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Instructions for the Provider Reimbursement Review Board - (Prior to August 21, 2008) The Provider Reimbursement Review Board's Instructions for providers and intermediaries are effective on March 1, 2002. These Instructions supercede those previously issued on May 5, 2000. [Issued March 1, 2002] [Note: A clerical correction was made to Part I-B.I.a.2. on March 25, 2002] Supplemental Instructions for ESRD Appeals A set of supplemental instructions which set forth hearing procedures for ESRD appeals. [Issued March 15, 2001] Supplemental Instructions for Appeals of Childrens Hospital Graduate Medical Education (CHGME) A set of supplemental instructions which set forth hearing procedures for Appeals of Children's Hospital Graduate Medical Education (CHGME). [Issued May 03, 2004]
NEW RULES - (Effective August 21, 2008) The Provider Reimbursement Review Board's (Board) Rules, which are effective August 21, 2008, are provided below. To coincide with the CMS Final Rule at 73 Fed. Reg. 30190 which updated, clarified and revised regulatory provisions governing Board appeals, these Board Rules apply to all appeals pending as of, or filed on or after, August 21, 2008. We will welcome written suggestions regarding these Rules through October 1, 2008. Please send your suggestions to SuggestionsonPRRBRules@cms.hhs.gov. These Rules supersede the Board's previous Instructions. The Board may revise these Rules to reflect changes in the law, regulations or the Board's policy and procedures. ALERT: Automatic Extension of Position Paper Due Dates - (August 13, 2008) If you received an acknowledgement letter prior to August 21, 2008 which set preliminary or final position paper due dates that fall due on or after September 1, 2008, the Provider's preliminary position paper deadlines (or proposed JSO) is extended by four months from the original due date. If a jointly executed proposed JSO is not filed by this 4 month extension, the Intermediary's preliminary position paper due date will be extended by six months from the original due date as noted in the acknowledgement letter. The parties may disregard any final position paper due dates set in acknowledgment letters issued before August 21, 2008. Final position paper due dates will be reset in the Board's Notice of Hearing. Example: An acknowledgement letter issued August 5 would set the Provider's and Intermediary's preliminary due dates as December 1 and February 1 respectively. Both parties' final position papers would have been due on April 1. Under this scenario, the parties would have to submit either a jointly signed proposed JSO or a provider preliminary position paper by April 1 and if a proposed JSO was not submitted, the intermediary preliminary position paper would be due 6 months from the original due date or on August 1. In either case, the original final position paper due dates would be suspended and new dates will be set in the Board's Notice of Hearing. NEW REGULATIONS - 2008 The Centers for Medicare & Medicaid Services issued new appeal regulations for Medicare Part A provider appeals on May 23, 2008. These regulations will affect Provider Reimbursement Review Board (PRRB) appeals pending as of or filed on or after August 21, 2008. The regulations are available for download. (See Related Links Outside CMS at the bottom of the page.)
Page Last Modified: 08/13/2008 3:39:04 PM
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