On October 3, 2013, CMS published an interim final rule with comment period revising disproportionate share hospital (DSH) payment calculations. By way of background, in the FY 2014 inpatient prospective payment system (IPPS) and long-term care hospital (LTCH) prospective payment (PPS) final rule, CMS established a methodology for determining the amount of uncompensated care payments made to hospitals eligible for the DSH payment adjustment in FY 2014 and a process for making interim and final payments. The new rule revises certain operational requirements for hospitals with Medicare cost reporting periods that span more than one federal fiscal year. It also makes changes to way Indian Health Service hospital data will be used in the uncompensated care payment calculation. The regulations are effective on October 1, 2013, and comments will be accepted on the rule until November 29, 2013.