--- title: Examining Medicare DSH Qualification and 340b Status Post Medicaid Redetermination description: The resumption of Medicaid redeterminations is having a substantial impact on Medicare DSH and 340B hospitals. Hospitals are at risk of reduced Medicare DSH payments / 340B savings. image: https://public.govdataservices.com/hubfs/A%20male%20doctor%20in%20coat%20in%20front%20of%20a%20blue%20wall%20holding%20a%20pill%20between%20his%20fingers%20with%20lines%20and%20white%20crosses%20in%20circles-1.jpeg --- [Skip to content](https://public.govdataservices.com/the-scoop/examining-medicare-dsh-qualification-and-340b-status-post-medicaid-redetermination#main-content) Close - [Services](https://public.govdataservices.com/services-page) - [Medicare DSH](https://public.govdataservices.com/medicare-dsh) - [SSI Realignment](https://govdataservices-21378692.hs-sites.com/medicare-dsh#SSI) - [340B MA Underpayments](https://public.govdataservices.com/340b-medicare-advantage-underpayments) - [Medicare Bad Debt](https://public.govdataservices.com/medicare-bad-debt) - [Worksheet S-10 Uncompensated Care](https://public.govdataservices.com/s-10) - [Transfer DRG](https://public.govdataservices.com/transfer-drg) - [Medicare ID & Shadow Billing](https://public.govdataservices.com/medicare-id-shadow-billing) - [MBI ID Finder](https://public.govdataservices.com/mbi-id-finder) - [MIDaS Insurance ID](https://public.govdataservices.com/midas-insurance-id) - [Annual Wellness Visit](https://public.govdataservices.com/annual-wellness-visit) - [Eligibility & Other Services](https://public.govdataservices.com/eligibility-and-other) - [Bundle & Save](https://public.govdataservices.com/bundle-and-save) - [Demo](https://public.govdataservices.com/demo-diagnostics-review) - Resources - [Links](https://public.govdataservices.com/links) - [Blog](https://public.govdataservices.com/the-scoop) - [Contact Us](https://public.govdataservices.com/contact-us) SEARCH [Client Login](https://www.govdataservices.com/gdswebsite/DesktopDefault.aspx) [![GDSlogo\_avenir\_2](https://public.govdataservices.com/hs-fs/hubfs/GDSlogo_avenir_2.png?width=1194&height=340&name=GDSlogo_avenir_2.png)](https://public.govdataservices.com/) - [Services](https://public.govdataservices.com/services-page) - [Medicare DSH](https://public.govdataservices.com/medicare-dsh) - [SSI Realignment](https://govdataservices-21378692.hs-sites.com/medicare-dsh#SSI) - [340B MA Underpayments](https://public.govdataservices.com/340b-medicare-advantage-underpayments) - [Medicare Bad Debt](https://public.govdataservices.com/medicare-bad-debt) - [Worksheet S-10 Uncompensated Care](https://public.govdataservices.com/s-10) - [Transfer DRG](https://public.govdataservices.com/transfer-drg) - [Medicare ID & Shadow Billing](https://public.govdataservices.com/medicare-id-shadow-billing) - [MBI ID Finder](https://public.govdataservices.com/mbi-id-finder) - [MIDaS Insurance ID](https://public.govdataservices.com/midas-insurance-id) - [Annual Wellness Visit](https://public.govdataservices.com/annual-wellness-visit) - [Eligibility & Other Services](https://public.govdataservices.com/eligibility-and-other) - [Bundle & Save](https://public.govdataservices.com/bundle-and-save) - [Demo](https://public.govdataservices.com/demo-diagnostics-review) - Resources - [Links](https://public.govdataservices.com/links) - [Blog](https://public.govdataservices.com/the-scoop) - [Contact Us](https://public.govdataservices.com/contact-us) [Client Login](https://www.govdataservices.com/gdswebsite/DesktopDefault.aspx) [Chris Cusimano](https://public.govdataservices.com/the-scoop/author/chris-cusimano) Dec 12, 2024, 1:06:06 PM 3 min read # Examining Medicare DSH Qualification and 340b Status Post Medicaid Redetermination [Previous](https://public.govdataservices.com/the-scoop/gds-again-achieved-soc2-type-ii-certification) [Next](https://public.govdataservices.com/the-scoop/cms-released-ffy-2023-ssi-file-for-inpatient-rehab-facilities) The resumption of Medicaid redeterminations is having a substantial impact on Medicare DSH and 340B hospitals. Hospitals are at risk of reduced Medicare DSH payments / 340B savings or even exclusion from one or both programs altogether. Here are key points: 1\. Medicaid Enrollment Trends Peak Enrollment: National Medicaid enrollment reached approximately 94 million participants in April 2023, significantly up from February 2020 due to the suspension of Medicaid Redeterminations (eligibility checks) during the COVID-19 pandemic. Resumption of Redeterminations: These checks resumed in April 2023, leading to a decline in Medicaid enrollment as about 25 million individuals lost their Medicaid coverage, with many not re-enrolling. 