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Notice

Medicaid Program; Final FY 2013 and Preliminary FY 2015 Disproportionate Share Hospital Allotments, and Final FY 2013 and Preliminary FY 2015 Institutions for Mental Diseases Disproportionate Share Hospital Limits

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Start Preamble

AGENCY:

Centers for Medicare & Medicaid Services (CMS), HHS.

ACTION:

Notice.

SUMMARY:

This notice announces the final federal share disproportionate share hospital (DSH) allotments for federal fiscal year (FY) 2013 and the preliminary federal share DSH allotments for FY 2015. This notice also announces the final FY 2013 and the preliminary FY 2015 limitations on aggregate DSH payments that states may make to institutions for mental disease and other mental health facilities. In addition, this notice includes background information describing the methodology for determining the amounts of states' FY DSH allotments.

DATES:

This notice is effective March 3, 2016. The final allotments and limitations set forth in this notice are effective for the fiscal years specified.

Start Further Info

FOR FURTHER INFORMATION CONTACT:

Stuart Goldstein, (410) 786-0694 and Richard Cuno, (410) 786-1111.

End Further Info End Preamble Start Supplemental Information

SUPPLEMENTARY INFORMATION:

I. Background

A. Fiscal Year DSH Allotments

A state's federal fiscal year (FY) disproportionate share hospital (DSH) allotment represents the aggregate limit on the federal share amount of the state's payments to DSH hospitals in the state for the FY. The amount of such allotment is determined in accordance with the provisions of section 1923(f)(3) of the Social Security Act (the Act). Under such provisions, in general a state's FY DSH allotment is calculated by increasing the amount of its DSH allotment for the preceding FY by the percentage change in the Consumer Price Index for all Urban Consumers (CPI-U) for the previous FY.

The Affordable Care Act amended Medicaid DSH provisions, adding section 1923(f)(7) of the Act which would have required reductions to states' FY DSH allotments beginning with FY 2014, the calculation of which was described in the Disproportionate Share Hospital Payment Reduction final rule published in the September 18, 2013 Federal Register (78 FR 57293). Under the DSH reduction methodology, first, each state's unreduced FY DSH allotment would have been calculated in accordance with the provisions of section 1923(f) of the Act, excluding section 1923(f)(7) of the Act; then, the reduction amount for each state would have been determined under the provisions of section 1923(f)(7) of the Act and implementing regulations at 42 CFR 447.294; and, finally, the net FY DSH allotment for each state would have been determined by subtracting the DSH reduction amount for the state from its unreduced FY 2014 DSH allotment.

The reductions under section 1923(f)(7) of the Act were most recently delayed and modified by the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) (Pub. L. 114-10), enacted on April 16, 2015. The reductions of states' fiscal year DSH allotments under section 1923(f)(7) of the Act that were applicable to FY 2017 were repealed, and are instead scheduled to begin in FY 2018 at modified levels. MACRA also extended DSH allotment reductions through 2025.

Because there is no reduction to DSH allotments for FY 2015 under section 1923(f)(7) of the Act, this notice contains only the state-specific preliminary FY 2015 DSH allotments, as calculated under the statute without application of the reductions that would have otherwise been imposed. This notice also provides information on the calculation of such FY DSH allotments, the calculation of the states' IMD DSH limits, and the amounts of states' preliminary FY 2015 IMD DSH limits.

B. Determination of Fiscal Year DSH Allotments

Generally, in accordance with the methodology specified under section 1923(f)(3) of the Act, a state's FY DSH allotment is calculated by increasing the amount of its DSH allotment for the preceding FY by the percentage change in the CPI-U for the previous FY. Also in accordance with section 1923(f)(3) of the Act, a state's DSH allotment for a FY is subject to the limitation that an increase to a state's DSH allotment for a FY cannot result in the DSH allotment exceeding the greater of the state's DSH allotment for the previous FY or 12 percent of the state's total medical assistance expenditures for the allotment year (this is referred to as the 12 percent limit).

Furthermore, under section 1923(h) of the Act, federal financial participation Start Printed Page 5449(FFP) for DSH payments to institutions for mental diseases (IMDs) and other mental health facilities is limited to state-specific aggregate amounts. Under this provision, the aggregate limit for DSH payments to IMDs and other mental health facilities is the lesser of a state's FY 1995 total computable (state and federal share) IMD and other mental health facility DSH expenditures applicable to the state's FY 1995 DSH allotment (as reported on the Form CMS-64 as of January 1, 1997), or the amount equal to the product of the state's current year total computable DSH allotment and the applicable percentage specified in section 1902(h) of the Act (the applicable percentage is the IMD share of DSH total computable expenditures as of FY 1995).

In general, we determine states' DSH allotments for a FY and the IMD DSH limits for the same FY using the most recent available estimates of or actual medical assistance expenditures, including DSH expenditures in their Medicaid programs and the most recent available change in the CPI-U used for the FY in accordance with the methodology prescribed in the statute. The indicated estimated or actual expenditures are obtained from states for each relevant FY from the most recent available quarterly Medicaid budget reports (Form CMS-37) or quarterly Medicaid expenditure reports (Form CMS-64), respectively, submitted by the states. For example, as part of the initial determination of a state's FY DSH allotment (referred to as the preliminary DSH allotments) that is determined before the beginning of the FY for which the DSH allotments and IMD DSH limits are being determined, we use estimated expenditures for the FY obtained from the August submission of the CMS-37 submitted by states prior to the beginning of the FY; such estimated expenditures are subject to update and revision during the FY before such actual expenditure data become available. We also use the most recent available estimated CPI-U percentage change that is available before the beginning of the FY for determining the states' preliminary FY DSH allotments; such estimated CPI-U percentage change is subject to update and revision during the FY before the actual CPI-U percentage change becomes available. In determining the final DSH allotments and IMD DSH limits for a FY we use the actual expenditures for the FY and actual CPI-U percentage change for the previous FY.

II. Provisions of the Notice

A. Calculation of the Final FY 2013 Federal Share State DSH Allotments and the Preliminary FY 2015 Federal Share State DSH Allotments

1. Final FY 2013 Federal Share State DSH Allotments

Addendum 1 to this notice provides the states' final FY 2013 DSH allotments determined in accordance with section 1923(f)(3) of the Act. As described in the background section of this notice, in general, the DSH allotment for a FY is calculated by increasing the FY DSH allotment for the preceding FY by the CPI-U increase for the previous fiscal year. For purposes of calculating the states' final FY 2013 DSH allotments, the preceding final fiscal year DSH allotments (for FY 2012) were published in the July 26, 2013 Federal Register (78 FR 45217). For purposes of calculating the states' final FY 2013 DSH allotments we are using the actual Medicaid expenditures for FY 2013. Finally, for purposes of calculating the states' final FY 2013 DSH allotments, the applicable historical percentage change in the CPI-U for the previous FY (FY 2012) was 2.4 percent; we note that this is the same as the estimated 2.4 percentage change in the CPI-U for FY 2012 that was available and used in the calculation of the preliminary FY 2013 DSH allotments which were published in the July 26, 2013 Federal Register (78 FR 45217).

