125,000 $306,480,000 $4,631,645,000 $664,369,251 MISSOURI 61.37% $486,107,200 $497,773,773 $9,167,121,000 $731,848,000 $8,435,273,000 $1,258,268,675 NEVADA 59.74% $47,456,375 $48,595,328 $1,788,469,000 $81,265,000 $1,707,204,000 $256,359,532 NEW HAMPSHIRE 50.00% $164,274,500 $168,217,088 $1,194,634,000 $76,100,000 $1,118,534,000 $176,610,632 NEW JERSEY 50.00% $660,541,446 $676,394,441 $10,885,937,000 $1,285,149,000 $9,600,788,000 $1,515,913,895 NEW YORK 50.00% $1,648,147,103 $1,687,702,633 $60,543,793,000 $3,138,550,000 $57,405,243,000 $9,063,985,737 NORTH CAROLINA 65.51% $302,694,721 $309,959,394 $12,152,941,000 $348,212,000 $11,804,729,000 $1,734,242,863 OHIO 63.58% $416,846,544 $426,850,861 $17,759,856,000 $0 $17,759,856,000 $2,626,998,785 PENNSYLVANIA 54.28% $575,889,532 $589,710,881 $21,684,533,000 $811,678,000 $20,872,855,000 $3,215,644,000 RHODE ISLAND 51.26% $66,695,447 $68,296,138 $2,138,378,000 $133,105,000 $2,005,273,000 $314,183,272 
CMS-2342-N 21 

 

 A B C D E F G H 

 FY 2013 Prior FY (2012) Prior FY (2012) FY 2013 FY 2013 FY 2013 "12% Amount" 

 STATE FMAPs DSH Allotments DSH Allotment (Col C) x TC MAP Exp. TC DSH TC MAP EXP. =Col G x 

100% + Pct Increase in CPIU: Including DSH Expenditures Net Of DSH .12/(1-.12/Col B)* 

102.4% Col E - F (In FS) 

SOUTH CAROLINA 70.43% $336,042,444 $344,107,463 $4,819,642,000 $488,104,000 $4,331,538,000 $626,534,769 TENNESSEE /2 na na na na na na na TEXAS 59.30% $981,192,634 $1,004,741,257 $30,522,421,000 $2,362,443,000 $28,159,978,000 $4,236,499,016 VERMONT 56.04% $23,086,886 $23,640,971 $1,453,569,000 $37,449,000 $1,416,120,000 $216,238,051 VIRGINIA 50.00% $89,892,713 $92,050,138 $7,614,317,000 $292,128,000 $7,322,189,000 $1,156,135,105 WASHINGTON 50.00% $189,825,503 $194,381,315 $7,263,797,000 $408,769,000 $6,855,028,000 $1,082,372,842 WEST VIRGINIA 72.04% $69,260,656 $70,922,912 $3,049,170,000 $70,185,000 $2,978,985,000 $428,926,208 TOTAL 0.00% $10,004,528,519 $10,244,637,203 $389,268,744,000 $15,144,424,000 $374,124,320,000 $57,467,222,436 