2\. 340B Registration Process Timeline: Providers can register for the 340B Drug Pricing Program during specific windows (1st–15th days of January, April, July, and October). Approved registrations become effective on the 1st day of the third month following registration (e.g., a January 10 registration becomes effective April 1). Connection to Medicare Cost Reports: The Medicare Cost Report, typically filed five months after the end of a hospital’s fiscal year, determines the Disproportionate Share Hospital (DSH) percentage, which is critical for 340B program eligibility. 3\. Hospital Eligibility and Strategic Considerations Eligibility Thresholds: Many hospitals qualify for the 340B program under a DSH adjustment percentage above 11.75%. Some could qualify with a lower threshold of 8% under a different entity type. Risk of Ineligibility: If a hospital's DSH percentage drops below the required threshold for its registered entity type, it immediately loses 340B program benefits after filing its cost report. Strategic Oversight: Hospitals must closely monitor Medicaid share trends and project DSH percentages. Timely action (e.g., adjusting entity type or re-registering during allowed windows) can prevent disqualification and avoid losing millions in benefits. 4\. Implications of Medicaid Enrollment Declines Declining Medicaid enrollment directly affects hospitals' DSH percentages, potentially reducing their eligibility for 340B program benefits. Providers unaware of alternate pathways for 340B eligibility may miss out on valuable program benefits due to delays in re-registration or incorrect assumptions about eligibility thresholds. Recommendation: Hospitals and providers should: Monitor Medicaid trends and their impact on DSH percentages. Evaluate eligibility under alternate 340B classifications proactively. Register strategically during open periods to maintain uninterrupted 340B program participation. Consider implementing operational strategies to maximize Medicaid eligible day counts. Careful planning can mitigate the financial risks associated with program ineligibility and Medicaid share declines. Contact Adam Blackwell at [adamblackwell@govdataservices.com](mailto:adamblackwell@govdataservices.com) for assistance related to this article. ![avatar](https://public.govdataservices.com/hs-fs/hubfs/chriscusimano.jpg?width=290&name=chriscusimano.jpg) #### [Chris Cusimano](https://public.govdataservices.com/the-scoop/author/chris-cusimano) ## RELATED ARTICLES ### [Chris Cusimano Jun 10, 2026, 10:43:33 AM 3 min read Medicare Advantage 340B Underpayment Settlements: What the Public Record Reveals One of the largest reimbursement issues affecting 340B hospitals today remains largely invisible to the public. Start Reading](https://public.govdataservices.com/the-scoop/medicare-advantage-340b-underpayment-settlements-what-the-public-record-reveals) ### [Chris Cusimano Jul 28, 2026, 9:45:21 AM 2 min read Medicare DSH Win: Courts Again Vacate 1115 Exclusion Rule On July 27 a decision in Covenant Medical Center v. Kennedy vacated the CMS 1115 Exclusion Rule. This is a major Medicare DSH ... Start Reading](https://public.govdataservices.com/the-scoop/medicare-dsh-win-courts-again-vacate-1115-exclusion-rule) ### [Chris Cusimano Mar 2, 2026, 3:19:03 PM 1 min read 340B MA Underpayments: Current Settlement Offers & Other Happenings Recently, a Medicare Advantage (MA) plan began issuing settlement offers to hospitals for 340B MA Underpayments. Active pursuit ... Start Reading](https://public.govdataservices.com/the-scoop/340b-ma-underpayments-current-settlement) [![gds-logo-1](https://public.govdataservices.com/hs-fs/hubfs/gds-logo-1.png?width=500&height=150&name=gds-logo-1.png)](https://public.govdataservices.com/) **Get in Touch** Government Data Services 3200 W. 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All rights reserved - [Site Use Agreement](https://public.govdataservices.com/terms-of-use) - [Confidentiality and Privacy](https://public.govdataservices.com/privacy) ```json { "@context" : "http://schema.org", "@type" : "Organization", "knowsLanguage" : "en", "name" : "", "url" : "https://public.govdataservices.com/the-scoop/examining-medicare-dsh-qualification-and-340b-status-post-medicaid-redetermination" } ``` ```json { "@context" : "http://schema.org", "@type" : "BlogPosting", "abstract" : "The resumption of Medicaid redeterminations is having a substantial impact on Medicare DSH and 340B hospitals. Hospitals are at risk of reduced Medicare DSH payments / 340B savings.", "author" : { "@type" : "Person", "name" : "Chris Cusimano" }, "dateModified" : "December 12, 2024 6 PM", "datePublished" : "December 12, 2024 6 