The Provider Reimbursement Review Board is an independent panel to which a certified Medicare provider of services may appeal if it is dissatisfied with a final determination of its fiscal intermediary or the Centers for Medicaid & Medicare Services (CMS). A decision of the Board may be affirmed, modified, reversed or vacated and remanded by the CMS Administrator within 60 days of notification to the provider of that decision.
| 2006D55 | 98-0580; 98-0463 | 14-5314 | Whether the Provider's exception requests to the skilled nursing facility (SNF) routine service cost limits under 42 C.F.R. Section 413.30(f) was properly denied because the Provider did not request the exceptions within 180 days of the original notices of program reimbursement. |
| 2008D09 | 03-0811 | 04-0091 | Whether the Provider's Disproportionate Share Hospital (DSH) adjustment was correctly calculated. |
| 2004D15 | 97-2025 | 05-0373 | Whether the Provider's budgeted beds are the most appropriate measure of available beds for proposes of computing the indirect medical education (IME) payment? |
| 2008D17 | 04-0088G | Various | Whether the Providers are entitled to receive additional indirect medical education (IME) and direct graduate medical education (DGME) payments for Medicare managed care enrollees for fiscal years ended December 31, 1998 and 1999. |
| 2003D04 | 01-0320 | 28-5149 | Whether the provider's appeal of bad debts was derived from an intermediary determination or adverse finding? |
| 2006D43 | 04-0025 | 17-0032 | Whether the Provider was improperly denied a Medicare low-volume adjustment. |
| 2007D44 | 01-2519 | 45-0039 | Whether the Provider timely filed additional information required to entitle it to an exemption from the skilled nursing facility (SNF) routine cost limit under 42 C.F.R. section 413.30(e). |
| 2007D08 | 05-0448 | 25-0085 | Whether the Provider Reimbursement Review Board may grant jurisdiction for the adjustment included in the Provider's initial Notice of Program Reimbursement.; 2. Whether the Intermediary's adjustment to remove unliquidated liabilities in the year incurred was proper. |
| 2007D43 | 98-1942 | 44-0048 | Whether the Provider is entitled under CMS Program Memorandum (PM) A-99-62 to include Social Security Act, Section 1115 waiver days for the expanded Medicaid populations (a/k/a TennCare) days in the Medicaid component of the disproportionate share hospital (DSH) calculation. |
| 2007D56 | 04-0823 | 35-0070 | Whether the Provider is entitled to Transitional Outpatient Payments (TOPs). |
Email
Print