2. Calculation of the Preliminary FY 2015 Federal Share State DSH Allotments

Addendum 2 to this notice provides the preliminary FY 2015 DSH allotments determined in accordance with section 1923(f)(3) of the Act. The preliminary FY 2015 DSH allotments contained in this notice were determined based on the most recent available estimates from states of their FY 2015 total computable Medicaid expenditures. Also, the preliminary FY 2015 allotments contained in this notice were determined by increasing the preliminary FY 2014 DSH allotments as contained in the notice published in the February 28, 2014 Federal Register (79 FR 11436) by 1.6 percent, representing the most recent available estimate of the percentage increase in the CPI-U for FY 2014 (the previous FY to FY 2015).

We will publish states' final FY 2015 DSH allotments in future notices based on the states' four quarterly Medicaid expenditure reports (Form CMS-64) for FY 2015 available following the end of FY 2015 and the actual change in the CPI-U for FY 2014.

B. Calculation of the Final FY 2013 and Preliminary FY 2015 IMD DSH Limits

Section 1923(h) of the Act specifies the methodology to be used to establish the limits on the amount of DSH payments that a state can make to IMDs and other mental health facilities. FFP is not available for IMD or DSH payments that exceed the IMD limits. In this notice, we are publishing the final FY 2013 and the preliminary FY 2015 IMD DSH Limits determined in accordance with the provisions discussed above.

Addendums 3 and 4 to this notice detail each state's final FY 2013 and preliminary FY 2015 IMD DSH Limit, respectively, determined in accordance with section 1923(h) of the Act.

III. Collection of Information Requirements

This notice does not impose any new or revised information collection or recordkeeping requirements. The requirements and burden associated with form CMS-37 (OMB control number 0938-1265) and form CMS-64 (OMB control number 0938-1265) are unaffected by this notice. As it pertains to the content of this notice, CMS-37 and CMS-64 are not subject to formal Office of Management and Budget review under the authority of the Paperwork Reduction Act of 1995 (44 U.S.C. 3501 et seq.).

IV. Regulatory Impact Statement

We have examined the impact of this notice as required by Executive Order 12866 on Regulatory Planning and Review (September 1993), the Regulatory Flexibility Act (RFA) (September 19, 1980, Pub. L. 96-354), section 1102(b) of the Act, section 202 of the Unfunded Mandates Reform Act of 1995 (March 22, 1995; Pub. L. 104-4), Executive Order 13132 on Federalism (August 4, 1999) and the Congressional Review Act (5 U.S.C. 804(2)).

Executive Order 12866 directs agencies to assess all costs and benefits of available regulatory alternatives and, if regulation is necessary, to select regulatory approaches that maximize net benefits (including potential economic, environmental, public health and safety effects, distributive impacts, and equity). A regulatory impact analysis (RIA) must be prepared for major rules with economically significant effects ($100 million or more in any 1 year). This notice reaches the $100 million economic threshold and thus is considered a major rule under the Congressional Review Act.

The final FY 2013 DSH allotments being published in this notice are equal Start Printed Page 5450to the preliminary FY 2013 DSH allotments published in the July 26, 2013 Federal Register (78 FR 45217). This is due to the actual percentage change in the CPI-U for FY 2012 used in the calculation of the final FY 2013 allotments (2.4 percent) being equal to the estimated percentage change in the CPI-U for FY 2012 used in the calculation of the preliminary FY 2013 allotments (2.4 percent). The final FY 2013 IMD DSH limits being published in this notice are also equal to the preliminary FY 2013 IMD DSH limits published in the July 26, 2013 Federal Register (78 FR 45217). Since the final FY 2013 DSH allotments were equal to the preliminary FY 2013 DSH allotments, the associated FY 2013 IMD DSH limits also remained the same.

The preliminary FY 2015 DSH allotments being published in this notice are about $240 million more than the preliminary FY 2014 DSH allotments published in the February 28, 2014 Federal Register (79 FR 11436). The increase in the DSH allotments is due to the application of the statutory formula for calculating DSH allotments under which the prior fiscal year allotments are increased by the percentage increase in the CPI-U for the prior fiscal year. The preliminary FY 2015 IMD DSH limits being published in this notice are about $14 million more than the preliminary FY 2014 IMD DSH limits published in the February 28, 2014 Federal Register (79 FR 11436). The increase in the IMD DSH limits is because the DSH allotment for a FY is a factor in the determination of the IMD DSH limit for the FY. Since the preliminary FY 2015 DSH allotments are greater than the preliminary FY 2014 DSH allotments, the associated preliminary FY 2015 IMD DSH limits for some states also increased.

The RFA requires agencies to analyze options for regulatory relief of small businesses, if a rule has a significant impact on a substantial number of small entities. For purposes of the RFA, small entities include small businesses, nonprofit organizations, and small governmental jurisdictions. Most hospitals and most other providers and suppliers are small entities, either by nonprofit status or by having revenues of less than $7.5 million to $38.5 million in any 1 year. Individuals and states are not included in the definition of a small entity. We are not preparing an analysis for the RFA because the Secretary has determined that this notice will not have significant economic impact on a substantial number of small entities. Specifically, any impact on providers is due to the effect of the various controlling statutes; providers are not impacted as a result of the independent regulatory action in publishing this notice. The purpose of the notice is to announce the latest distributions as required by the statute.

In addition, section 1102(b) of the Act requires us to prepare a regulatory impact analysis if a rule may have a significant impact on the operations of a substantial number of small rural hospitals. This analysis must conform to the provisions of section 604 of the RFA. For purposes of section 1102(b) of the Act, we define a small rural hospital as a hospital that is located outside of a Core-Based Statistical Area for Medicaid payment regulations and has fewer than 100 beds. We are not preparing analysis for section 1102(b) of the Act because the Secretary has determined that this notice will not have a significant impact on the operations of a substantial number of small rural hospitals.

The Medicaid statute specifies the methodology for determining the amounts of states' DSH allotments and IMD DSH limits; and as described previously, the application of the methodology specified in statute results in the decreases or increases in states' DSH allotments and IMD DSH limits for the applicable FYs. The statute applicable to these allotments and limits does not apply to the determination of the amounts of DSH payments made to specific DSH hospitals; rather, these allotments and limits represent an overall limit on the total of such DSH payments. In this regard, we do not believe that this notice will have a significant economic impact on a substantial number of small entities.

Section 202 of the Unfunded Mandates Reform Act of 1995 also requires that agencies assess anticipated costs and benefits before issuing any rule whose mandates require spending in any 1 year of $100 million in 1995 dollars, updated annually for inflation. In 2015, that is approximately $144 million. This notice will have no consequential effect on state, local, or tribal governments, in the aggregate, or on the private sector.

Executive Order 13132 establishes certain requirements that an agency must meet when it issues a proposed rule (and subsequent final rule) that imposes substantial direct requirement costs on state and local governments, preempts state law, or otherwise has Federalism implications. Since this notice does not impose any costs on state or local governments, the requirements of E.O. 13132 are not applicable.

A. Alternatives Considered

The methodologies for determining the states' fiscal year DSH allotments and IMD DSH Limits, as reflected in this notice, were established in accordance with the methodologies and formula for determining states' allotments as specified in the statute. This notice does not put forward any further discretionary administrative policies for determining such allotments.

B. Accounting Statement

As required by OMB Circular A-4 (available at http://www.whitehouse.gov/​omb/​circulars/​a004/​a-4.pdf), in the Table 1, we have prepared an accounting statement showing the classification of the estimated expenditures associated with the provisions of this notice. Table 1 provides our best estimate of the change (decrease) in the federal share of states' Medicaid DSH payments resulting from the application of the provisions of the Medicaid statute relating to the calculation of states' FY DSH allotments and the increase in the FY DSH allotments from FY 2014 to FY 2015.