LOW DSH STATES 

ALASKA 50.00% $20,901,012 $21,402,636 $4,345,689,000 $43,820,000 $4,301,869,000 $679,242,473.68 ARKANSAS 70.17% $44,262,980 $45,325,292 $1,580,616,000 $16,393,000 $1,564,223,000 $226,429,145 DELAWARE 55.67% $9,289,338 $9,512,282 $1,656,878,000 $19,283,000 $1,637,595,000 $250,510,411 HAWAII /1 51.86% $10,000,000 $10,240,000 $15,891,835,000 $492,771,000 $15,399,064,000 $2,404,201,080.90 IDAHO 71.00% $16,866,254 $17,271,044 $1,804,672,000 $22,633,000 $1,782,039,000 $257,338,513.22 IOWA 59.59% $40,408,349 $41,378,149 $3,701,627,000 $53,705,000 $3,647,922,000 $548,131,133 MINNESOTA 50.00% $76,637,045 $78,476,334 $9,033,277,000 $127,149,000 $8,906,128,000 $1,406,230,737 MONTANA 66.00% $11,646,847 $11,926,371 $1,035,493,000 $18,023,000 $1,017,470,000 $149,228,933 NEBRASKA 55.76% $29,036,347 $29,733,219 $1,982,015,000 $40,798,000 $1,941,217,000 $296,825,210 NEW MEXICO 69.07% $20,901,012 $21,402,636 $3,663,793,000 $21,380,000 $3,642,413,000 $528,995,548 NORTH DAKOTA 52.27% $9,801,133 $10,036,360 $783,683,000 $1,474,000 $782,209,000 $121,835,802 OKLAHOMA 64.00% $37,157,353 $38,049,129 $4,822,776,000 $49,525,000 $4,773,251,000 $704,972,455 OREGON 62.44% $46,446,693 $47,561,414 $5,261,131,000 $100,645,000 $5,160,486,000 $766,583,852 SOUTH DAKOTA 56.19% $11,332,733 $11,604,719 $792,356,000 $2,821,000 $789,535,000 $120,472,428 UTAH 69.61% $20,129,695 $20,612,808 $2,104,256,000 $29,583,000 $2,074,673,000 $300,818,582 WISCONSIN 59.74% $96,998,597 $99,326,563 $7,576,743,000 $159,936,000 $7,416,807,000 $1,113,732,845 WYOMING 50.00% $232,233 $237,807 $548,369,000 $463,000 $547,906,000 $86,511,474 
CMS-2342-N 22 

 

 A B C D E F G H 

 FY 2013 Prior FY (2012) Prior FY (2012) FY 2013 FY 2013 FY 2013 "12% Amount" 

 STATE FMAPs DSH Allotments DSH Allotment (Col C) x TC MAP Exp. TC DSH TC MAP EXP. =Col G x 

100% + Pct Increase in CPIU: Including DSH Expenditures Net Of DSH .12/(1-.12/Col B)* 

102.4% Col E - F (In FS) 

TOTAL LOW DSH STATES 0.00% $502,047,621 $514,096,764 $66,585,209,000 $1,200,402,000 $65,384,807,000 $9,962,060,622 TOTAL 0.00% $10,506,576,140 $10,758,733,967 $455,853,953,000 $16,344,826,000 $439,509,127,000 $67,429,283,058 FOOTNOTES: /1 Begining FY 2013, under section 1923(f)(6)(B)(II) of the Act, Hawaii's DSH allotments are determined as for low-DSH states. This means its allotments are determined as for all States, by increasing the previous fiscal year a/2 Tennessee's DSH allotments are determined under section 1923(f)(6)(A)(v)(II) of the Act. Under this provision, Tennessee's DSH payments for FY 2013 are limited to $53,100,000 /3 FY 2013 DSH allotment for Louisiana determined under the provisions of section 1903(f)(3)(C) and (D) of the Act. 
 CMS-2384-N CPL 5/31/2012 23 

Key to Chart 3. Final IMD DSH Limit for FY 2012 

 

Key to Chart 3.--FINAL IMD DSH LIMIT FOR FY: 2012 

The final FY 2012 IMD DSH Limits for the Non-Low DSH States are presented 

in the top section of this chart and the final FY 2012 IMD DSH Limits for the 

Low-DSH States are presented in the bottom section of the chart 

 

Column Description 

Column A State. 

Column B Inpatient Hospital Services FY 95 DSH Total Computable. 

 This column contains the States' total computable FY 

 1995 inpatient hospital DSH expenditures as reported on 

 the Form CMS-64. 

Column C IMD and Mental Health Services FY 95 DSH Total 

 Computable. This column contains the total computable 

 FY 1995 mental health facility DSH expenditures as 

 reported on the Form CMS-64 as of January 1, 1997. 

