U.S. flag

An official website of the United States government

Dot gov

The .gov means it's official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you're on a federal government site.


The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Department of Health and Human Services

"Review of Disproportionate Share Hospital Costs Claimed by the State of Missouri for Fiscal Year Ended June 30, 1999," (A-07-01-02093)

August 16, 2002

Complete Text of Report is available in PDF format (922 KB). Copies can also be obtained by contacting the Office of Public Affairs at 202-619-1343.


This final audit report points out that the State of Missouri overstated its disproportionate share hospital (DSH) claims by $36.2 million (federal share) for State Fiscal Year 1999. Contrary to the Omnibus Budget Reconciliation Act of 1993 (OBRA), the State included nonhospital (community mental health center) costs in the DSH calculations. We recommended a financial adjustment for the $36.2 million. We also recommended that the State identify and refund similar excessive claims from subsequent years, and implement procedures and controls to prevent similar types of DSH claims in future periods. The State did not concur, contending that the nonhospital costs were allowable.