Table 1—Accounting Statement: Classification of Estimated Expenditures, From the FY 2014 to FY 2015

[In millions]

CategoryTransfers
Annualized Monetized Transfers$240.
From Whom To Whom?Federal Government to States.

Congressional Review Act

This proposed regulation is subject to the Congressional Review Act provisions of the Small Business Regulatory Enforcement Fairness Act of 1996 (5 U.S.C. 801 et seq.) and has been transmitted to the Congress and the Comptroller General for review.

In accordance with the provisions of Executive Order 12866, this notice was reviewed by the Office of Management and Budget.

Start Signature

Dated: December 3, 2015.

Andrew M. Slavitt,

Acting Administrator, Centers for Medicare & Medicaid Services.

Dated: January 20, 2016.

Sylvia M. Burwell,

Secretary, Department of Health and Human Services.

End Signature Start Printed Page 5451

Key to Addendum 1—Final DSH Allotments for FY 2013

[The Final FY 2013 DSH Allotments for the NON-Low DSH States are presented in the top section of this addendum, and the Final FY 2013 DSH Allotments for the Low-DSH States are presented in the bottom section of this addendum]

ColumnDescription
Column AState.
Column BFY 2013 FMAPs. This column contains the States' FY 2013 Federal Medical Assistance Percentages.
Column CPrior FY (2012) DSH Allotments This column contains the States' prior FY 2012 DSH Allotments.
Column DPrior FY (2012) DSH Allotments (Col C) × (100 percent + Percentage Increase in CPIU): 102.4 percent. This column contains the amount in Column C increased by 1 plus the percentage increase in the CPI-U for the prior FY (102.4 percent).
Column EFY 2013 TC MAP Exp. Including DSH. This column contains the amount of the States' FY 2013 total computable (TC) medical assistance expenditures including DSH expenditures.
Column FFY 2013 TC DSH Expenditures. This column contains the amount of the States' FY 2013 total computable DSH expenditures.
Column GFY 2013 TC MAP Exp. Net of DSH. This column contains the amount of the States' FY 2013 total computable medical assistance expenditures net of DSH expenditures, calculated as the amount in Column E minus the amount in Column F.
Column H12 percent Amount. This column contains the amount of the “12 percent limit” in Federal share, determined in accordance with the provisions of section 1923(f)(3) of the Act.
Column IGreater of FY 2012 Allotment or 12 percent Limit. This column contains the greater of the State's prior FY (FY 2012) DSH allotment or the amount of the 12 percent Limit, determined as the maximum of the amount in Column C or Column H
Column JFY 2013 DSH Allotment. This column contains the States' final FY 2013 DSH allotments, determined as the minimum of the amount in Column I or Column D.
For states with “na” in Columns I or D, refer to the footnotes in the addendum.
Start Printed Page 5452