Column D Total Inpatient & IMD & Mental Health FY 95 DSH Total 

 Computable, Col. B + C. This column contains the total 

 computation of all inpatient hospital DSH expenditures 

 and mental health facility DSH expenditures for FY 

 1995 as reported on the Form CMS-64 as of January 1, 

 1997 (representing the sum of Column B and Column C). 

Column E Applicable Percent Col. C/D. This column contains 

 the "applicable percentage" representing the total 

 Computable FY 1995 mental health facility DSH 

 expenditures divided by total computable all inpatient 

 hospital and mental health facility DSH expenditures 

 for FY 1995 (the amount in Column C divided by the 

 amount in Column D) Per section 1923(h)(2)(A)(ii)(III) 

 Of the Act, for FYs after FY 2002, the applicable 

 Percentage can be no greater than 33 percent. 

Column F FY 2012 Federal Share DSH Allotment. This column contains the 

 states' final FY 2012 DSH allotments. 

Column G FY 2012 FMAP. 

Column H FY 2012 DSH Allotments in Total Computable Col. F/G. 

 This column contains States' FY 2012 total computable DSH 

allotment (determined as Column F/Column G). 

Column I Col E x Col H in TC. 

 This column contains the applicable percent of FY 2012 total 

computable DSH allotment (calculated as the percentage in Column 

E multiplied by the amount in Column H) 

Column J 

FY 2012 TC IMD DSH Limit. Lesser of Col. 

 C or I. This column contains the total computable amount of the FY 

2012 TC IMD DSH Limit equal to the lesser of the amount in 
CMS-2342-N 24 

Key to Chart 3.--FINAL IMD DSH LIMIT FOR FY: 2012 

The final FY 2012 IMD DSH Limits for the Non-Low DSH States are presented 

in the top section of this chart and the final FY 2012 IMD DSH Limits for the 

Low-DSH States are presented in the bottom section of the chart 

 

Column Description 

Column C or Column I. 

Column K FY 2012 IMD DSH Limit in Federal Share, Col. G x J. 

 This column contains the FY 2012 federal share IMD DSH limit 

determined by converting the total computable FY 2012 IMD DSH 

Limit from Column J into a federal share amount by multiplying it 

by the FY 2012 FMAP in Column G. 

 

 
CMS-2384-N CPL 5/31/2012 25 

CHART 3 - FINAL IMD DSH LIMIT FOR FY: 2012 

 : 

 A B C D E F G H I J 

 Inpatient Hospital IMD And Total Inpatient & IMD & Applicable 

 FY 2012 FY 2012 FY 2012 CoL E x Col H FY 2012 

 Services for FY 95 DSH Mental Health Mental Health FY 95 DSH Percent Allotment FMAP Allotments In TC TC IMD Limit 

STATE Total Computable Services FY 95 DSH Total Computable In TC (Lesser Of 

 Total Computable Col B + C Col C/D In FS Col F/G Col I or Col C) 

