Document headings vary by document type but may contain
                    the following: the agency or agencies that issued and signed a document
the number of the CFR title and the number of each part
                      the document amends, proposes to amend, or is directly
                      related to
the agency docket number / agency internal file number
the RIN which identifies each regulatory action listed in
                      the Unified Agenda of Federal Regulatory and Deregulatory
                      Actions See the
                    Document Drafting Handbook
                    for more details.
 Department of Health and Human Services Centers for Medicare & Medicaid Services [CMS-2398-N]
RIN 0983-ZB24
 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) 2013 and the preliminary federal share DSH allotments for FY 2015. This notice also announces the final FY 2013 and the preliminary FY 2015 limitations on aggregate DSH payments that states may make to institutions for mental disease and other mental health facilities. In addition, this notice includes background information describing the methodology for determining the amounts of states' FY DSH allotments.
 DATES: This notice is effective March 3, 2016. The final allotments and limitations set forth in this notice are effective for the fiscal years specified.
 FOR FURTHER INFORMATION CONTACT: Stuart Goldstein, (410) 786-0694 and Richard Cuno, (410) 786-1111.


SUPPLEMENTARY INFORMATION: I. Background A. Fiscal Year DSH Allotments A state's federal fiscal year (FY) disproportionate share hospital (DSH) allotment represents the aggregate limit on the federal share amount of the state's payments to DSH hospitals in the state for the FY. The amount of such allotment is determined in accordance with the provisions of section 1923(f)(3) of the Social Security Act (the Act). Under such provisions, in general a state's FY 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. The Affordable Care Act amended Medicaid DSH provisions, adding section 1923(f)(7) of the Act which would have required reductions to states' FY DSH allotments beginning with FY 2014, the calculation of which was described in the Disproportionate Share Hospital Payment Reduction final rule published in the September 18, 2013 
                    **Federal Register**
                     (78 FR 57293). Under the DSH reduction methodology, first, each state's unreduced FY DSH allotment would have been calculated in accordance with the provisions of section 1923(f) of the Act, excluding section 1923(f)(7) of the Act; then, the reduction amount for each state would have been determined under the provisions of section 1923(f)(7) of the Act and implementing regulations at 42 CFR 447.294; and, finally, the net FY DSH allotment for each state would have been determined by subtracting the DSH reduction amount for the state from its unreduced FY 2014 DSH allotment. The reductions under section 1923(f)(7) of the Act were most recently delayed and modified by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) (Pub. L. 114-10), enacted on April 16, 2015. The reductions of states' fiscal year DSH allotments under section 1923(f)(7) of the Act that were applicable to FY 2017 were repealed, and are instead scheduled to begin in FY 2018 at modified levels. MACRA also extended DSH allotment reductions through 2025. Because there is no reduction to DSH allotments for FY 2015 under section 1923(f)(7) of the Act, this notice contains only the state-specific preliminary FY 2015 DSH allotments, as calculated under the statute without application of the reductions that would have otherwise been imposed. This notice also provides information on the calculation of such FY DSH allotments, the calculation of the states' IMD DSH limits, and the amounts of states' preliminary FY 2015 IMD DSH limits. B. Determination of Fiscal Year DSH Allotments Generally, in accordance with the methodology specified under section 1923(f)(3) of the Act, a state's FY DSH allotment is calculated by increasing the amount of its DSH allotment for the preceding FY by the percentage change in the 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 
                    ( print page 5449)
                    (FFP) for DSH payments to institutions for mental diseases (IMDs) and other mental health facilities is limited to state-specific aggregate amounts. 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). In general, we determine states' DSH allotments for a FY and the IMD DSH limits for the same 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 the 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 CPI-U percentage change for the previous FY. II. Provisions of the Notice A. Calculation of the Final FY 2013 Federal Share State DSH Allotments and the Preliminary FY 2015 Federal Share State DSH Allotments 1. Final FY 2013 Federal Share State DSH Allotments Addendum 1 to this notice provides the states' final FY 2013 DSH allotments determined in accordance with section 1923(f)(3) of the Act. As described in the background section of this notice, 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 2013 DSH allotments, the preceding final fiscal year DSH allotments (for FY 2012) were published in the July 26, 2013 
                    **Federal Register**
                     (78 FR 45217). For purposes of calculating the states' final FY 2013 DSH allotments we are using the actual Medicaid expenditures for FY 2013. Finally, for purposes of calculating the states' final FY 2013 DSH allotments, the applicable historical percentage change in the CPI-U for the previous FY (FY 2012) was 2.4 percent; we note that this is the same as the estimated 2.4 percentage change in the CPI-U for FY 2012 that was available and used in the calculation of the preliminary FY 2013 DSH allotments which were published in the July 26, 2013 
                    **Federal Register**
                     (78 FR 45217). 2. Calculation of the Preliminary FY 2015 Federal Share State DSH Allotments Addendum 2 to this notice provides the preliminary FY 2015 DSH allotments determined in accordance with section 1923(f)(3) of the Act. The preliminary FY 2015 DSH allotments contained in this notice were determined based on the most recent available estimates from states of their FY 2015 total computable Medicaid expenditures. Also, the preliminary FY 2015 allotments contained in this notice were determined by increasing the preliminary FY 2014 DSH allotments as contained in the notice published in the February 28, 2014 
                    **Federal Register**
                     (79 FR 11436) by 1.6 percent, representing the most recent available estimate of the percentage increase in the CPI-U for FY 2014 (the previous FY to FY 2015). We will publish states' final FY 2015 DSH allotments in future notices based on the states' four quarterly Medicaid expenditure reports (Form CMS-64) for FY 2015 available following the end of FY 2015 and the actual change in the CPI-U for FY 2014. B. Calculation of the Final FY 2013 and Preliminary FY 2015 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 2013 and the preliminary FY 2015 IMD DSH Limits determined in accordance with the provisions discussed above. Addendums 3 and 4 to this notice detail each state's final FY 2013 and preliminary FY 2015 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 CMS-37 (OMB control number 0938-1265) and form CMS-64 (OMB control number 0938-1265) are unaffected by this notice. As it pertains to the content of this notice, CMS-37 and CMS-64 are not subject to formal 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 threshold and thus is considered a major rule under the Congressional Review Act. The final FY 2013 DSH allotments being published in this notice are equal 
                    ( print page 5450)
                    to the preliminary FY 2013 DSH allotments published in the July 26, 2013 
                    **Federal Register**
                     (78 FR 45217). This is due to the actual percentage change in the CPI-U for FY 2012 used in the calculation of the final FY 2013 allotments (2.4 percent) being equal to the estimated percentage change in the CPI-U for FY 2012 used in the calculation of the preliminary FY 2013 allotments (2.4 percent). The final FY 2013 IMD DSH limits being published in this notice are also equal to the preliminary FY 2013 IMD DSH limits published in the July 26, 2013 
                    **Federal Register**
                     (78 FR 45217). Since the final FY 2013 DSH allotments were equal to the preliminary FY 2013 DSH allotments, the associated FY 2013 IMD DSH limits also remained the same. The preliminary FY 2015 DSH allotments being published in this notice are about $240 million more than the preliminary FY 2014 DSH allotments published in the February 28, 2014 
                    **Federal Register**
                     (79 FR 11436). 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 2015 IMD DSH limits being published in this notice are about $14 million more than the preliminary FY 2014 IMD DSH limits published in the February 28, 2014 
                    **Federal Register**
                     (79 FR 11436). 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 2015 DSH allotments are greater than the preliminary FY 2014 DSH allotments, the associated preliminary FY 2015 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 $7.5 million to $38.5 million in any 1 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 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 2015, that is approximately $144 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 issues 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. A. 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 the statute. This notice does not put forward any further discretionary administrative policies for determining such allotments. B. 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 2014 to FY 2015. Table 1—Accounting Statement: Classification of Estimated Expenditures, From the FY 2014 to FY 2015
[In millions]
Category
TransfersAnnualized Monetized Transfers
$240.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. Dated: December 3, 2015. Andrew M. Slavitt, Acting Administrator, Centers for Medicare & Medicaid Services. Dated: January 20, 2016. Sylvia M. Burwell, Secretary, Department of Health and Human Services.
 