Addendum 1—Final DSH Allotments for FY 2013

StateFY 2013 FMAPs (percent)Prior FY (2012) DSH allotmentsPrior FY (2012) DSH allotment (Col C) × 100% + Pct increase in CPIU: 102.4%FY 2013 TC MAP Exp. including DSHFY 2013 TC DSH expendituresFY 2013 TC MAP EXP. net of DSH Col E-F“12% Amount” = Col G × .12/(1-.12/Col B)* (in FS)Greater of Col H or Col C (12% limit, FY 2012 Allotment)FY 2013 DSH allotment MIN Col I, Col D
ABCDEFGHIJ
ALABAMA68.53$315,520,769$323,093,267$4,999,646,843$470,923,104$4,528,723,739$658,807,935$658,807,935$323,093,267
ARIZONA65.68103,890,985106,384,3698,437,380,837173,082,8138,264,298,0241,213,410,7921,213,410,792106,384,369
CALIFORNIA50.001,124,844,3651,151,840,63061,425,894,7192,119,710,40959,306,184,3109,364,134,3659,364,134,3651,151,840,630
COLORADO50.0094,912,75197,190,6575,048,193,724194,191,8584,854,001,866766,421,347766,421,34797,190,657
CONNECTICUT50.00205,216,760210,141,9626,415,388,481272,860,2466,142,528,235969,872,879969,872,879210,141,962
DISTRICT OF COLUMBIA70.0062,847,63264,355,9752,275,681,17156,387,7672,219,293,404321,414,907321,414,90764,355,975
FLORIDA58.08205,216,760210,141,96218,411,438,180335,009,63718,076,428,5432,734,059,8172,734,059,817210,141,962
GEORGIA65.56275,760,021282,378,2628,887,641,041429,964,5488,457,676,4931,242,312,0331,242,312,033282,378,262
ILLINOIS50.00220,608,017225,902,60915,493,580,784447,072,18515,046,508,5992,375,764,5162,375,764,516225,902,609
INDIANA67.16219,325,413224,589,2237,930,553,510337,536,5797,593,016,9311,109,384,3741,109,384,374224,589,223
KANSAS56.5142,325,95743,341,7802,544,769,05776,622,7852,468,146,272376,027,713376,027,71343,341,780
KENTUCKY70.55148,782,151152,352,9235,726,056,802216,263,6665,509,793,136796,685,033796,685,033152,352,923
LOUISIANA/1nananananananana731,960,000
MAINE62.57107,738,799110,324,5302,826,874,56337,489,4372,789,385,126414,155,018414,155,018110,324,530
MARYLAND50.0078,238,89080,116,6237,688,146,740134,340,8167,553,805,9241,192,706,1991,192,706,19980,116,623
MASSACHUSETTS50.00312,955,559320,466,49212,999,170,453012,999,170,4532,052,500,5982,052,500,598320,466,492
MICHIGAN66.39271,912,207278,438,10012,308,409,960387,951,24711,920,458,7131,746,054,6141,746,054,614278,438,100
MISSISSIPPI73.43156,477,779160,233,2464,708,563,005217,999,5544,490,563,451644,132,328644,132,328160,233,246
MISSOURI61.37486,107,200497,773,7738,863,322,084703,393,6598,159,928,4251,217,196,2101,217,196,210497,773,773
NEVADA59.7447,456,37548,595,3281,797,228,66481,373,6001,715,855,064257,658,605257,658,60548,595,328
NEW HAMPSHIRE50.00164,274,500168,217,0881,188,634,37240,923,9141,147,710,458181,217,441181,217,441168,217,088
NEW JERSEY50.00660,541,446676,394,44110,480,866,4401,298,115,1619,182,751,2791,449,908,0971,449,908,097676,394,441
NEW YORK50.001,648,147,1031,687,702,63352,489,778,8793,423,365,42349,066,413,4567,747,328,4407,747,328,4401,687,702,633
NORTH CAROLINA65.51302,694,721309,959,39411,721,921,735617,376,63311,104,545,1021,631,378,2461,631,378,246309,959,394
OHIO63.58416,846,544426,850,86116,628,494,101649,120,74415,979,373,3572,363,633,7142,363,633,714426,850,861
PENNSYLVANIA54.28575,889,532589,710,88120,922,389,122847,055,68420,075,333,4383,092,778,9003,092,778,900589,710,881
RHODE ISLAND51.2666,695,44768,296,1381,909,141,351129,846,0571,779,295,294278,777,412278,777,41268,296,138
SOUTH CAROLINA70.43336,042,444344,107,4634,690,094,944457,173,2094,232,921,735612,270,432612,270,432344,107,463
TENNESSEE/2nananananananana53,100,000
TEXAS59.30981,192,6341,004,741,25727,752,018,303226,747,94127,525,270,3624,141,011,0764,141,011,0761,004,741,257
VERMONT56.0423,086,88623,640,9711,452,095,08437,448,7811,414,646,303216,013,021216,013,02123,640,971
VIRGINIA50.0089,892,71392,050,1387,218,485,856186,468,4337,032,017,4231,110,318,5401,110,318,54092,050,138
WASHINGTON50.00189,825,503194,381,3157,805,501,929366,733,9307,438,767,9991,174,542,3161,174,542,316194,381,315
WEST VIRGINIA72.0469,260,65670,922,9123,007,417,19875,434,1372,931,983,061422,158,680422,158,68070,922,912
Total0.0010,004,528,51910,244,637,203366,054,779,93215,047,983,957351,006,795,97553,874,035,59853,874,035,59811,029,697,203
LOW DSH STATES
ALASKA50.0020,901,01221,402,6361,340,719,40021,706,4741,319,012,926208,265,198.84208,265,19921,402,636
ARKANSAS70.1744,262,98045,325,2924,156,350,92961,000,0004,095,350,929592,822,640592,822,64045,325,292
DELAWARE55.679,289,3389,512,2821,557,544,10010,874,6691,546,669,431236,601,110236,601,1109,512,282
HAWAII51.8610,000,00010,240,0001,586,220,30724,971,2801,561,249,027243,752,256.52243,752,25710,240,000
IDAHO71.0016,866,25417,271,0441,641,925,39323,708,9801,618,216,413233,681,421.00233,681,42117,271,044
IOWA59.5940,408,34941,378,1493,622,873,64254,606,3703,568,267,272536,162,337536,162,33741,378,149
MINNESOTA50.0076,637,04578,476,3348,781,239,28946,287,0998,734,952,1901,379,202,9771,379,202,97778,476,334
MONTANA66.0011,646,84711,926,371996,801,71517,703,206979,098,509143,601,115143,601,11511,926,371
NEBRASKA55.7629,036,34729,733,2191,790,372,94745,313,1621,745,059,785266,831,445266,831,44529,733,219
NEW MEXICO69.0720,901,01221,402,6363,280,561,20225,164,1463,255,397,056472,788,382472,788,38221,402,636
NORTH DAKOTA52.279,801,13310,036,360775,035,7261,265,931773,769,795120,521,323120,521,32310,036,360
OKLAHOMA64.0037,157,35338,049,1294,481,944,28041,759,6504,440,184,630655,781,115655,781,11538,049,129
OREGON62.4446,446,69347,561,4145,070,815,86476,536,2354,994,279,629741,894,100741,894,10047,561,414
SOUTH DAKOTA56.1911,332,73311,604,719758,090,0421,441,151756,648,891115,454,450115,454,45011,604,719
UTAH69.6120,129,69520,612,8082,087,187,05928,794,7082,058,392,351298,457,958298,457,95820,612,808
WISCONSIN59.7496,998,59799,326,5637,034,898,860581,3257,034,317,5351,056,296,9321,056,296,93299,326,563
WYOMING50.00232,233237,807546,576,901463,560546,113,34186,228,42286,228,422237,807
Start Printed Page 5453
Total Low DSH States0.00502,047,621514,096,76449,509,157,656482,177,94649,026,979,7107,388,343,1827,388,343,182514,096,763
Total0.0010,506,576,14010,758,733,967415,563,937,58815,530,161,903400,033,775,68561,262,378,78061,262,378,78011,543,793,966
1 FY 2013 DSH allotment for Louisiana determined under the provisions of section 1903(f)(3)(C) and (D) of the Act.
2 Tennessee's DSH allotments are determined under section 1923(f)(6)(A)(v)(II) of the Act. Under this provision, Tennessee's DSH payments for FY 2013 are limited to $53,100,000.
3 Beginning FY 2013, under section 1923(f)(6)(B)(II) of the Act, Hawaii's DSH allotments are determined as for low-DSH states. This means its allotments are determined as for all States, by increasing the previous fiscal year allotment by the CPIU for the previous fiscal year.
Start Printed Page 5454

Key to Addendum 2—Preliminary DSH Allotments for FY 2015

[The Preliminary FY 2015 DSH Allotments for the NON-Low DSH States are presented in the top section of this addendum, and the Preliminary FY 2015 DSH Allotments for the Low-DSH States are presented in the bottom section of this addendum]

ColumnDescription
Column AState.
Column BFY 2015 FMAPs. This column contains the States' FY 2015 Federal Medical Assistance Percentages.
Column CPrior FY (2014) DSH Allotments. This column contains the States' prior FY 2014 DSH Allotments
Column DPrior FY (2014) DSH Allotments (Col C) × (100 percent + Percentage Increase in CPIU): 101.6 percent. This column contains the amount in Column C increased by 1 plus the estimated percentage increase in the CPI-U for the prior FY (101.6 percent).
Column EFY 2015 TC MAP Exp. Including DSH. This column contains the amount of the States' projected FY 2015 total computable (TC) medical assistance expenditures including DSH expenditures.
Column FFY 2015 TC DSH Expenditures. This column contains the amount of the States' projected FY 2015 total computable DSH expenditures.
Column GFY 2015 TC MAP Exp. Net of DSH. This column contains the amount of the States' projected FY 2015 total computable medical assistance expenditures net of DSH expenditures, calculated as the amount in Column E minus the amount in Column F.
Column H12 percent Amount. This column contains the amount of the “12 percent limit” in Federal share, determined in accordance with the provisions of section 1923(f)(3) of the Act.
Column IGreater of FY 2014 Allotment or 12 percent Limit. This column contains the greater of the State's prior FY (FY 2014) DSH allotment or the amount of the 12 percent Limit, determined as the maximum of the amount in Column C or Column H.
Column JFY 2015 DSH Allotment. This column contains the States' preliminary FY 2015 DSH allotments, determined as the minimum of the amount in Column I or Column D. For states with “na” in Columns I or D, refer to the footnotes in the addendum.
Start Printed Page 5455