ALABAMA $413,006,229 $4,451,770 $417,457,999 1.07% $315,520,769 68.62% $459,808,757 $4,903,398 $4,451,770 ARIZONA $93,916,100 $28,474,900 $122,391,000 23.27% $103,890,985 67.30% $154,369,963 $35,914,971 $28,474,900 CALIFORNIA $2,189,879,543 $1,555,919 $2,191,435,462 0.07% $1,124,844,365 50.00% $2,249,688,730 $1,597,279 $1,555,919 COLORADO $173,900,441 $594,776 $174,495,217 0.34% $94,912,751 50.00% $189,825,502 $647,030 $594,776 CONNECTICUT $303,359,275 $105,573,725 $408,933,000 25.82% $205,216,760 50.00% $410,433,520 $105,961,112 $105,573,725 DISTRICT OF COLUMBIA $39,532,234 $6,545,136 $46,077,370 14.20% $62,847,632 70.00% $89,782,331 $12,753,279 $6,545,136 FLORIDA $184,468,014 $149,714,986 $334,183,000 33.00% $205,216,760 56.04% $366,196,931 $120,844,987 $120,844,987 GEORGIA $407,343,557 $0 $407,343,557 0.00% $275,760,021 66.16% $416,807,771 $0 $0 HAWAII $0 $0 $0 0.00% $10,000,000 50.48% $19,809,826 $0 $0 ILLINOIS $315,868,508 $89,408,276 $405,276,784 22.06% $220,608,017 50.00% $441,216,034 $97,336,849 $89,408,276 INDIANA $79,960,783 $153,566,302 $233,527,085 33.00% $219,325,413 66.96% $327,546,913 $108,090,481 $108,090,481 KANSAS $11,587,208 $76,663,508 $88,250,716 33.00% $42,325,957 56.91% $74,373,497 $24,543,254 $24,543,254 KENTUCKY $158,804,908 $37,443,073 $196,247,981 19.08% $148,782,151 71.18% $209,022,409 $39,880,366 $37,443,073 LOUISIANA $1,078,512,169 $132,917,149 $1,211,429,318 10.97% $731,960,000 61.09% $1,198,166,639 $131,461,977 $131,461,977 MAINE $99,957,958 $60,958,342 $160,916,300 33.00% $107,738,799 63.27% $170,284,177 $56,193,779 $56,193,779 MARYLAND $22,226,467 $120,873,531 $143,099,998 33.00% $78,238,890 50.00% $156,477,780 $51,637,667 $51,637,667 MASSACHUSETTS $469,653,946 $105,635,054 $575,289,000 18.36% $312,955,559 50.00% $625,911,118 $114,930,330 $105,635,054 MICHIGAN $133,258,800 $304,765,552 $438,024,352 33.00% $271,912,207 66.14% $411,116,128 $135,668,322 $135,668,322 MISSISSIPPI $182,608,033 $0 $182,608,033 0.00% $156,477,779 74.18% $210,943,353 $0 $0 MISSOURI $521,946,524 $207,234,618 $729,181,142 28.42% $486,107,200 63.45% $766,126,399 $217,734,528 $207,234,618 NEVADA $73,560,000 $0 $73,560,000 0.00% $47,456,375 56.20% $84,441,948 $0 $0 NEW HAMPSHIRE $92,675,916 $94,753,948 $187,429,864 33.00% $164,274,500 50.00% $328,549,000 $108,421,170 $94,753,948 NEW JERSEY $736,742,539 $357,370,461 $1,094,113,000 32.66% $660,541,446 50.00% $1,321,082,892 $431,505,706 $357,370,461 NEW YORK $2,418,869,368 $605,000,000 $3,023,869,368 20.01% $1,648,147,103 50.00% $3,296,294,206 $659,505,340 $605,000,000 NORTH CAROLINA $193,201,966 $236,072,627 $429,274,593 33.00% $302,694,721 65.28% $463,686,766 $153,016,633 $153,016,633 OHIO $535,731,956 $93,432,758 $629,164,714 14.85% $416,846,544 64.15% $649,799,757 $96,497,121 $93,432,758 PENNSYLVANIA $388,207,319 $579,199,682 $967,407,001 33.00% $575,889,532 55.07% $1,045,740,933 $345,094,508 $345,094,508 RHODE ISLAND $108,503,167 $2,397,833 $110,901,000 2.16% $66,695,447 52.12% $127,965,171 $2,766,784 $2,397,833 SOUTH CAROLINA $366,681,364 $72,076,341 $438,757,705 16.43% $336,042,444 70.24% $478,420,336 $78,591,867 $72,076,341 
CMS-2342-N 26 

 : 

 A B C D E F G H I J 

 Inpatient Hospital IMD And Total Inpatient & IMD & Applicable 

 FY 2012 FY 2012 FY 2012 CoL E x Col H FY 2012 

 Services for FY 95 DSH Mental Health Mental Health FY 95 DSH Percent Allotment FMAP Allotments In TC TC IMD Limit 

STATE Total Computable Services FY 95 DSH Total Computable In TC (Lesser Of 

 Total Computable Col B + C Col C/D In FS Col F/G Col I or Col C) 

