Inpatient Hospital Resources Disproportionate Share (DSH) Audits

Annual DSH Audit Survey for Hospitals

As required by CMS, DSH audits are required of all hospitals that received Medicaid Disproportionate Share dollars.
To download this survey, please click here

For IMD (State Hospital), there is a separate survey. To download the IMD survey, please click here

The Annual DSH Audit Survey is due by each April 1st.

Federal Regulations

Each DSH payment is funded by State and Federal funds with Federal funds being the largest share (about 70 Percent for State fiscal year 2012).

The references below outline the federal requirements, which must be met:

  • Electronic Code of Federal Regulations (http://www.ecfr.gov/) opens in a new tab
  • 42 CFR 447.299 – Reporting Requirements
  • 42 CFR 455.300 – Independent Certified Audit of State Disproportionate Share Payment Adjustments (Purpose)
  • 42 CFR 455.301 – Independent Certified Audit of State Disproportionate Share Payment Adjustments (Definitions)
  • 42 CFR 455.304 – Condition for Federal financial participation (FFP)

Inpatient Resources

Please click on one of the following links to be directed to specific resources available for that category:


Diagnosis-Related Group (DRG)


Disproportionate Share (DSH)
     - (DSH) Expenditures
     - (DSH) Audits

Graduate Medical Education (GME)


Hospital Assessment


Shaken Baby Syndrome

Contact Information

General Information

Via U.S. Post Office

Via UPS or FedEx

DHHS, Division of Integrated Healthcare

ORCA/Reimbursement

PO Box 143325

Salt Lake City, UT  84114-3325

DHHS, Division of Integrated Healthcare

ORCA/Reimbursement

288 North 1460 West

Salt Lake City, UT  84116-3231

If you are unsure about an issue, please ask questions.