 
 Key to Addendum 1—Final DSH Allotments for FY 2013
[The Final FY 2013 DSH Allotments for the NON-Low DSH States are presented in the top section of this addendum, and the Final FY 2013 DSH Allotments for the Low-DSH States are presented in the bottom section of this addendum]
Column
DescriptionColumn 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) × (100 percent + Percentage Increase in CPIU): 102.4 percent.
                             This column contains the amount in Column C increased by 1 plus the 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' 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' FY 2013 total computable DSH expenditures.Column G
FY 2013 TC MAP Exp. Net of DSH.
                             This column contains the amount of the States' 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 percent 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 percent Limit.
                             This column contains the greater of the State's prior FY (FY 2012) DSH allotment or the amount of the 12 percent Limit, determined as the maximum of the amount in Column C or Column HColumn J
FY 2013 DSH Allotment.
                             This column contains the States' final 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 addendum.
 
 
 Addendum 1—Final DSH Allotments for FY 2013
State
FY 2013 FMAPs
                             (percent)
Prior FY (2012) DSH allotments
Prior FY (2012) DSH allotment (Col C) × 100% + Pct increase in CPIU: 102.4%
FY 2013 TC MAP Exp. including DSH
FY 2013 TC DSH expenditures
FY 2013 TC MAP EXP. net of DSH Col E-F
“12% Amount” = Col G × .12/(1-.12/Col B)* 
                             (in FS)
Greater of Col H or Col C (12% limit, FY 2012 
                             Allotment)
FY 2013 DSH 
                             allotment  
                             MIN Col I, Col DA
B
C
D
E
F
G
H
I
JALABAMA
68.53
$315,520,769
$323,093,267
$4,999,646,843
$470,923,104
$4,528,723,739
$658,807,935
$658,807,935
$323,093,267ARIZONA
65.68
103,890,985
106,384,369
8,437,380,837
173,082,813
8,264,298,024
1,213,410,792
1,213,410,792
106,384,369CALIFORNIA
50.00
1,124,844,365
1,151,840,630
61,425,894,719
2,119,710,409
59,306,184,310
9,364,134,365
9,364,134,365
1,151,840,630COLORADO
50.00
94,912,751
97,190,657
5,048,193,724
194,191,858
4,854,001,866
766,421,347
766,421,347
97,190,657CONNECTICUT
50.00
205,216,760
210,141,962
6,415,388,481
272,860,246
6,142,528,235
969,872,879
969,872,879
210,141,962DISTRICT OF COLUMBIA
70.00
62,847,632
64,355,975
2,275,681,171
56,387,767
2,219,293,404
321,414,907
321,414,907
64,355,975FLORIDA
58.08
205,216,760
210,141,962
18,411,438,180
335,009,637
18,076,428,543
2,734,059,817
2,734,059,817
210,141,962GEORGIA
65.56
275,760,021
282,378,262
8,887,641,041
429,964,548
8,457,676,493
1,242,312,033
1,242,312,033
282,378,262ILLINOIS
50.00
220,608,017
225,902,609
15,493,580,784
447,072,185
15,046,508,599
2,375,764,516
2,375,764,516
225,902,609INDIANA
67.16
219,325,413
224,589,223
7,930,553,510
337,536,579
7,593,016,931
1,109,384,374
1,109,384,374
224,589,223KANSAS
56.51
42,325,957
43,341,780
2,544,769,057
76,622,785
2,468,146,272
376,027,713
376,027,713
43,341,780KENTUCKY
70.55
148,782,151
152,352,923
5,726,056,802
216,263,666
5,509,793,136
796,685,033
796,685,033
152,352,923LOUISIANA/1
na
na
na
na
na
na
na
na
731,960,000MAINE
62.57
107,738,799
110,324,530
2,826,874,563
37,489,437
2,789,385,126
414,155,018
414,155,018
110,324,530MARYLAND
50.00
78,238,890
80,116,623
7,688,146,740
134,340,816
7,553,805,924
1,192,706,199
1,192,706,199
80,116,623MASSACHUSETTS
50.00
312,955,559
320,466,492
12,999,170,453
0
12,999,170,453
2,052,500,598
2,052,500,598
320,466,492MICHIGAN
66.39
271,912,207
278,438,100
12,308,409,960
387,951,247
11,920,458,713
1,746,054,614
1,746,054,614
278,438,100MISSISSIPPI
73.43
156,477,779
160,233,246
4,708,563,005
217,999,554
4,490,563,451
644,132,328
644,132,328
160,233,246MISSOURI
61.37
486,107,200
497,773,773
8,863,322,084
703,393,659
8,159,928,425
1,217,196,210
1,217,196,210
497,773,773NEVADA
59.74
47,456,375
48,595,328
1,797,228,664
81,373,600
1,715,855,064
257,658,605
257,658,605
48,595,328NEW HAMPSHIRE
50.00
164,274,500
168,217,088
1,188,634,372
40,923,914
1,147,710,458
181,217,441
181,217,441
168,217,088NEW JERSEY
50.00
660,541,446
676,394,441
10,480,866,440
1,298,115,161
9,182,751,279
1,449,908,097
1,449,908,097
676,394,441NEW YORK
50.00
1,648,147,103
1,687,702,633
52,489,778,879
3,423,365,423
49,066,413,456
7,747,328,440
7,747,328,440
1,687,702,633NORTH CAROLINA
65.51
302,694,721
309,959,394
11,721,921,735
617,376,633
11,104,545,102
1,631,378,246
1,631,378,246
309,959,394OHIO
63.58
416,846,544
426,850,861
16,628,494,101
649,120,744
15,979,373,357
2,363,633,714
2,363,633,714
426,850,861PENNSYLVANIA
54.28
575,889,532
589,710,881
20,922,389,122
847,055,684
20,075,333,438
3,092,778,900
3,092,778,900
589,710,881RHODE ISLAND
51.26
66,695,447
68,296,138
1,909,141,351
129,846,057
1,779,295,294
278,777,412
278,777,412
68,296,138SOUTH CAROLINA
70.43
336,042,444
344,107,463
4,690,094,944
457,173,209
4,232,921,735
612,270,432
612,270,432
344,107,463TENNESSEE/2
na
na
na
na