TENNESSEE $0 $0 $0 0.00% $123,562,982 66.36% $186,200,998 $0 $0 TEXAS $1,220,515,401 $292,513,592 $1,513,028,993 19.33% $981,192,634 58.22% $1,685,318,849 $325,822,355 $292,513,592 VERMONT $19,979,252 $9,071,297 $29,050,549 31.23% $23,086,886 57.58% $40,095,321 $12,520,127 $9,071,297 VIRGINIA $129,313,480 $7,770,268 $137,083,748 5.67% $89,892,713 50.00% $179,785,426 $10,190,712 $7,770,268 WASHINGTON $171,725,815 $163,836,435 $335,562,250 33.00% $189,825,503 50.00% $379,651,006 $125,284,832 $125,284,832 WEST VIRGINIA $66,962,606 $18,887,045 $85,849,651 22.00% $69,260,656 72.62% $95,374,079 $20,982,433 $18,887,045 TOTAL $13,402,460,846 $4,118,758,904 $17,521,219,750 $10,870,051,501 $19,310,314,466 $3,630,299,198 $3,392,027,231 LOW DSH STATES ALASKA $2,506,827 $17,611,765 $20,118,592 33.00% $20,901,012 50.00% $41,802,024 $13,794,668 $13,794,668 ARKANSAS $2,422,649 $819,351 $3,242,000 25.27% $44,262,980 70.71% $62,597,907 $15,820,376 $819,351 DELAWARE $0 $7,069,000 $7,069,000 33.00% $9,289,338 54.17% $17,148,492 $5,659,002 $5,659,002 IDAHO $2,081,429 $0 $2,081,429 0.00% $16,866,254 70.23% $24,015,740 $0 $0 IOWA $12,011,250 $0 $12,011,250 0.00% $40,408,349 60.71% $66,559,626 $0 $0 MINNESOTA $24,240,000 $5,257,214 $29,497,214 17.82% $76,637,045 50.00% $153,274,090 $27,317,654 $5,257,214 MONTANA $237,048 $0 $237,048 0.00% $11,646,847 66.11% $17,617,376 $0 $0 NEBRASKA $6,449,102 $1,811,337 $8,260,439 21.93% $29,036,347 56.64% $51,264,737 $11,241,257 $1,811,337 NEW MEXICO $6,490,015 $254,786 $6,744,801 3.78% $20,901,012 69.36% $30,134,100 $1,138,321 $254,786 NORTH DAKOTA $214,523 $988,478 $1,203,001 33.00% $9,801,133 55.40% $17,691,576 $5,838,220 $988,478 OKLAHOMA $20,019,969 $3,273,248 $23,293,217 14.05% $37,157,353 63.88% $58,167,428 $8,173,900 $3,273,248 OREGON $11,437,908 $19,975,092 $31,413,000 33.00% $46,446,693 62.91% $73,830,381 $24,364,026 $19,975,092 SOUTH DAKOTA $321,120 $751,299 $1,072,419 33.00% $11,332,733 59.13% $19,165,792 $6,324,711 $751,299 UTAH $3,621,116 $934,586 $4,555,702 20.51% $20,129,695 70.99% $28,355,677 $5,817,066 $934,586 WISCONSIN $6,609,524 $4,492,011 $11,101,535 33.00% $96,998,597 60.53% $160,248,797 $52,882,103 $4,492,011 WYOMING $0 $0 $0 0.00% $232,233 50.00% $464,466 $0 $0 TOTAL LOW DSH STATES $98,662,480 $63,238,167 $161,900,647 $492,047,621 $822,338,209 $178,371,303 $58,011,072 TOTAL $13,501,123,326 $4,181,997,071 $17,683,120,397 $11,362,099,122 $20,132,652,675 $3,808,670,501 $3,450,038,303 
 CMS-2384-N CPL 5/31/2012 27 

Key to Chart 4. Preliminary IMD DSH Limit for FY 2013 

 

Key to Chart 4.--PRELIMINARY IMD DSH LIMIT FOR FY: 2013 

The preliminary FY 2013 IMD DSH Limits for the Non-Low DSH States are 

presented in the top section of this chart and the preliminary FY 2013 IMD 

DSH Limits for the Low-DSH States are presented in the bottom section of 

the chart 

 

Column Description 

Column A State. 