PM", "headline" : "Examining Medicare DSH Qualification and 340b Status Post Medicaid Redetermination", "image" : "https://21378692.fs1.hubspotusercontent-na1.net/hubfs/21378692/A%20male%20doctor%20in%20coat%20in%20front%20of%20a%20blue%20wall%20holding%20a%20pill%20between%20his%20fingers%20with%20lines%20and%20white%20crosses%20in%20circles-1.jpeg", "inLanguage" : "en", "keywords" : "[340B, Legal News, Disproportionate Share Hospital (DSH)]", "mainEntityOfPage" : { "@type" : "WebPage" }, "name" : "Examining Medicare DSH Qualification and 340b Status Post Medicaid Redetermination", "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject", "url" : "" }, "name" : "" }, "text" : "The resumption of Medicaid redeterminations is having a substantial impact on Medicare DSH and 340B hospitals. Hospitals are at risk of reduced Medicare DSH payments / 340B savings or even exclusion from one or both programs altogether. Here are key points: 1. Medicaid Enrollment Trends Peak Enrollment: National Medicaid enrollment reached approximately 94 million participants in April 2023, significantly up from February 2020 due to the suspension of Medicaid Redeterminations (eligibility checks) during the COVID-19 pandemic. Resumption of Redeterminations: These checks resumed in April 2023, leading to a decline in Medicaid enrollment as about 25 million individuals lost their Medicaid coverage, with many not re-enrolling. 2. 340B Registration Process Timeline: Providers can register for the 340B Drug Pricing Program during specific windows (1st–15th days of January, April, July, and October). Approved registrations become effective on the 1st day of the third month following registration (e.g., a January 10 registration becomes effective April 1). Connection to Medicare Cost Reports: The Medicare Cost Report, typically filed five months after the end of a hospital’s fiscal year, determines the Disproportionate Share Hospital (DSH) percentage, which is critical for 340B program eligibility. 3. Hospital Eligibility and Strategic Considerations Eligibility Thresholds: Many hospitals qualify for the 340B program under a DSH adjustment percentage above 11.75%. Some could qualify with a lower threshold of 8% under a different entity type. Risk of Ineligibility: If a hospital's DSH percentage drops below the required threshold for its registered entity type, it immediately loses 340B program benefits after filing its cost report. Strategic Oversight: Hospitals must closely monitor Medicaid share trends and project DSH percentages. Timely action (e.g., adjusting entity type or re-registering during allowed windows) can prevent disqualification and avoid losing millions in benefits. 4. Implications of Medicaid Enrollment Declines Declining Medicaid enrollment directly affects hospitals' DSH percentages, potentially reducing their eligibility for 340B program benefits. Providers unaware of alternate pathways for 340B eligibility may miss out on valuable program benefits due to delays in re-registration or incorrect assumptions about eligibility thresholds. Recommendation: Hospitals and providers should: Monitor Medicaid trends and their impact on DSH percentages. Evaluate eligibility under alternate 340B classifications proactively. Register strategically during open periods to maintain uninterrupted 340B program participation. Consider implementing operational strategies to maximize Medicaid eligible day counts. Careful planning can mitigate the financial risks associated with program ineligibility and Medicaid share declines. Contact Adam Blackwell at adamblackwell@govdataservices.com for assistance related to this article.", "url" : "https://public.govdataservices.com/the-scoop/examining-medicare-dsh-qualification-and-340b-status-post-medicaid-redetermination", "wordCount" : "637" } ``` ```json { "@context" : "https://schema.org", "@type" : "BlogPosting", "author" : { "@type" : "Person", "name" : "Chris Cusimano", "url" : "https://public.govdataservices.com/the-scoop/author/chris-cusimano" }, "dateModified" : "2024-12-12T18:14:02.981Z", "datePublished" : "2024-12-12T18:06:06.000Z", "headline" : "Examining Medicare DSH Qualification and 340b Status Post Medicaid Redetermination", "image" : [ "https://public.govdataservices.com/hubfs/A%20male%20doctor%20in%20coat%20in%20front%20of%20a%20blue%20wall%20holding%20a%20pill%20between%20his%20fingers%20with%20lines%20and%20white%20crosses%20in%20circles-1.jpeg" ], "mainEntityOfPage" : { "@id" : "https://public.govdataservices.com/the-scoop/examining-medicare-dsh-qualification-and-340b-status-post-medicaid-redetermination", "@type" : "WebPage" }, "publisher" : { "@type" : "Organization", "logo" : { "@type" : "ImageObject" } } } ```