na
na
na
na
53,100,000TEXAS
59.30
981,192,634
1,004,741,257
27,752,018,303
226,747,941
27,525,270,362
4,141,011,076
4,141,011,076
1,004,741,257VERMONT
56.04
23,086,886
23,640,971
1,452,095,084
37,448,781
1,414,646,303
216,013,021
216,013,021
23,640,971VIRGINIA
50.00
89,892,713
92,050,138
7,218,485,856
186,468,433
7,032,017,423
1,110,318,540
1,110,318,540
92,050,138WASHINGTON
50.00
189,825,503
194,381,315
7,805,501,929
366,733,930
7,438,767,999
1,174,542,316
1,174,542,316
194,381,315WEST VIRGINIA
72.04
69,260,656
70,922,912
3,007,417,198
75,434,137
2,931,983,061
422,158,680
422,158,680
70,922,912Total
0.00
10,004,528,519
10,244,637,203
366,054,779,932
15,047,983,957
351,006,795,975
53,874,035,598
53,874,035,598
11,029,697,203**LOW DSH STATES**ALASKA
50.00
20,901,012
21,402,636
1,340,719,400
21,706,474
1,319,012,926
208,265,198.84
208,265,199
21,402,636ARKANSAS
70.17
44,262,980
45,325,292
4,156,350,929
61,000,000
4,095,350,929
592,822,640
592,822,640
45,325,292DELAWARE
55.67
9,289,338
9,512,282
1,557,544,100
10,874,669
1,546,669,431
236,601,110
236,601,110
9,512,282HAWAII
51.86
10,000,000
10,240,000
1,586,220,307
24,971,280
1,561,249,027
243,752,256.52
243,752,257
10,240,000IDAHO
71.00
16,866,254
17,271,044
1,641,925,393
23,708,980
1,618,216,413
233,681,421.00
233,681,421
17,271,044IOWA
59.59
40,408,349
41,378,149
3,622,873,642
54,606,370
3,568,267,272
536,162,337
536,162,337
41,378,149MINNESOTA
50.00
76,637,045
78,476,334
8,781,239,289
46,287,099
8,734,952,190
1,379,202,977
1,379,202,977
78,476,334MONTANA
66.00
11,646,847
11,926,371
996,801,715
17,703,206
979,098,509
143,601,115
143,601,115
11,926,371NEBRASKA
55.76
29,036,347
29,733,219
1,790,372,947
45,313,162
1,745,059,785
266,831,445
266,831,445
29,733,219NEW MEXICO
69.07
20,901,012
21,402,636
3,280,561,202
25,164,146
3,255,397,056
472,788,382
472,788,382
21,402,636NORTH DAKOTA
52.27
9,801,133
10,036,360
775,035,726
1,265,931
773,769,795
120,521,323
120,521,323
10,036,360OKLAHOMA
64.00
37,157,353
38,049,129
4,481,944,280
41,759,650
4,440,184,630
655,781,115
655,781,115
38,049,129OREGON
62.44
46,446,693
47,561,414
5,070,815,864
76,536,235
4,994,279,629
741,894,100
741,894,100
47,561,414SOUTH DAKOTA
56.19
11,332,733
11,604,719
758,090,042
1,441,151
756,648,891
115,454,450
115,454,450
11,604,719UTAH
69.61
20,129,695
20,612,808
2,087,187,059
28,794,708
2,058,392,351
298,457,958
298,457,958
20,612,808WISCONSIN
59.74
96,998,597
99,326,563
7,034,898,860
581,325
7,034,317,535
1,056,296,932
1,056,296,932
99,326,563WYOMING
50.00
232,233
237,807
546,576,901
463,560
546,113,341
86,228,422
86,228,422
237,807( print page 5453)Total Low DSH States
0.00
502,047,621
514,096,764
49,509,157,656
482,177,946
49,026,979,710
7,388,343,182
7,388,343,182
514,096,763Total
0.00
10,506,576,140
10,758,733,967
415,563,937,588
15,530,161,903
400,033,775,685
61,262,378,780
61,262,378,780
11,543,793,9661
                         FY 2013 DSH allotment for Louisiana determined under the provisions of section 1903(f)(3)(C) and (D) of the Act.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
                         Beginning 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 allotment by the CPIU for the previous fiscal year.
 
 
 Key to Addendum 2—Preliminary DSH Allotments for FY 2015
[The Preliminary FY 2015 DSH Allotments for the NON-Low DSH States are presented in the top section of this addendum, and the Preliminary FY 2015 DSH Allotments for the Low-DSH States are presented in the bottom section of this addendum]
Column
DescriptionColumn A
State.Column B
FY 2015 FMAPs.
                             This column contains the States' FY 2015 Federal Medical Assistance Percentages.Column C
Prior FY (2014) DSH Allotments.
                             This column contains the States' prior FY 2014 DSH AllotmentsColumn D
Prior FY (2014) DSH Allotments (Col C) × (100 percent + Percentage Increase in CPIU): 101.6 percent.
                             This column contains the amount in Column C increased by 1 plus the estimated percentage increase in the CPI-U for the prior FY (101.6 percent).Column E
FY 2015 TC MAP Exp. Including DSH.
                             This column contains the amount of the States' projected FY 2015 total computable (TC) medical assistance expenditures including DSH expenditures.Column F
FY 2015 TC DSH Expenditures.
                             This column contains the amount of the States' projected FY 2015 total computable DSH expenditures.Column G
FY 2015 TC MAP Exp. Net of DSH.
                             This column contains the amount of the States' projected FY 2015 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 percent 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 2014 Allotment or 12 percent Limit.
                             This column contains the greater of the State's prior FY (FY 2014) DSH allotment or the amount of the 12 percent Limit, determined as the maximum of the amount in Column C or Column H.Column J
FY 2015 DSH Allotment.
                             This column contains the States' preliminary FY 2015 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 addendum.
 