Addendum 2—Preliminary DSH Allotments for FY 2015

StateFY 2015 FMAPs (percent)Prior FY (2014) DSH allotmentsPrior FY (2014) DSH Allotment (Col C) × 100% + Pct increase in CPIU: 101.6%FY 2015 TC MAP Exp. Including DSH 4FY 2015 TC DSH Expenditures 4FY 2015 TC MAP EXP. Net Of DSH Col E-F“12% Amount” = Col G × .12/(1-.12/Col B)* (in FS)Greater of Col H or Col C (12% Limit, FY 2014 allotment)FY 2015 DSH Allotment Min Col I, Col D
ABCDEFGHIJ
ALABAMA68.99$327,939,666$333,186,701$5,727,646,000$507,528,000$5,220,118,000$758,313,966$758,313,966$333,186,701
ARIZONA68.46107,980,135109,707,81711,262,757,000167,012,00011,095,745,0001,614,483,9591,614,483,959109,707,817
CALIFORNIA50.001,169,118,2391,187,824,13196,031,140,000597,609,00095,433,531,00015,068,452,26315,068,452,2631,187,824,131
COLORADO51.0198,648,517100,226,8936,927,502,000204,899,0006,722,603,0001,054,867,9181,054,867,918100,226,893
CONNECTICUT50.00213,294,091216,706,7967,094,230,000125,646,0006,968,584,0001,100,302,7371,100,302,737216,706,796
DISTRICT OF COLUMBIA70.0065,321,31566,366,4562,630,681,00037,174,0002,593,507,000375,611,359375,611,35966,366,456
FLORIDA59.72213,294,091216,706,79622,430,097,000362,102,00022,067,995,0003,314,083,8093,314,083,809216,706,796
GEORGIA66.94286,613,936291,199,7599,915,707,000434,725,0009,480,982,0001,386,218,2781,386,218,278291,199,759
ILLINOIS50.76229,291,148232,959,80619,753,482,000456,614,00019,296,868,0003,032,535,6653,032,535,665232,959,806
INDIANA66.52227,958,061231,605,39010,719,730,000474,987,00010,244,743,0001,499,956,6491,499,956,649231,605,390
KANSAS56.6343,991,90744,695,7783,161,490,00074,228,0003,087,262,000470,082,851470,082,85144,695,778
KENTUCKY69.94154,638,217157,112,4288,903,447,000241,000,0008,662,447,0001,254,784,0041,254,784,004157,112,428
LOUISIANA 162.05731,960,000743,671,3607,995,712,000551,048,0007,444,664,0001,107,551,8111,107,551,811743,671,360
MAINE61.88111,979,398113,771,0682,565,931,00038,566,0002,527,365,000376,247,024376,247,024113,771,068
MARYLAND50.0081,318,37282,619,46611,133,665,00092,859,00011,040,806,0001,743,285,1581,743,285,15882,619,466
MASSACHUSETTS50.00325,273,489330,477,86516,287,567,000016,287,567,0002,571,721,1052,571,721,105330,477,865
MICHIGAN65.54282,614,672287,136,50716,050,268,000322,351,00015,727,917,0002,310,364,6182,310,364,618287,136,507
MISSISSIPPI73.58162,636,745165,238,9335,362,441,000228,204,0005,134,237,000736,168,545736,168,545165,238,933
MISSOURI63.45505,240,380513,324,2269,641,725,000713,722,0008,928,003,0001,321,240,3271,321,240,327513,324,226
NEVADA64.3649,324,25850,113,4462,848,030,00078,128,0002,769,902,000408,565,835408,565,83550,113,446
NEW HAMPSHIRE50.00170,740,344173,472,1901,816,048,00076,097,0001,739,951,000274,729,105274,729,105173,472,190
NEW JERSEY50.00686,540,358697,525,00414,214,233,0001,213,776,00013,000,457,0002,052,703,7372,052,703,737697,525,004
NEW YORK50.001,713,018,1721,740,426,46368,512,267,0005,326,800,00063,185,467,0009,976,652,6849,976,652,6841,740,426,463
NORTH CAROLINA65.88314,608,785319,642,52612,482,232,000411,389,00012,070,843,0001,771,107,2091,771,107,209319,642,526
OHIO62.64433,253,624440,185,68221,305,059,000021,305,059,0003,162,438,1423,162,438,142440,185,682
PENNSYLVANIA51.82598,556,544608,133,44924,679,963,000787,072,00023,892,891,0003,731,179,1413,731,179,141608,133,449
RHODE ISLAND50.0069,320,58070,429,7093,117,756,000142,487,0002,975,269,000469,779,316469,779,31670,429,709
SOUTH CAROLINA70.64349,269,075354,857,3805,636,583,000494,437,0005,142,146,000743,331,228743,331,228354,857,380
TENNESSEE 2nananananananana53,100,000
TEXAS58.051,019,812,3761,036,129,37435,894,535,0002,630,047,00033,264,488,0005,031,931,0195,031,931,0191,036,129,374
VERMONT 556.2123,995,58624,379,5151,577,599,00037,449,0001,540,150,000234,983,483234,983,48324,379,515
VIRGINIA50.0093,430,89094,925,7848,689,637,000193,862,0008,495,775,0001,341,438,1581,341,438,15894,925,784
WASHINGTON50.03197,297,035200,453,78812,536,442,000405,243,00012,131,199,0001,915,089,8321,915,089,832200,453,788
WEST VIRGINIA71.3571,986,75673,138,5443,631,855,00071,987,0003,559,868,000513,556,694513,556,69473,138,544
Total11,130,266,76211,308,351,030490,537,457,00017,499,048,000473,038,409,00072,723,757,62972,723,757,62911,361,451,030
LOW DSH STATES
ALASKA50.0021,723,67622,071,2551,661,590,00021,894,0001,639,696,000258,899,368.42258,899,36822,071,255
ARKANSAS70.8846,005,17146,741,2546,070,657,00065,820,0006,004,837,000867,437,867867,437,86746,741,254
DELAWARE53.639,654,9669,809,4451,549,168,00024,248,0001,524,920,000235,738,053235,738,0539,809,445
HAWAII 352.2310,393,60010,559,8981,951,834,00001,951,834,000304,084,384.25304,084,38410,559,898
IDAHO71.7517,530,11017,810,5922,009,716,00024,470,0001,985,246,000286,074,779.25286,074,77917,810,592
IOWA55.5441,998,82142,670,8024,714,183,00034,688,0004,679,495,000716,304,508716,304,50842,670,802
MINNESOTA50.0079,653,47980,927,93511,849,443,000154,792,00011,694,651,0001,846,523,8421,846,523,84280,927,935
MONTANA65.9012,105,26712,298,9511,030,146,0001,896,0001,028,250,000150,860,872150,860,87212,298,951
NEBRASKA53.2730,179,21730,662,0842,053,612,00042,720,0002,010,892,000311,471,433311,471,43330,662,084
NEW MEXICO69.6521,723,67622,071,2554,758,998,00031,196,0004,727,802,000685,428,779685,428,77922,071,255
NORTH DAKOTA50.0010,186,90510,349,8951,155,141,0001,735,0001,153,406,000182,116,737182,116,73710,349,895
OKLAHOMA62.3038,619,86639,237,7845,404,554,00058,140,0005,346,414,000794,628,053794,628,05339,237,784
OREGON64.0648,274,83549,047,2328,294,293,00081,136,0008,213,157,0001,212,757,9811,212,757,98149,047,232
SOUTH DAKOTA51.6411,778,79011,967,251857,827,0001,613,000856,214,000133,849,317133,849,31711,967,251
UTAH70.5620,922,00021,256,7522,276,646,00031,390,0002,245,256,000324,641,933324,641,93321,256,752
WISCONSIN58.27100,816,461102,429,5248,016,231,000166,265,0007,849,966,0001,186,300,0271,186,300,027102,429,524
WYOMING50.00241,374245,236596,915,000476,000596,439,00094,174,57994,174,579245,236
Start Printed Page 5456
Total Low DSH States521,808,214530,157,14564,250,954,000742,479,00063,508,475,0009,591,292,5129,591,292,512530,157,145
Total11,652,074,97611,838,508,176554,788,411,00018,241,527,000536,546,884,00082,315,050,14182,315,050,14111,891,608,175
1 Louisiana's FY 2015 DSH allotment is determined under the provisions of section 1923(f)(3)(C) and (D) of the Act.
2 Tennessee's DSH allotment for FY 2015 determined under section 1923(f)(6)(A)(vi) of the Act
3 Beginning FY 2013, under section 1923(f)(6)(B)(II) of the Act, Hawaii's DSH allotment for a fiscal year is determined as for low-DSH states. This means Hawaii's DSH allotment for a fiscal year is determined as for all States, by increasing the previous fiscal year allotment by the percentage increase in the CPIU for the previous fiscal year.
4 Expenditures based on the amounts reported by States on the Form CMS-37.
5 FMAP for Vermont for FY 2015 determined in accordance with section 1905(z)(1)(A) of the Act.
Start Printed Page 5457

