On February 24, 2023, the Centers for Medicare & Medicaid Services (CMS) published a notice of proposed rulemaking that implements statutory changes to disproportionate share hospital (DSH) payments enacted in the Consolidated Appropriations Act, 2021 (CAA, P.L. 116-260) and makes additional technical changes to CMS’s oversight of DSH policy (CMS 2023). This presentation summarized the proposed rule and proposed potential policy areas for the Commission to comment.