 
 Addendum 2—Preliminary DSH Allotments for FY 2015
State
FY 2015 FMAPs
                             (percent)
Prior FY (2014) DSH allotments
Prior FY (2014) DSH Allotment (Col C) × 100% + Pct increase in CPIU: 101.6%
FY 2015 TC MAP Exp. Including DSH 4
FY 2015 TC DSH Expenditures 4
FY 2015 TC MAP EXP. Net Of DSH Col E-F
“12% Amount” = Col G × .12/(1-.12/Col B)* (in FS)
Greater of Col H or Col C (12% Limit, FY 2014
                             allotment)
FY 2015 DSH 
                             Allotment Min Col I, Col DA
B
C
D
E
F
G
H
I
JALABAMA
68.99
$327,939,666
$333,186,701
$5,727,646,000
$507,528,000
$5,220,118,000
$758,313,966
$758,313,966
$333,186,701ARIZONA
68.46
107,980,135
109,707,817
11,262,757,000
167,012,000
11,095,745,000
1,614,483,959
1,614,483,959
109,707,817CALIFORNIA
50.00
1,169,118,239
1,187,824,131
96,031,140,000
597,609,000
95,433,531,000
15,068,452,263
15,068,452,263
1,187,824,131COLORADO
51.01
98,648,517
100,226,893
6,927,502,000
204,899,000
6,722,603,000
1,054,867,918
1,054,867,918
100,226,893CONNECTICUT
50.00
213,294,091
216,706,796
7,094,230,000
125,646,000
6,968,584,000
1,100,302,737
1,100,302,737
216,706,796DISTRICT OF COLUMBIA
70.00
65,321,315
66,366,456
2,630,681,000
37,174,000
2,593,507,000
375,611,359
375,611,359
66,366,456FLORIDA
59.72
213,294,091
216,706,796
22,430,097,000
362,102,000
22,067,995,000
3,314,083,809
3,314,083,809
216,706,796GEORGIA
66.94
286,613,936
291,199,759
9,915,707,000
434,725,000
9,480,982,000
1,386,218,278
1,386,218,278
291,199,759ILLINOIS
50.76
229,291,148
232,959,806
19,753,482,000
456,614,000
19,296,868,000
3,032,535,665
3,032,535,665
232,959,806INDIANA
66.52
227,958,061
231,605,390
10,719,730,000
474,987,000
10,244,743,000
1,499,956,649
1,499,956,649
231,605,390KANSAS
56.63
43,991,907
44,695,778
3,161,490,000
74,228,000
3,087,262,000
470,082,851
470,082,851
44,695,778KENTUCKY
69.94
154,638,217
157,112,428
8,903,447,000
241,000,000
8,662,447,000
1,254,784,004
1,254,784,004
157,112,428LOUISIANA 1
62.05
731,960,000
743,671,360
7,995,712,000
551,048,000
7,444,664,000
1,107,551,811
1,107,551,811
743,671,360MAINE
61.88
111,979,398
113,771,068
2,565,931,000
38,566,000
2,527,365,000
376,247,024
376,247,024
113,771,068MARYLAND
50.00
81,318,372
82,619,466
11,133,665,000
92,859,000
11,040,806,000
1,743,285,158
1,743,285,158
82,619,466MASSACHUSETTS
50.00
325,273,489
330,477,865
16,287,567,000
0
16,287,567,000
2,571,721,105
2,571,721,105
330,477,865MICHIGAN
65.54
282,614,672
287,136,507
16,050,268,000
322,351,000
15,727,917,000
2,310,364,618
2,310,364,618
287,136,507MISSISSIPPI
73.58
162,636,745
165,238,933
5,362,441,000
228,204,000
5,134,237,000
736,168,545
736,168,545
165,238,933MISSOURI
63.45
505,240,380
513,324,226
9,641,725,000
713,722,000
8,928,003,000
1,321,240,327
1,321,240,327
513,324,226NEVADA
64.36
49,324,258
50,113,446
2,848,030,000
78,128,000
2,769,902,000
408,565,835
408,565,835
50,113,446NEW HAMPSHIRE
50.00
170,740,344
173,472,190
1,816,048,000
76,097,000
1,739,951,000
274,729,105
274,729,105
173,472,190NEW JERSEY
50.00
686,540,358
697,525,004
14,214,233,000
1,213,776,000
13,000,457,000
2,052,703,737
2,052,703,737
697,525,004NEW YORK
50.00
1,713,018,172
1,740,426,463
68,512,267,000
5,326,800,000
63,185,467,000
9,976,652,684
9,976,652,684
1,740,426,463NORTH CAROLINA
65.88
314,608,785
319,642,526
12,482,232,000
411,389,000
12,070,843,000
1,771,107,209
1,771,107,209
319,642,526OHIO
62.64
433,253,624
440,185,682
21,305,059,000
0
21,305,059,000
3,162,438,142
3,162,438,142
440,185,682PENNSYLVANIA
51.82
598,556,544
608,133,449
24,679,963,000
787,072,000
23,892,891,000
3,731,179,141
3,731,179,141
608,133,449RHODE ISLAND
50.00
69,320,580
70,429,709
3,117,756,000
142,487,000
2,975,269,000
469,779,316
469,779,316
70,429,709SOUTH CAROLINA
70.64
349,269,075
354,857,380
5,636,583,000
494,437,000
5,142,146,000
743,331,228
743,331,228
354,857,380TENNESSEE 2
na
na
na
na
na
na
na
na
53,100,000TEXAS
58.05
1,019,812,376
1,036,129,374
35,894,535,000
2,630,047,000
33,264,488,000
5,031,931,019
5,031,931,019
1,036,129,374VERMONT 5
56.21
23,995,586
24,379,515
1,577,599,000
37,449,000
1,540,150,000
234,983,483
234,983,483
24,379,515VIRGINIA
50.00
93,430,890
94,925,784
8,689,637,000
193,862,000
8,495,775,000
1,341,438,158
1,341,438,158
94,925,784WASHINGTON
50.03
197,297,035
200,453,788
12,536,442,000
405,243,000
12,131,199,000
1,915,089,832
1,915,089,832
200,453,788WEST VIRGINIA
71.35
71,986,756
73,138,544
3,631,855,000
71,987,000
3,559,868,000
513,556,694
513,556,694
73,138,544Total