Key to Addendum 3—Final IMD DSH Limits for FY 2013

[The final FY 2013 IMD DSH Limits for the Non-Low DSH States are presented in the top section of this addendum and the preliminary FY 2013 IMD DSH Limits for the Low-DSH States are presented in the bottom section of the addendum]

ColumnDescription
Column AState.
Column BInpatient Hospital Services FY 95 DSH Total Computable This column contains the States' total computable FY 1995 inpatient hospital DSH expenditures as reported on the Form CMS-64.
Column CIMD and Mental Health Services FY 95 DSH Total Computable. This column contains the total computable FY 1995 mental health facility DSH expenditures as reported on the Form CMS-64 as of January 1, 1997.
Column DTotal Inpatient Hospital & IMD & Mental Health FY 95 DSH Total Computable, Col. B + C. This column contains the total computation of all inpatient hospital DSH expenditures and mental health facility DSH expenditures for FY 1995 as reported on the Form CMS-64 as of January 1, 1997 (representing the sum of Column B and Column C).
Column EApplicable Percentage, Col. C/D. This column contains the “applicable percentage” representing the total Computable FY 1995 mental health facility DSH expenditures divided by total computable all inpatient hospital and mental health facility DSH expenditures for FY 1995 (the amount in Column C divided by the amount in Column D) Per section 1923(h)(2)(A)(ii)(III) of the Act, for FYs after FY 2002, the applicable percentage can be no greater than 33 percent.
Column FFY 2013 Federal Share DSH Allotment This column contains the states' FY 2013 DSH allotments from Column J Addendum 1.
Column GFY 2013 FMAP.
Column HFY 2013 DSH Allotments in Total Computable, Col. F/G. This column contains states' FY 2013 total computable DSH allotment (determined as Column F/Column G).
Column IApplicable Percentage Applied to FY 2013 Allotments in TC, Col E × Col H. This column contains the applicable percentage of FY 2012 total computable DSH allotment (calculated as the percentage in Column E multiplied by the amount in Column H).
Column JFY 2013 TC IMD DSH Limit. Lesser of Col. I or C. This column contains the total computable FY 2013 TC IMD DSH Limit equal to the lesser of the amount in Column I or Column C.
Column KFY 2013 IMD DSH Limit in Federal Share, Col. G × J. This column contains the FY 2013 Federal Share IMD DSH limit determined by converting the total computable FY 2013 IMD DSH Limit from Column J into a federal share amount by multiplying it by the FY 2013 FMAP in Column G.
Start Printed Page 5458

Addendum 3—Final IMD DSH Limits for FY 2013

StateInpatient Hospital services FY 95 DSH Total computableIMD And mental health services FY 95 DSH Total computableTotal inpatient & IMD & mental health FY 95 DSH total computable Col B + CApplicable percent Col C/D (percent)FY 2013 Allotment In FSFY 2013 FMAPs (percent)FY 2013 Allotments in TC Col F/GApplicable percentage applied to FY 2013 allotments in TC Col E × Col HFY 2013 TC IMD Limit (Lesser Of Col I or Col C)FY 2013 IMD Limit In FS Col G × JMMA LOW DSH Status
ABCDEFGHIJKL
ALABAMA$413,006,229$4,451,770$417,457,9991.07$323,093,26768.53471,462,523$5,027,674$4,451,770$3,050,798N/A
ARIZONA93,916,10028,474,900122,391,00023.27106,384,36965.68161,973,76537,684,03528,474,90018,702,314N/A
CALIFORNIA2,189,879,5431,555,9192,191,435,4620.071,151,840,63050.002,303,681,2601,635,6141,555,919777,960N/A
COLORADO173,900,441594,776174,495,2170.3497,190,65750.00194,381,314662,559594,776297,388N/A
CONNECTICUT303,359,275105,573,725408,933,00025.82210,141,96250.00420,283,924108,504,179105,573,72552,786,863N/A
DISTRICT OF COLUMBIA39,532,2346,545,13646,077,37014.2064,355,97570.0091,937,10713,059,3586,545,1364,581,595N/A
FLORIDA184,468,014149,714,986334,183,00033.00210,141,96258.08361,814,673119,398,842119,398,84269,346,847N/A
GEORGIA407,343,5570407,343,5570.00282,378,26265.56430,717,300000N/A
ILLINOIS315,868,50889,408,276405,276,78422.06225,902,60950.00451,805,21899,672,93389,408,27644,704,138N/A
INDIANA79,960,783153,566,302233,527,08533.00224,589,22367.16334,409,206110,355,038110,355,03874,114,444N/A
KANSAS11,587,20876,663,50888,250,71633.0043,341,78056.5176,697,54025,310,18825,310,18814,302,787N/A
KENTUCKY158,804,90837,443,073196,247,98119.08152,352,92370.55215,950,28141,202,16737,443,07326,416,088N/A
LOUISIANA1,078,512,169132,917,1491,211,429,31810.97731,960,00065.511,117,325,599122,592,157122,592,15780,310,122N/A
MAINE99,957,95860,958,342160,916,30033.00110,324,53062.57176,321,76858,186,18358,186,18336,407,095N/A
MARYLAND22,226,467120,873,531143,099,99833.0080,116,62350.00160,233,24652,876,97152,876,97126,438,486N/A
MASSACHUSETTS469,653,946105,635,054575,289,00018.36320,466,49250.00640,932,984117,688,658105,635,05452,817,527N/A
MICHIGAN133,258,800304,765,552438,024,35233.00278,438,10066.39419,397,650138,401,225138,401,22591,884,573N/A
MISSISSIPPI182,608,0330182,608,0330.00160,233,24673.43218,212,238000N/A
MISSOURI521,946,524207,234,618729,181,14228.42497,773,77361.37811,102,775230,516,896207,234,618127,179,885N/A
NEVADA73,560,000073,560,0000.0048,595,32859.7481,344,707000N/A
NEW HAMPSHIRE92,675,91694,753,948187,429,86433.00168,217,08850.00336,434,176111,023,27894,753,94847,376,974N/A
NEW JERSEY736,742,539357,370,4611,094,113,00032.66676,394,44150.001,352,788,882441,861,843357,370,461178,685,231N/A
NEW YORK2,418,869,368605,000,0003,023,869,36820.011,687,702,63350.003,375,405,266675,333,468605,000,000302,500,000N/A
NORTH CAROLINA193,201,966236,072,627429,274,59333.00309,959,39465.51473,148,212156,138,910156,138,910102,286,600N/A
OHIO535,731,95693,432,758629,164,71414.85426,850,86163.58671,360,27299,698,91993,432,75859,404,548N/A
PENNSYLVANIA388,207,319579,199,682967,407,00133.00589,710,88154.281,086,423,878358,519,880358,519,880194,604,591N/A
RHODE ISLAND108,503,1672,397,833110,901,0002.1668,296,13851.26133,234,7602,880,7202,397,8331,229,129N/A
SOUTH CAROLINA366,681,36472,076,341438,757,70516.43344,107,46370.43488,580,80880,260,96572,076,34150,763,367N/A
TENNESSEE0000.0053,100,00066.1380,296,386000N/A
TEXAS1,220,515,401292,513,5921,513,028,99319.331,004,741,25759.301,694,336,015327,565,642292,513,592173,460,560N/A
VERMONT19,979,2529,071,29729,050,54931.2323,640,97156.0442,185,88713,172,9259,071,2975,083,555N/A
VIRGINIA129,313,4807,770,268137,083,7485.6792,050,13850.00184,100,27610,435,2897,770,2683,885,134N/A
WASHINGTON171,725,815163,836,435335,562,25033.00194,381,31550.00388,762,630128,291,668128,291,66864,145,834N/A
WEST VIRGINIA66,962,60618,887,04585,849,65122.0070,922,91272.0498,449,35021,658,99718,887,04513,606,227N/A
Total13,402,460,8464,118,758,90417,521,219,75011,029,697,20319,545,491,8773,709,617,1803,410,261,8521,921,150,660
LOW DSH STATES
ALASKA$2,506,827$17,611,765$20,118,59233.00$21,402,63650.00$42,805,272$14,125,740$14,125,740$7,062,870LOW DSH
ARKANSAS2,422,649819,3513,242,00025.2745,325,29270.1764,593,54716,324,734819,351574,939LOW DSH
DELAWARE07,069,0007,069,00033.009,512,28255.6717,086,9095,638,6805,638,6803,139,053LOW DSH
HAWAII0000.0010,240,00051.8619,745,469000LOW DSH
IDAHO2,081,42902,081,4290.0017,271,04471.0024,325,414000LOW DSH
IOWA12,011,250012,011,2500.0041,378,14959.5969,438,075000LOW DSH
MINNESOTA24,240,0005,257,21429,497,21417.8278,476,33450.00156,952,66827,973,2785,257,2142,628,607LOW DSH
MONTANA237,0480237,0480.0011,926,37166.0018,070,259000LOW DSH
NEBRASKA6,449,1021,811,3378,260,43921.9329,733,21955.7653,323,56311,692,7131,811,3371,010,002LOW DSH
NEW MEXICO6,490,015254,7866,744,8013.7821,402,63669.0730,986,8771,170,535254,786175,981LOW DSH
NORTH DAKOTA214,523988,4781,203,00133.0010,036,36052.2719,200,9956,336,328988,478516,677LOW DSH
OKLAHOMA20,019,9693,273,24823,293,21714.0538,049,12964.0059,451,7648,354,3793,273,2482,094,879LOW DSH
Start Printed Page 5459
OREGON11,437,90819,975,09231,413,00033.0047,561,41462.4476,171,38725,136,55819,975,09212,472,447LOW DSH
SOUTH DAKOTA321,120751,2991,072,41933.0011,604,71956.1920,652,6416,815,372751,299422,155LOW DSH
UTAH3,621,116934,5864,555,70220.5120,612,80869.6129,611,8496,074,765934,586650,565LOW DSH
WISCONSIN6,609,5244,492,01111,101,53533.0099,326,56359.74166,264,75254,867,3684,492,0112,683,527LOW DSH
WYOMING0000.00237,80750.00475,614000LOW DSH
Total Low DSH States98,662,48063,238,167161,900,647514,096,763869,157,055184,510,44958,321,82233,431,702
Total13,501,123,3264,181,997,07117,683,120,39711,543,793,96620,414,648,9323,894,127,6303,468,583,6741,954,582,362
Start Printed Page 5460

