CMS published a Federal Register Notice on March 16, 2022 implementing a congressionally-mandated increase in Medicaid Disproportionate Share Hospital (DSH) allotments for FYs 2020 and 2021 to account for the enhanced federal Medicaid matching rates during the public health emergency. Notably, because the enhanced matching rate was only in effect for three quarters of FY 2020 (beginning January 1, 2020), CMS will only allow states to use the increased allotments to the extent it made DSH payments after January 1, 2020. Therefore, the timing of FY 2020 DSH payments will determine a state’s final DSH allotments. The allotments announced for FY 2021 are not dependent on when DSH payments are made since the enhanced matching rates were in effect for the entire federal fiscal year.