The Department of Health Care Services (DHCS), Disproportionate Share Hospital (DSH) Financing, is soliciting bids from firms that are able to conduct an annual audit for California's DSH Program. Bids must address all of the services described in the Invitation for Bid (IFB) section entitled, “Scope of Work”.
The DSH Program intends to make a single contract award to the most responsive and responsible firm offering the lowest bid. This procurement is open to all eligible firms and/or individuals that meet the qualification requirements. As of 2003, Congress has required the State to submit for each hospital annual reports and separately, to submit for each hospital an annual independent certified audit of DSH payments (P.L. 108-173). The annual reports for each DSH hospital must include the following: the hospital specific DSH limit, the Medicaid inpatient utilization rate, the low-income utilization rate, the State-defined DSH qualification criteria, and all Medicaid payments (including fee-for-service, managed care, and non-DSH supplemental payments (§1923(j) of the Social Security Act and 42, Code of Federal Regulations (CFR), §447.299). The annual independent audits must certify that each DSH hospital qualifies for payment, that DSH payments do not exceed allowable uncompensated care costs, and that the hospital accurately reported payments, spending and utilization.
On December 19, 2008, the Centers for Medicare & Medicaid Services (CMS) published a final rule (42 CFR Parts 447 and 455) specifying the elements of the required DSH report and the verifications required for the audit.
Pursuant to the Social Security Act and Federal Regulations, the Contractor will annually evaluate and determine:
1. Whether each DSH hospital qualifies for payment.
2. Whether DSH payments do/do not exceed allowable uncompensated care costs.
3. Whether each hospital accurately reported payments, spending and utilization.
The Contractor will provide DHCS with a report documenting the above on an annual basis.
Questions regarding this IFB should be submitted via email to: George.Marley@dhcs.ca.gov