Vendor shall complete the following Verifications: Verification One: Verify the state has permitted hospitals to retain DSH payments. Verification Two: Verify state procedure performed ensure DSH payments do not exceed hospital specific DSH limits. Verification Three: Verify state procedures performed ensures the uncompensated care cost is included in hospital specific DSH limit. Verification Four: Verify all payments have been included in the hospital specific DSH limits. Verification Five: Verify the state retains all documentation related to DSH computations. Verification Six: Verify the state has detailed methodology in place covering DSH payments. Vendor shall compare Provider Data Summary Schedule (PDSS) to the DSH Reporting Schedule, noting any differences pursuant to 42 CFR 447.299. Vendor shall issue independent examination in accordance with Attestation standards established by the American Institute of Certified Public Accountants (AICPA). Vendor shall follow specific steps developed by Vendor for each hospital, depending on DSH level of risk. Vendor shall perform the following DSH Audit procedures: Timelines for DSH audits are based on a facility’s fiscal year end. Vendor shall work with each DSH hospital according to their fiscal year end to coordinate audits. Request from each DSH hospital detailed uninsured patient data and Medicaid and Medicaid eligible patient data for the provider’s fiscal year. Ensure hospital meets minimum requirements to participate in DSH program. Review the ratio of costs to charges and per diems for reasonableness and investigate as necessary. Obtain Medicaid Management Information System (MMIS) summary report from the state and compare to provider submitted data. Perform detailed analysis of uninsured charges. Verify payments from non-governmental/non-third-party payers. Validate data from each hospital receiving DSH payments to determine its hospital specific DSH limit, its total annual uncompensated care cost, and amount of DSH payments received. Prepare PDSS.