Column B Inpatient Hospital Services FY 95 DSH Total Computable. 

 This column contains the States' total computable FY 

 1995 inpatient hospital DSH expenditures as reported on the 

 Form CMS-64. 

Column C IMD and Mental Health Services FY 95 DSH Total 

 Computable. This column contains the total computable 

 FY 1995 mental health facility DSH expenditures as reported on the 

 Form CMS-64 as of January 1, 1997. 

Column D Total Inpatient Hospital & IMD & Mental Health FY 95 DSH Total 

 Computable, Col. B + C. This column contains the total 

 computation of all inpatient hospital DSH expenditures 

 and mental health facility DSH expenditures for FY 

 1995 as reported on the Form CMS-64 as of January 1, 

 1997 (representing the sum of Column B and Column C). 

Column E Applicable Percentage, Col. C/D. This column contains 

 the "applicable percentage" representing the total 

 Computable FY 1995 mental health facility DSH 

 expenditures divided by total computable all inpatient 

 hospital and mental health facility DSH expenditures 

 for FY 1995 (the amount in Column C divided by the 

 amount in Column D) Per section 1923(h)(2)(A)(ii)(III) 

 Of the Act, for FYs after FY 2002, the applicable 

 Percentage can be no greater than 33 percent. 

Column F FY 2013 Federal Share DSH Allotment. This column contains the 

 states' preliminary FY 2012 DSH allotments. 

Column G FY 2013 FMAP. 

Column H FY 2013 DSH Allotments in Total Computable, Col. F/G. 

 This column contains states' FY 2013 total computable DSH 

allotment (determined as Column F/Column G). 
CMS-2342-N 28 

Key to Chart 4.--PRELIMINARY IMD DSH LIMIT FOR FY: 2013 

The preliminary FY 2013 IMD DSH Limits for the Non-Low DSH States are 

presented in the top section of this chart and the preliminary FY 2013 IMD 

DSH Limits for the Low-DSH States are presented in the bottom section of 

the chart 

 

Column Description 

Column I Applicable Percentage Applied to FY 2013 Allotments in TC, Col E 

x Col H. 

 This column contains the applicable percentage of FY 2013 total 

computable DSH allotment (calculated as the percentage in Column 

E multiplied by the amount in Column H). 

Column J FY 2013 TC IMD DSH Limit. Lesser of Col. 

 I or C. This column contains the total computable FY 2013 TC IMD 

DSH Limit equal to the lesser of the amount in Column I or 

Column C. 

Column K FY 2013 IMD DSH Limit in Federal Share, Col. G x J. 

 This column contains the FY 2013 Federal Share IMD DSH limit 

determined by converting the total computable FY 2013 IMD DSH 

Limit from Column J into a federal share amount by multiplying it 

by the FY 2013 FMAP in Column G. 

 
CMS-2342-N 29 

CHART 4 - PRELIMINARY IMD DSH LIMIT FOR FY: 2013 

 

 A B C D E F G H I 

 Inpatient Hospital IMD And Total Inpatient & IMD & Applicable 

 FY 2013 FY 2013 FY 2013 Applica

Percenta

 Services FY 95 DSH Mental Health Mental Health FY 95 DSH Percentage Allotment FMAPs Allotments Applied to F

