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FROM:           RANDY MAY, Deputy Administrator

                        State Operations


On September 30, 2002, Idaho Medicaid will distribute a DSH payment to all eligible hospitals for federal fiscal year 2002.  In order to be considered for a DSH payment, the hospital must:


·        Provide all data requested on the attached survey.  All data entered on the survey should be for the fiscal year indicated on the survey form.


·        Verify that the information in the shaded areas on the survey is correct, as provided by Myers and Stauffer LC.   If you disagree with any of this information, please attach documentation supporting the correct information.


·        Return the survey by May 31, 2002 to:

      Myers and Stauffer LC

      Attn:  Julia Hill

      8555 W. Hackamore Dr., Suite 100

      Boise, ID  83709


      Please note: if the survey is received after May 31, 2002, the hospital will not be considered for a DSH payment.


If you have any questions concerning the survey, please contact Julia Hill at (800) 336-7721 or (208) 378-1400.  Thank you for your participation in Idaho Medicaid.




Attachment is provider specific and is not available electronically.