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.
| 2007D22 | 01-0654; 02-0235 | 01-7009 | Whether the relevant claims were timely filed by Alacare under 42 C.F.R. Section 424.44. |
| 2000D36 | 97-0795 | 01-7009 | Was the Intermediary's adjustment calculation proper to bring the expenses of Healthstar, Inc., a related party, to the cost of ownership? |
| 2000D04 | 94-0426, 94-0429 | 03-0002 | Must the Provider have a written agreement with its related facilities in order to have the resident rotations included in its GME count? |
| 2002D03 | 98-3317G; 98-2888G | 03-0002, 03-0065, 03-0001, 03-0089 | Was the Intermediary's adjustment to home office interest expense proper? |
| 2005D11 | 00-3166, 00-3167, 00-3119 | 03-0023, 03-7047 | Whether the Intermediary's denial of a request for exception to the Home Health Agency (HHA) per visit cost limits was proper? |
| 2000D14 | 95-1201 | 03-0024 | 1. Were the Intermediary's adjustments excluding certain interest expense proper?; 2. Were the Intermediary's adjustments grossing up days and charges for employee patients proper? |
| 2006D27 | 00-1020 | 03-0030 | Whether the Intermediary improperly failed to offset investment losses incurred by the Provider's home office against interest income earned on funds the Provider deposited with a trustee to retire the debt associated with an advance refunding transaction. |
| 2005D36 | 02-0216; 02-0217 | 03-0064 | 1. Were the Intermediary's adjustments reducing the Provider's Indirect Medical Education (IME) full-time equivalent (FTE) resident count for time spent by residents in research proper?; 2. Were the Intermediary's adjustments reducing the Provider's FTE resident count for IME and Direct Graduate Medical Education (GME) for time spent by residents on vacation proper? |
| 2006D19 | 04-0133 | 03-0101 | Whether the Intermediary's adjustment of the Provider's disproportionate share (DSH) calculation was based upon a proper interpretation of the Medicare DSH statute as amended by the Benefits Improvement and Protection Act of 2000. |
| 1998D003 | 91-0133 | 03-4001 | Is the Provider entitled to an adjustment to its TEFRA limits for malpractice insurance costs for FYEs June 30, 1986 and June 30, 1987? |
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