STATE Total Computable Services FY 95 DSH Total Computable in TC Allotments 

 Total Computable Col B + C Col C/D In FS Col F/G Col E x C

ALABAMA $413,006,229 $4,451,770 $417,457,999 1.07% $323,093,267 68.53% $471,462,523 $5,0ARIZONA $93,916,100 $28,474,900 $122,391,000 23.27% $106,384,369 65.68% $161,973,765 $37,6CALIFORNIA $2,189,879,543 $1,555,919 $2,191,435,462 0.07% $1,151,840,630 50.00% $2,303,681,260 $1,6COLORADO $173,900,441 $594,776 $174,495,217 0.34% $97,190,657 50.00% $194,381,314 $6CONNECTICUT $303,359,275 $105,573,725 $408,933,000 25.82% $210,141,962 50.00% $420,283,924 $108,5DISTRICT OF COLUMBIA $39,532,234 $6,545,136 $46,077,370 14.20% $64,355,975 70.00% $91,937,107 $13,0FLORIDA $184,468,014 $149,714,986 $334,183,000 33.00% $210,141,962 58.08% $361,814,673 $119,3GEORGIA $407,343,557 $0 $407,343,557 0.00% $282,378,262 65.56% $430,717,300 ILLINOIS $315,868,508 $89,408,276 $405,276,784 22.06% $225,902,609 50.00% $451,805,218 $99,6INDIANA $79,960,783 $153,566,302 $233,527,085 33.00% $224,589,223 67.16% $334,409,206 $110,3KANSAS $11,587,208 $76,663,508 $88,250,716 33.00% $43,341,780 56.51% $76,697,540 $25,3KENTUCKY $158,804,908 $37,443,073 $196,247,981 19.08% $152,352,923 70.55% $215,950,281 $41,2LOUISIANA $1,078,512,169 $132,917,149 $1,211,429,318 10.97% $731,960,000 61.24% $1,195,231,875 $131,1MAINE $99,957,958 $60,958,342 $160,916,300 33.00% $110,324,530 62.57% $176,321,768 $58,1MARYLAND $22,226,467 $120,873,531 $143,099,998 33.00% $80,116,623 50.00% $160,233,246 $52,8MASSACHUSETTS $469,653,946 $105,635,054 $575,289,000 18.36% $320,466,492 50.00% $640,932,984 $117,6MICHIGAN $133,258,800 $304,765,552 $438,024,352 33.00% $278,438,100 66.39% $419,397,650 $138,4MISSISSIPPI $182,608,033 $0 $182,608,033 0.00% $160,233,246 73.43% $218,212,238 MISSOURI $521,946,524 $207,234,618 $729,181,142 28.42% $497,773,773 61.37% $811,102,775 $230,5NEVADA $73,560,000 $0 $73,560,000 0.00% $48,595,328 59.74% $81,344,707 NEW HAMPSHIRE $92,675,916 $94,753,948 $187,429,864 33.00% $168,217,088 50.00% $336,434,176 $111,0NEW JERSEY $736,742,539 $357,370,461 $1,094,113,000 32.66% $676,394,441 50.00% $1,352,788,882 $441,8NEW YORK $2,418,869,368 $605,000,000 $3,023,869,368 20.01% $1,687,702,633 50.00% $3,375,405,266 $675,3NORTH CAROLINA $193,201,966 $236,072,627 $429,274,593 33.00% $309,959,394 65.51% $473,148,212 $156,1OHIO $535,731,956 $93,432,758 $629,164,714 14.85% $426,850,861 63.58% $671,360,272 $99,6PENNSYLVANIA $388,207,319 $579,199,682 $967,407,001 33.00% $589,710,881 54.28% $1,086,423,878 $358,5
CMS-2342-N 30 

 

 A B C D E F G H I 

 Inpatient Hospital IMD And Total Inpatient & IMD & Applicable 

 FY 2013 FY 2013 FY 2013 Applica

Percenta

 Services FY 95 DSH Mental Health Mental Health FY 95 DSH Percentage Allotment FMAPs Allotments Applied to F