11,130,266,762
11,308,351,030
490,537,457,000
17,499,048,000
473,038,409,000
72,723,757,629
72,723,757,629
11,361,451,030**LOW DSH STATES**ALASKA
50.00
21,723,676
22,071,255
1,661,590,000
21,894,000
1,639,696,000
258,899,368.42
258,899,368
22,071,255ARKANSAS
70.88
46,005,171
46,741,254
6,070,657,000
65,820,000
6,004,837,000
867,437,867
867,437,867
46,741,254DELAWARE
53.63
9,654,966
9,809,445
1,549,168,000
24,248,000
1,524,920,000
235,738,053
235,738,053
9,809,445HAWAII 3
52.23
10,393,600
10,559,898
1,951,834,000
0
1,951,834,000
304,084,384.25
304,084,384
10,559,898IDAHO
71.75
17,530,110
17,810,592
2,009,716,000
24,470,000
1,985,246,000
286,074,779.25
286,074,779
17,810,592IOWA
55.54
41,998,821
42,670,802
4,714,183,000
34,688,000
4,679,495,000
716,304,508
716,304,508
42,670,802MINNESOTA
50.00
79,653,479
80,927,935
11,849,443,000
154,792,000
11,694,651,000
1,846,523,842
1,846,523,842
80,927,935MONTANA
65.90
12,105,267
12,298,951
1,030,146,000
1,896,000
1,028,250,000
150,860,872
150,860,872
12,298,951NEBRASKA
53.27
30,179,217
30,662,084
2,053,612,000
42,720,000
2,010,892,000
311,471,433
311,471,433
30,662,084NEW MEXICO
69.65
21,723,676
22,071,255
4,758,998,000
31,196,000
4,727,802,000
685,428,779
685,428,779
22,071,255NORTH DAKOTA
50.00
10,186,905
10,349,895
1,155,141,000
1,735,000
1,153,406,000
182,116,737
182,116,737
10,349,895OKLAHOMA
62.30
38,619,866
39,237,784
5,404,554,000
58,140,000
5,346,414,000
794,628,053
794,628,053
39,237,784OREGON
64.06
48,274,835
49,047,232
8,294,293,000
81,136,000
8,213,157,000
1,212,757,981
1,212,757,981
49,047,232SOUTH DAKOTA
51.64
11,778,790
11,967,251
857,827,000
1,613,000
856,214,000
133,849,317
133,849,317
11,967,251UTAH
70.56
20,922,000
21,256,752
2,276,646,000
31,390,000
2,245,256,000
324,641,933
324,641,933
21,256,752WISCONSIN
58.27
100,816,461
102,429,524
8,016,231,000
166,265,000
7,849,966,000
1,186,300,027
1,186,300,027
102,429,524WYOMING
50.00
241,374
245,236
596,915,000
476,000
596,439,000
94,174,579
94,174,579
245,236( print page 5456)Total Low DSH States

521,808,214
530,157,145
64,250,954,000
742,479,000
63,508,475,000
9,591,292,512
9,591,292,512
530,157,145Total

11,652,074,976
11,838,508,176
554,788,411,000
18,241,527,000
536,546,884,000
82,315,050,141
82,315,050,141
11,891,608,1751
                         Louisiana's FY 2015 DSH allotment is determined under the provisions of section 1923(f)(3)(C) and (D) of the Act.2
                         Tennessee's DSH allotment for FY 2015 determined under section 1923(f)(6)(A)(vi) of the Act3
                         Beginning FY 2013, under section 1923(f)(6)(B)(II) of the Act, Hawaii's DSH allotment for a fiscal year is determined as for low-DSH states. This means Hawaii's DSH allotment for a fiscal year is determined as for all States, by increasing the previous fiscal year allotment by the percentage increase in the CPIU for the previous fiscal year.4
                         Expenditures based on the amounts reported by States on the Form CMS-37.5
                         FMAP for Vermont for FY 2015 determined in accordance with section 1905(z)(1)(A) of the Act.
 
 
 Key to Addendum 3—Final IMD DSH Limits for FY 2013
[The final FY 2013 IMD DSH Limits for the Non-Low DSH States are presented in the top section of this addendum and the preliminary FY 2013 IMD DSH Limits for the Low-DSH States are presented in the bottom section of the addendum]
Column
DescriptionColumn 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' FY 2013 DSH allotments from Column J Addendum 1.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).Column I
Applicable Percentage Applied to FY 2013 Allotments in TC, Col E × Col H.
                             This column contains the applicable percentage of FY 2012 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 × 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.
 
