Reimbursement Unit

In-Patient Hospital Resources

For questions, contact

801-538-6149

Utah Medicaid DRG Calculators:

Download MS-DRG Calculator (versions 29-30) for discharges on or after October 1, 2011 (The calculator is now named to coincide with the MS-DRG version.)

Download MS-DRG Calculator (version 16) for discharges between October 1, 2009 and September 30, 2011

Download DRG Calculator (version 13) for discharges between October 1, 2001 and September 30, 2009.

Download DRG Calculator (version 3) for discharges prior to October 1, 2001.

Utah Medicaid DRG Factors:

Current and historical DRG base rates, overall outlier and hospital specific outlier payment factors can be found here.

Disproportionate Share (DSH) Expenditures by Year

Medicaid Disproportionate Share (DSH) Expenditures spent by Federal Fiscal Year.

FFY 2012
FFY 2011
FFY 2010
FFY 2009

Disproportionate Share (DSH) Add On by Year

Medicaid Disproportionate Share (DSH) Add On spent by Federal Fiscal Year.

FFY 2013

DSH Uncompensated Care Cost Survey

Hospitals may download an Excel version of the survey to be used in determining qualification for Disproportionate Share (DSH) hospital payments at Disproportionate Share Hospital Survey & Uncompensated Care Survey by clicking here. This survey is due each August 1st and is used to determine eligibility for the subsequent federal fiscal year DSH progrm.

Government hospitals can download an Excel version of the Uncompensated Care and DSH Survey to be used in determining qualification for Disproportionate Share Hospital (DSH) payments by clicking here.

Hospital Annual DSH Audit Survey

As required by CMS, DSH audits are required of all hospitals that received Medicaid Disproportionate Share dollars for federal fiscal year 2010. To download this survey, please click here.

DSH Audit Reports

DSH Audit Report (2005).pdf
DSH Audit Report (2006).pdf
DSH Audit Report (2007).pdf
DSH Audit Report (2008).pdf
DSH Audit Report (2009).pdf

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://ecfr.gpoaccess.gov)
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)

Shaken Baby Syndrome by Year

Utah Medicaid Payments for Shaken Baby Syndrome spent by State Fiscal Year.

SFY 2012
SFY 2011
SFY 2010