Key to Addendum 4—Preliminary IMD DSH Limits for FY 2015

[The preliminary FY 2015 IMD DSH Limits for the Non-Low DSH States are presented in the top section of this addendum and the preliminary FY 2015 IMD DSH Limits for the Low-DSH States are presented in the bottom section of the addendum]

ColumnDescription
Column AState.
Column BInpatient Hospital Services FY 95 DSH Total Computable. This column contains the States' total computable FY 1995 inpatient hospital DSH expenditures as reported on the Form CMS-64.
Column CIMD and Mental Health Services FY 95 DSH Total Computable. This column contains the total computable FY 1995 mental health facility DSH expenditures as reported on the Form CMS-64 as of January 1, 1997.
Column DTotal Inpatient Hospital & IMD & Mental Health FY 95 DSH Total Computable, Col. B + C. This column contains the total computation of all inpatient hospital DSH expenditures and mental health facility DSH expenditures for FY 1995 as reported on the Form CMS-64 as of January 1, 1997 (representing the sum of Column B and Column C).
Column EApplicable Percentage, Col. C/D. This column contains the “applicable percentage” representing the total Computable FY 1995 mental health facility DSH expenditures divided by total computable all inpatient hospital and mental health facility DSH expenditures for FY 1995 (the amount in Column C divided by the amount in Column D) Per section 1923(h)(2)(A)(ii)(III) of the Act, for FYs after FY 2002, the applicable percentage can be no greater than 33 percent.
Column FFY 2015 Federal Share DSH Allotment. This column contains the states' preliminary FY 2015 DSH allotments from Column J Addendum 1.
Column GFY 2015 FMAP.
Column HFY 2015 DSH Allotments in Total Computable, Col. F/G. This column contains states' FY 2015 total computable DSH allotment (determined as Column F/Column G).
Column IApplicable Percentage Applied to FY 2015 Allotments in TC, Col E x Col H. This column contains the applicable percentage of FY 2014 total computable DSH allotment (calculated as the percentage in Column E multiplied by the amount in Column H).
Column JFY 2015 TC IMD DSH Limit. Lesser of Col. I or C. This column contains the total computable FY 2015 TC IMD DSH Limit equal to the lesser of the amount in Column I or Column C.
Column KFY 2015 IMD DSH Limit in Federal Share, Col. G × J. This column contains the FY 2015 Federal Share IMD DSH limit determined by converting the total computable FY 2015 IMD DSH Limit from Column J into a federal share amount by multiplying it by the FY 2015 FMAP in Column G.
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Addendum 4—Preliminary IMD DSH Limits for FY 2015