 
 Addendum 3—Final IMD DSH Limits for FY 2013
State
Inpatient 
                             Hospital  
                             services FY  
                             95 DSH  
                             Total  
                             computable
IMD And 
                             mental  
                             health  
                             services FY  
                             95 DSH  
                             Total  
                             computable
Total inpatient 
                             & IMD &  
                             mental health  
                             FY 95 DSH  
                             total  
                             computable 
                             Col B + C
Applicable 
                             percent  
                             Col C/D  
                             (percent)
FY 2013 
                             Allotment  
                             In FS
FY 2013 
                             FMAPs  
                             (percent)
FY 2013 
                             Allotments  
                             in TC  
                             Col F/G
Applicable 
                             percentage  
                             applied to  
                             FY 2013  
                             allotments  
                             in TC  
                             Col E × Col H
FY 2013 
                             TC IMD Limit  
                             (Lesser Of  
                             Col I or Col C)
FY 2013 
                             IMD Limit  
                             In FS  
                             Col G × J
MMA 
                             LOW DSH  
                             StatusA
B
C
D
E
F
G
H
I
J
K
LALABAMA
$413,006,229
$4,451,770
$417,457,999
1.07
$323,093,267
68.53
471,462,523
$5,027,674
$4,451,770
$3,050,798
N/AARIZONA
93,916,100
28,474,900
122,391,000
23.27
106,384,369
65.68
161,973,765
37,684,035
28,474,900
18,702,314
N/ACALIFORNIA
2,189,879,543
1,555,919
2,191,435,462
0.07
1,151,840,630
50.00
2,303,681,260
1,635,614
1,555,919
777,960
N/ACOLORADO
173,900,441
594,776
174,495,217
0.34
97,190,657
50.00
194,381,314
662,559
594,776
297,388
N/ACONNECTICUT
303,359,275
105,573,725
408,933,000
25.82
210,141,962
50.00
420,283,924
108,504,179
105,573,725
52,786,863
N/ADISTRICT OF COLUMBIA
39,532,234
6,545,136
46,077,370
14.20
64,355,975
70.00
91,937,107
13,059,358
6,545,136
4,581,595
N/AFLORIDA
184,468,014
149,714,986
334,183,000
33.00
210,141,962
58.08
361,814,673
119,398,842
119,398,842
69,346,847
N/AGEORGIA
407,343,557
0
407,343,557
0.00
282,378,262
65.56
430,717,300
0
0
0
N/AILLINOIS
315,868,508
89,408,276
405,276,784
22.06
225,902,609
50.00
451,805,218
99,672,933
89,408,276
44,704,138
N/AINDIANA
79,960,783
153,566,302
233,527,085
33.00
224,589,223
67.16
334,409,206
110,355,038
110,355,038
74,114,444
N/AKANSAS
11,587,208
76,663,508
88,250,716
33.00
43,341,780
56.51
76,697,540
25,310,188
25,310,188
14,302,787
N/AKENTUCKY
158,804,908
37,443,073
196,247,981
19.08
152,352,923
70.55
215,950,281
41,202,167
37,443,073
26,416,088
N/ALOUISIANA
1,078,512,169
132,917,149
1,211,429,318
10.97
731,960,000
65.51
1,117,325,599
122,592,157
122,592,157
80,310,122
N/AMAINE
99,957,958
60,958,342
160,916,300
33.00
110,324,530
62.57
176,321,768
58,186,183
58,186,183
36,407,095
N/AMARYLAND
22,226,467
120,873,531
143,099,998
33.00
80,116,623
50.00
160,233,246
52,876,971
52,876,971
26,438,486
N/AMASSACHUSETTS
469,653,946
105,635,054
575,289,000
18.36
320,466,492
50.00
640,932,984
117,688,658
105,635,054
52,817,527
N/AMICHIGAN
133,258,800
304,765,552
438,024,352
33.00
278,438,100
66.39
419,397,650
138,401,225
138,401,225
91,884,573
N/AMISSISSIPPI
182,608,033
0
182,608,033
0.00
160,233,246
73.43
218,212,238
0
0
0
N/AMISSOURI
521,946,524
207,234,618
729,181,142
28.42
497,773,773
61.37
811,102,775
230,516,896
207,234,618
127,179,885
N/ANEVADA
73,560,000
0
73,560,000
0.00
48,595,328
59.74
81,344,707
0
0
0
N/ANEW HAMPSHIRE
92,675,916
94,753,948
187,429,864
33.00
168,217,088
50.00
336,434,176
111,023,278
94,753,948
47,376,974
N/ANEW JERSEY
736,742,539
357,370,461
1,094,113,000
32.66
676,394,441
50.00
1,352,788,882
441,861,843
357,370,461
178,685,231
N/ANEW YORK
2,418,869,368
605,000,000
3,023,869,368
20.01
1,687,702,633
50.00
3,375,405,266
675,333,468
605,000,000
302,500,000
N/ANORTH CAROLINA
193,201,966
236,072,627
429,274,593
33.00
309,959,394
65.51
473,148,212
156,138,910
156,138,910
102,286,600
N/AOHIO
535,731,956
93,432,758
629,164,714
14.85
426,850,861
63.58
671,360,272
99,698,919
93,432,758
59,404,548
N/APENNSYLVANIA
388,207,319
579,199,682
967,407,001
33.00
589,710,881
54.28
1,086,423,878
358,519,880
358,519,880
194,604,591
N/ARHODE ISLAND
108,503,167
2,397,833
110,901,000
2.16
68,296,138
51.26
133,234,760
2,880,720
2,397,833
1,229,129
N/ASOUTH CAROLINA
366,681,364
72,076,341
438,757,705
16.43
344,107,463
70.43
488,580,808
80,260,965
72,076,341
50,763,367
N/ATENNESSEE
0
0
0
0.00
53,100,000
66.13
80,296,386
0
0
0
N/ATEXAS
1,220,515,401
292,513,592
1,513,028,993
19.33
1,004,741,257
59.30
1,694,336,015
327,565,642
292,513,592
173,460,560
N/AVERMONT
19,979,252
9,071,297
29,050,549
31.23
23,640,971
56.04
42,185,887
13,172,925
9,071,297
5,083,555
N/AVIRGINIA
129,313,480
7,770,268
137,083,748
5.67
92,050,138
50.00
184,100,276
10,435,289
7,770,268
3,885,134
N/AWASHINGTON
171,725,815
163,836,435
335,562,250
33.00
194,381,315
50.00
388,762,630
128,291,668
128,291,668
64,145,834
N/AWEST VIRGINIA
66,962,606
18,887,045
85,849,651
22.00
70,922,912
72.04
98,449,350
21,658,997
18,887,045
13,606,227
N/ATotal
13,402,460,846
4,118,758,904
17,521,219,750

