MACPAC is statutorily required to report annually on Medicaid disproportionate share hospital (DSH) allotments in its March report to Congress. This presentation follows up on the presentation at MACPAC’s October Commission meeting of the key data elements in this analysis with the draft DSH chapter in the March report to Congress. The presentation also updates the Commission on the potential impact of the November 2019 Medicaid fiscal accountability rule on the DSH program and on the status of the DSH allotment reductions. Although the allotment reductions were originally set for 2014, they have been delayed several times and, at the time of this presentation, were scheduled to take effect on December 21, 2019.