StateInpatient hospital services FY 95 DSH total computableIMD and mental health services FY 95 DSH total computableTotal inpatient & IMD & mental health FY 95 DSH total computable Col B + CApplicable percent Col C/DFY 2015 allotment in FSFY 2015 FMAPs (percent)FY 2015 allotments in TC Col. F/GApplicable percentage applied to FY 2015 allotments in TC Col E × Col HFY 2015 TC IMD Limit (Lesser Of Col I or Col C)FY 2015 TC IMD limit in FS Col G × JMMA LOW DSH Status
ABCDEFGHIJKL
ALABAMA$413,006,229$4,451,770$417,457,9991.07$333,186,70168.99$482,949,269$5,150,169$4,451,770$3,071,276N/A
ARIZONA93,916,10028,474,900122,391,00023.27109,707,81768.46160,250,97437,283,21928,474,90019,493,917N/A
CALIFORNIA2,189,879,5431,555,9192,191,435,4620.071,187,824,13150.002,375,648,2621,686,7101,555,919777,960N/A
COLORADO173,900,441594,776174,495,2170.34100,226,89351.01196,484,793669,729594,776303,395N/A
CONNECTICUT303,359,275105,573,725408,933,00025.82216,706,79650.00433,413,592111,893,849105,573,72552,786,863N/A
DISTRICT OF COLUMBIA39,532,2346,545,13646,077,37014.2066,366,45670.0094,809,22313,467,3326,545,1364,581,595N/A
FLORIDA184,468,014149,714,986334,183,00033.00216,706,79659.72362,871,393119,747,560119,747,56071,513,243N/A
GEORGIA407,343,5570407,343,5570.00291,199,75966.94435,016,073000N/A
ILLINOIS315,868,50889,408,276405,276,78422.06232,959,80650.76458,943,668101,247,74989,408,27645,383,641N/A
INDIANA79,960,783153,566,302233,527,08533.00231,605,39066.52348,174,068114,897,442114,897,44276,429,779N/A
KANSAS11,587,20876,663,50888,250,71633.0044,695,77856.6378,925,97226,045,57126,045,57114,749,607N/A
KENTUCKY158,804,90837,443,073196,247,98119.08157,112,42869.94224,638,87342,859,90537,443,07326,187,685N/A
LOUISIANA1,078,512,169132,917,1491,211,429,31810.97743,671,36062.051,198,503,400131,498,927131,498,92781,595,084N/A
MAINE99,957,95860,958,342160,916,30033.00113,771,06861.88183,857,57660,673,00060,673,00037,544,452N/A
MARYLAND22,226,467120,873,531143,099,99833.0082,619,46650.00165,238,93254,528,84854,528,84827,264,424N/A
MASSACHUSETTS469,653,946105,635,054575,289,00018.36330,477,86550.00660,955,730121,365,252105,635,05452,817,527N/A
MICHIGAN133,258,800304,765,552438,024,35233.00287,136,50765.54438,108,799144,575,904144,575,90494,755,047N/A
MISSISSIPPI182,608,0330182,608,0330.00165,238,93373.58224,570,444000N/A
MISSOURI521,946,524207,234,618729,181,14228.42513,324,22663.45809,021,633229,925,432207,234,618131,490,365N/A
NEVADA73,560,000073,560,0000.0050,113,44664.3677,864,273000N/A
NEW HAMPSHIRE92,675,91694,753,948187,429,86433.00173,472,19050.00346,944,380114,491,64594,753,94847,376,974N/A
NEW JERSEY736,742,539357,370,4611,094,113,00032.66697,525,00450.001,395,050,008455,665,607357,370,461178,685,231N/A
NEW YORK2,418,869,368605,000,0003,023,869,36820.011,740,426,46350.003,480,852,926696,430,885605,000,000302,500,000N/A
NORTH CAROLINA193,201,966236,072,627429,274,59333.00319,642,52665.88485,189,019160,112,376160,112,376105,482,034N/A
OHIO535,731,95693,432,758629,164,71414.85440,185,68262.64702,722,992104,356,37293,432,75858,526,280N/A
PENNSYLVANIA388,207,319579,199,682967,407,00133.00608,133,44951.821,173,549,689387,271,397387,271,397200,684,038N/A
RHODE ISLAND108,503,1672,397,833110,901,0002.1670,429,70950.00140,859,4183,045,5752,397,8331,198,917N/A
SOUTH CAROLINA366,681,36472,076,341438,757,70516.43354,857,38070.64502,346,23482,522,26272,076,34150,914,727N/A
TENNESSEE*0000.0053,100,00064.9981,704,878000N/A
TEXAS1,220,515,401292,513,5921,513,028,99319.331,036,129,37458.051,784,891,256345,072,669292,513,592169,804,140N/A
VERMONT**19,979,2529,071,29729,050,54931.2324,379,51556.2143,372,20213,543,3639,071,2975,098,976N/A
VIRGINIA129,313,4807,770,268137,083,7485.6794,925,78450.00189,851,56810,761,2877,770,2683,885,134N/A
WASHINGTON171,725,815163,836,435335,562,25033.00200,453,78850.03400,667,176132,220,168132,220,16866,149,750N/A
WEST VIRGINIA66,962,60618,887,04585,849,65122.0073,138,54471.35102,506,71922,551,62418,887,04513,475,907N/A
Total13,402,460,8464,118,758,90417,521,219,75011,361,451,03020,240,755,4143,845,561,8283,471,761,9831,944,527,968
LOW DSH STATES
ALASKA2,506,82717,611,76520,118,59233.0022,071,25550.0044,142,51014,567,02814,567,0287,283,514LOW DSH
ARKANSAS2,422,649819,3513,242,00025.2746,741,25470.8865,944,20716,666,086819,351580,756LOW DSH
DELAWARE07,069,0007,069,00033.009,809,44553.6318,290,9666,036,0196,036,0193,237,117LOW DSH
HAWAII0000.0010,559,89852.2320,218,070000LOW DSH
IDAHO2,081,42902,081,4290.0017,810,59271.7524,823,125000LOW DSH
IOWA12,011,250012,011,2500.0042,670,80255.5476,828,956000LOW DSH
MINNESOTA24,240,0005,257,21429,497,21417.8280,927,93550.00161,855,87028,847,1635,257,2142,628,607LOW DSH
MONTANA237,0480237,0480.0012,298,95165.9018,663,052000LOW DSH
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NEBRASKA6,449,1021,811,3378,260,43921.9330,662,08453.2757,559,76012,621,6201,811,337964,899LOW DSH
NEW MEXICO6,490,015254,7866,744,8013.7822,071,25569.6531,688,8081,197,050254,786177,458LOW DSH
NORTH DAKOTA214,523988,4781,203,00133.0010,349,89550.0020,699,7906,830,931988,478494,239LOW DSH
OKLAHOMA20,019,9693,273,24823,293,21714.0539,237,78462.3062,981,9978,850,4603,273,2482,039,234LOW DSH
OREGON11,437,90819,975,09231,413,00033.0049,047,23264.0676,564,52125,266,29219,975,09212,796,044LOW DSH
SOUTH DAKOTA321,120751,2991,072,41933.0011,967,25151.6423,174,3827,647,546751,299387,971LOW DSH
UTAH3,621,116934,5864,555,70220.5121,256,75270.5630,125,7826,180,197934,586659,444LOW DSH
WISCONSIN6,609,5244,492,01111,101,53533.00102,429,52458.27175,784,32158,008,8264,492,0112,617,495LOW DSH
WYOMING0000.00245,23650.00490,472000LOW DSH
Total Low DSH States98,662,48063,238,167161,900,647530,157,145909,836,589192,719,21959,160,44933,866,778
Total13,501,123,3264,181,997,07117,683,120,39711,891,608,17521,150,592,0034,038,281,0473,530,922,4321,978,394,746
* Tennessee's DSH allotment for FY 2015 determined under section 1923(f)(6)(A)(vi) of the Act.
** Vermont's FMAP for FY 2015 determined in accordance with section 1905(z)(1)(A) of the Act
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[FR Doc. 2016-01836 Filed 2-1-16; 8:45 am]

BILLING CODE 4120-01-P