11,029,697,203

19,545,491,877
3,709,617,180
3,410,261,852
1,921,150,660**LOW DSH STATES**ALASKA
$2,506,827
$17,611,765
$20,118,592
33.00
$21,402,636
50.00
$42,805,272
$14,125,740
$14,125,740
$7,062,870
LOW DSHARKANSAS
2,422,649
819,351
3,242,000
25.27
45,325,292
70.17
64,593,547
16,324,734
819,351
574,939
LOW DSHDELAWARE
0
7,069,000
7,069,000
33.00
9,512,282
55.67
17,086,909
5,638,680
5,638,680
3,139,053
LOW DSHHAWAII
0
0
0
0.00
10,240,000
51.86
19,745,469
0
0
0
LOW DSHIDAHO
2,081,429
0
2,081,429
0.00
17,271,044
71.00
24,325,414
0
0
0
LOW DSHIOWA
12,011,250
0
12,011,250
0.00
41,378,149
59.59
69,438,075
0
0
0
LOW DSHMINNESOTA
24,240,000
5,257,214
29,497,214
17.82
78,476,334
50.00
156,952,668
27,973,278
5,257,214
2,628,607
LOW DSHMONTANA
237,048
0
237,048
0.00
11,926,371
66.00
18,070,259
0
0
0
LOW DSHNEBRASKA
6,449,102
1,811,337
8,260,439
21.93
29,733,219
55.76
53,323,563
11,692,713
1,811,337
1,010,002
LOW DSHNEW MEXICO
6,490,015
254,786
6,744,801
3.78
21,402,636
69.07
30,986,877
1,170,535
254,786
175,981
LOW DSHNORTH DAKOTA
214,523
988,478
1,203,001
33.00
10,036,360
52.27
19,200,995
6,336,328
988,478
516,677
LOW DSHOKLAHOMA
20,019,969
3,273,248
23,293,217
14.05
38,049,129
64.00
59,451,764
8,354,379
3,273,248
2,094,879
LOW DSH( print page 5459)OREGON
11,437,908
19,975,092
31,413,000
33.00
47,561,414
62.44
76,171,387
25,136,558
19,975,092
12,472,447
LOW DSHSOUTH DAKOTA
321,120
751,299
1,072,419
33.00
11,604,719
56.19
20,652,641
6,815,372
751,299
422,155
LOW DSHUTAH
3,621,116
934,586
4,555,702
20.51
20,612,808
69.61
29,611,849
6,074,765
934,586
650,565
LOW DSHWISCONSIN
6,609,524
4,492,011
11,101,535
33.00
99,326,563
59.74
166,264,752
54,867,368
4,492,011
2,683,527
LOW DSHWYOMING
0
0
0
0.00
237,807
50.00
475,614
0
0
0
LOW DSHTotal Low DSH States
98,662,480
63,238,167
161,900,647

514,096,763

869,157,055
184,510,449
58,321,822
33,431,702Total
13,501,123,326
4,181,997,071
17,683,120,397

11,543,793,966

20,414,648,932
3,894,127,630
3,468,583,674
1,954,582,362
 
 
 Key to Addendum 4—Preliminary IMD DSH Limits for FY 2015
[The preliminary FY 2015 IMD DSH Limits for the Non-Low DSH States are presented in the top section of this addendum and the preliminary FY 2015 IMD DSH Limits for the Low-DSH States are presented in the bottom section of the addendum]
Column
DescriptionColumn 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 2015 Federal Share DSH Allotment.
                             This column contains the states' preliminary FY 2015 DSH allotments from Column J Addendum 1.Column G
FY 2015 FMAP.Column H
FY 2015 DSH Allotments in Total Computable, Col. F/G.
                             This column contains states' FY 2015 total computable DSH allotment (determined as Column F/Column G).Column I
Applicable Percentage Applied to FY 2015 Allotments in TC, Col E x Col H.
                             This column contains the applicable percentage of FY 2014 total computable DSH allotment (calculated as the percentage in Column E multiplied by the amount in Column H).Column J
FY 2015 TC IMD DSH Limit. Lesser of Col.
                             I or C. This column contains the total computable FY 2015 TC IMD DSH Limit equal to the lesser of the amount in Column I or Column C.Column K
FY 2015 IMD DSH Limit in Federal Share, Col. G × J.
                             This column contains the FY 2015 Federal Share IMD DSH limit determined by converting the total computable FY 2015 IMD DSH Limit from Column J into a federal share amount by multiplying it by the FY 2015 FMAP in Column G.
 
 
 Addendum 4—Preliminary IMD DSH Limits for FY 2015
State
Inpatient hospital services FY 95 DSH total computable
IMD and mental health services FY 95 DSH total computable
Total inpatient & IMD & mental health FY 95 DSH total computable Col B + C
Applicable
                             percent 
                             Col C/D
FY 2015 allotment in FS
FY 2015 FMAPs
                             (percent)
FY 2015 
                             allotments in TC Col. F/G
Applicable 
                             percentage  
                             applied to FY 2015  
                             allotments in TC  
                             Col E × Col H
FY 2015 TC IMD Limit (Lesser Of Col I or Col C)
FY 2015 TC IMD limit in FS 
                             Col G × J
MMA LOW DSH StatusA
B
C
D
E
F
G
H
I
J
K
LALABAMA
$413,006,229
$4,451,770
$417,457,999
1.07
$333,186,701
68.99
$482,949,269
$5,150,169
$4,451,770
$3,071,276
N/AARIZONA
93,916,100
28,474,900
122,391,000
23.27
109,707,817
68.46
160,250,974
37,283,219
28,474,900
19,493,917
N/ACALIFORNIA
2,189,879,543
1,555,919
2,191,435,462
0.07
1,187,824,131
50.00
2,375,648,262
1,686,710
1,555,919
777,960
N/ACOLORADO
173,900,441
594,776
174,495,217
0.34
100,226,893
51.01
196,484,793
669,729
594,776
303,395
N/ACONNECTICUT
303,359,275
105,573,725
408,933,000
25.82
216,706,796
50.00
433,413,592
111,893,849
105,573,725
52,786,863
N/ADISTRICT OF COLUMBIA
39,532,234
6,545,136
46,077,370
14.20
66,366,456
70.00
94,809,223
13,467,332
6,545,136
4,581,595
N/AFLORIDA
184,468,014
149,714,986
334,183,000
33.00
216,706,796
59.72
362,871,393
119,747,560
119,747,560
71,513,243
N/AGEORGIA
407,343,557
0
407,343,557
0.00
291,199,759
66.94
435,016,073
0
0
0
N/AILLINOIS
315,868,508
89,408,276
405,276,784
22.06
232,959,806
50.76
458,943,668
101,247,749
89,408,276
45,383,641
N/AINDIANA
79,960,783
153,566,302
233,527,085
33.00
231,605,390
66.52
348,174,068
114,897,442
114,897,442
76,429,779
N/AKANSAS
11,587,208
76,663,508
88,250,716
33.00
44,695,778
56.63
78,925,972
26,045,571
26,045,571
14,749,607
N/AKENTUCKY
158,804,908
37,443,073
196,247,981
19.08
157,112,428
69.94
224,638,873
42,859,905
37,443,073
26,187,685
N/ALOUISIANA
1,078,512,169
132,917,149
1,211,429,318
10.97
743,671,360
62.05
1,198,503,400
131,498,927
131,498,927
81,595,084
N/AMAINE
99,957,958
60,958,342
160,916,300
33.00
113,771,068
61.88
183,857,576
60,673,000
60,673,000
37,544,452
N/AMARYLAND
22,226,467
120,873,531
143,099,998
33.00
82,619,466
50.00
165,238,932
54,528,848
54,528,848
27,264,424
N/AMASSACHUSETTS
469,653,946
105,635,054
575,289,000
18.36
330,477,865
50.00
660,955,730
121,365,252
105,635,054
52,817,527
N/AMICHIGAN
133,258,800
304,765,552
438,024,352
33.00
287,136,507
65.54
438,108,799
144,575,904
144,575,904
94,755,047
N/AMISSISSIPPI
182,608,033
0
182,608,033
0.00
165,238,933
73.58
224,570,444
0
0
0
N/AMISSOURI
521,946,524
207,234,618
729,181,142
28.42
513,324,226
63.45
809,021,633
229,925,432
207,234,618
131,490,365
N/ANEVADA
73,560,000
0
73,560,000
0.00
50,113,446
64.36
77,864,273
0
0
0
N/ANEW HAMPSHIRE
92,675,916
94,753,948
187,429,864
33.00
173,472,190
50.00
346,944,380
114,491,645
94,753,948
47,376,974
N/ANEW JERSEY
736,742,539
357,370,461
1,094,113,000
32.66
697,525,004
50.00
1,395,050,008
455,665,607
357,370,461
178,685,231
N/ANEW YORK
2,418,869,368
605,000,000
3,023,869,368
20.01
1,740,426,463
50.00
3,480,852,926
696,430,885
605,000,000
302,500,000
N/ANORTH CAROLINA
193,201,966
236,072,627
429,274,593
33.00
319,642,526
65.88
485,189,019
160,112,376
160,112,376
105,482,034
N/AOHIO
535,731,956
93,432,758
629,164,714
14.85
440,185,682
62.64
702,722,992
104,356,372
93,432,758
58,526,280
N/APENNSYLVANIA
388,207,319
579,199,682
967,407,001
33.00
608,133,449
51.82
1,173,549,689
387,271,397
387,271,397
200,684,038
N/ARHODE ISLAND
108,503,167
2,397,833
110,901,000
2.16
70,429,709
50.00
140,859,418
3,045,575
2,397,833
1,198,917
N/ASOUTH CAROLINA
366,681,364
72,076,341
438,757,705
16.43
354,857,380
70.64
502,346,234
82,522,262
72,076,341
50,914,727
N/ATENNESSEE*
0
0
0
0.00
53,100,000
64.99
81,704,878
0
0
0
N/ATEXAS
1,220,515,401
292,513,592
1,513,028,993
19.33
1,036,129,374
58.05
1,784,891,256
345,072,669
292,513,592
169,804,140
N/AVERMONT**
19,979,252
9,071,297
29,050,549
31.23
24,379,515
56.21
43,372,202
13,543,363
9,071,297
5,098,976
N/AVIRGINIA
129,313,480
7,770,268
137,083,748
5.67
94,925,784
50.00
189,851,568
10,761,287
7,770,268
3,885,134
N/AWASHINGTON
171,725,815
163,836,435
335,562,250
33.00
200,453,788
50.03
400,667,176
132,220,168
132,220,168
66,149,750
N/AWEST VIRGINIA
66,962,606
18,887,045
85,849,651
22.00
73,138,544
71.35
102,506,719
22,551,624
18,887,045
13,475,907
N/ATotal
13,402,460,846
4,118,758,904
17,521,219,750