STATE Total Computable Services FY 95 DSH Total Computable in TC Allotments 

 Total Computable Col B + C Col C/D In FS Col F/G Col E x C

RHODE ISLAND $108,503,167 $2,397,833 $110,901,000 2.16% $68,296,138 51.26% $133,234,760 $2,8SOUTH CAROLINA $366,681,364 $72,076,341 $438,757,705 16.43% $344,107,463 70.43% $488,580,808 $80,2TENNESSEE $0 $0 $0 0.00% $53,100,000 66.13% $80,296,386 TEXAS $1,220,515,401 $292,513,592 $1,513,028,993 19.33% $1,004,741,257 59.30% $1,694,336,015 $327,5VERMONT $19,979,252 $9,071,297 $29,050,549 31.23% $23,640,971 56.04% $42,185,887 $13,1VIRGINIA $129,313,480 $7,770,268 $137,083,748 5.67% $92,050,138 50.00% $184,100,276 $10,4WASHINGTON $171,725,815 $163,836,435 $335,562,250 33.00% $194,381,315 50.00% $388,762,630 $128,2WEST VIRGINIA $66,962,606 $18,887,045 $85,849,651 22.00% $70,922,912 72.04% $98,449,350 $21,6TOTAL $13,402,460,846 $4,118,758,904 $17,521,219,750 $11,029,697,203 $19,623,398,153 $3,718,1LOW DSH STATES ALASKA $2,506,827 $17,611,765 $20,118,592 33.00% $21,402,636 50.00% $42,805,272 $14,1ARKANSAS $2,422,649 $819,351 $3,242,000 25.27% $45,325,292 70.17% $64,593,547 $16,3DELAWARE $0 $7,069,000 $7,069,000 33.00% $9,512,282 55.67% $17,086,909 $5,6HAWAII $0 $0 $0 0.00% $10,240,000 51.86% $19,745,469 IDAHO $2,081,429 $0 $2,081,429 0.00% $17,271,044 71.00% $24,325,414 IOWA $12,011,250 $0 $12,011,250 0.00% $41,378,149 59.59% $69,438,075 MINNESOTA $24,240,000 $5,257,214 $29,497,214 17.82% $78,476,334 50.00% $156,952,668 $27,9MONTANA $237,048 $0 $237,048 0.00% $11,926,371 66.00% $18,070,259 NEBRASKA $6,449,102 $1,811,337 $8,260,439 21.93% $29,733,219 55.76% $53,323,563 $11,6NEW MEXICO $6,490,015 $254,786 $6,744,801 3.78% $21,402,636 69.07% $30,986,877 $1,1NORTH DAKOTA $214,523 $988,478 $1,203,001 33.00% $10,036,360 52.27% $19,200,995 $6,3OKLAHOMA $20,019,969 $3,273,248 $23,293,217 14.05% $38,049,129 64.00% $59,451,764 $8,3OREGON $11,437,908 $19,975,092 $31,413,000 33.00% $47,561,414 62.44% $76,171,387 $25,1SOUTH DAKOTA $321,120 $751,299 $1,072,419 33.00% $11,604,719 56.19% $20,652,641 $6,8UTAH $3,621,116 $934,586 $4,555,702 20.51% $20,612,808 69.61% $29,611,849 $6,0WISCONSIN $6,609,524 $4,492,011 $11,101,535 33.00% $99,326,563 59.74% $166,264,752 $54,8WYOMING $0 $0 $0 0.00% $237,807 50.00% $475,614 
CMS-2342-N 31 

 

 A B C D E F G H I 

 Inpatient Hospital IMD And Total Inpatient & IMD & Applicable 

 FY 2013 FY 2013 FY 2013 Applica

Percenta

 Services FY 95 DSH Mental Health Mental Health FY 95 DSH Percentage Allotment FMAPs Allotments Applied to F

STATE Total Computable Services FY 95 DSH Total Computable in TC Allotments 

 Total Computable Col B + C Col C/D In FS Col F/G Col E x C

TOTAL LOW DSH STATES $98,662,480 $63,238,167 $161,900,647 $514,096,763 $869,157,055 $184,5TOTAL $13,501,123,326 $4,181,997,071 $17,683,120,397 $11,543,793,966 $20,492,555,208 $3,902,6

[FR Doc. 2013-17965 Filed 07/25/2013 at 8:45 am; Publication Date: 07/26/2013]