Disproportionate Share Hospital Payments

Disproportionate Share Hospital (DSH) payments provide financial assistance to hospitals that serve a large number of low-income patients such as people on Medicaid and the uninsured. Medicaid DSH payments are the largest source of federal funding for uncompensated care.


Scheduled Payment Dates

Disproportionate Share Hospital payments are scheduled to be made each summer.

Payment History

2011 - 2013 [PDF] [RTF]

Additional DSH funds were available to hospitals as a part of intergovernmental agreements between AHCCCS, and a political subdivision / tribal government /State university using local funds to match federal DSH funding for DSH years 2010 and 2011.

IGA Allocations for 2010 DSH [PDF]

NOTE: - Hospitals must have final IGAs to AHCCCS by April 15, 2012 so that AHCCCS can make final Pool 5 reconciliation and distributions by June 1, 2012.

Notice of DSH Funding Opportunities

AHCCCS has posted information about opportunities to fund Graduate Medical Education (GME) and Disproportionate Share Hospital (DSH) payments.

For more information visit the GME page.

Proposed amended DSH pages in 1115 Waiver [PDF]

Template IGA Agreement for 2010 DSH [Word]

Template IGA Agreement for 2011 DSH [Word]

Template IGA Agreement for 2012 DSH [Word]

Template IGA Agreement for 2013 DSH [Word]

FY 2011 Changes to DSH Funding

Mon Dec 6, 2010
AHCCCS will be submitting a waiver to CMS to implement legislatively mandated changes to the Disproportionate Share Hospital (DSH) Payment methodology. As part of the FY 2011 budget, the legislature eliminated pool 3 from DSH funding. The FY 2011 budget authorized a total of $9.3 million for Pool 1, 1A, 2 and 2A. The proposed waiver language also includes $16 million in DSH funding that can be allocated if local dollars are voluntarily made available.

Any comments regarding the proposed language should be submitted to AHCCCS by January 3, 2011. Proposed changes to the waiver regarding DSH are included below.

FY 2011 Proposed Waiver DSH Changes 1/26/11 [PDF]


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