11,361,451,030

20,240,755,414
3,845,561,828
3,471,761,983
1,944,527,968**LOW DSH STATES**ALASKA
2,506,827
17,611,765
20,118,592
33.00
22,071,255
50.00
44,142,510
14,567,028
14,567,028
7,283,514
LOW DSHARKANSAS
2,422,649
819,351
3,242,000
25.27
46,741,254
70.88
65,944,207
16,666,086
819,351
580,756
LOW DSHDELAWARE
0
7,069,000
7,069,000
33.00
9,809,445
53.63
18,290,966
6,036,019
6,036,019
3,237,117
LOW DSHHAWAII
0
0
0
0.00
10,559,898
52.23
20,218,070
0
0
0
LOW DSHIDAHO
2,081,429
0
2,081,429
0.00
17,810,592
71.75
24,823,125
0
0
0
LOW DSHIOWA
12,011,250
0
12,011,250
0.00
42,670,802
55.54
76,828,956
0
0
0
LOW DSHMINNESOTA
24,240,000
5,257,214
29,497,214
17.82
80,927,935
50.00
161,855,870
28,847,163
5,257,214
2,628,607
LOW DSHMONTANA
237,048
0
237,048
0.00
12,298,951
65.90
18,663,052
0
0
0
LOW DSH( print page 5462)NEBRASKA
6,449,102
1,811,337
8,260,439
21.93
30,662,084
53.27
57,559,760
12,621,620
1,811,337
964,899
LOW DSHNEW MEXICO
6,490,015
254,786
6,744,801
3.78
22,071,255
69.65
31,688,808
1,197,050
254,786
177,458
LOW DSHNORTH DAKOTA
214,523
988,478
1,203,001
33.00
10,349,895
50.00
20,699,790
6,830,931
988,478
494,239
LOW DSHOKLAHOMA
20,019,969
3,273,248
23,293,217
14.05
39,237,784
62.30
62,981,997
8,850,460
3,273,248
2,039,234
LOW DSHOREGON
11,437,908
19,975,092
31,413,000
33.00
49,047,232
64.06
76,564,521
25,266,292
19,975,092
12,796,044
LOW DSHSOUTH DAKOTA
321,120
751,299
1,072,419
33.00
11,967,251
51.64
23,174,382
7,647,546
751,299
387,971
LOW DSHUTAH
3,621,116
934,586
4,555,702
20.51
21,256,752
70.56
30,125,782
6,180,197
934,586
659,444
LOW DSHWISCONSIN
6,609,524
4,492,011
11,101,535
33.00
102,429,524
58.27
175,784,321
58,008,826
4,492,011
2,617,495
LOW DSHWYOMING
0
0
0
0.00
245,236
50.00
490,472
0
0
0
LOW DSHTotal Low DSH States
98,662,480
63,238,167
161,900,647

530,157,145

909,836,589
192,719,219
59,160,449
33,866,778Total
13,501,123,326
4,181,997,071
17,683,120,397

11,891,608,175

21,150,592,003
4,038,281,047
3,530,922,432
1,978,394,746* Tennessee's DSH allotment for FY 2015 determined under section 1923(f)(6)(A)(vi) of the Act.** Vermont's FMAP for FY 2015 determined in accordance with section 1905(z)(1)(A) of the Act


[FR Doc. 2016-01836 Filed 2-1-16; 8:45 am] BILLING CODE 4120-01-P