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.
1998D081 | 92-2398 | 42-T078 | Was HCFA's denial of the Provider's request for an adjustment to its TEFRA target rate for certain costs proper? |
1998D082 | 94-2577 | 17-0086 | Was the Intermediary's reopening of the Medicare cost report to reduce reimbursement for indirect medical education ("";IME"";) expense proper? |
1998D083 | 92-1569 | 05-0191 | Was the Provider's request for an adjustment to the TEFRA limits for the fiscal year ended June 30, 1989 timely? |
1998D084 | 96-0066G | Various | Was the Intermediary's inclusion of neonatal intensive care unit ("";NICU"";) beds in the indirect medical education ("";IME"";) calculation proper? |
1998D085 | 96-0378 | 05-0281; 55-5294 | Should the Provider's Medicaid patient days in its "";subacute unit""; be included in calculating the disproportionate share hospital ("";DSH"";) adjustment? |
1998D086 | 94-3045 | 33-2546 | Was the Intermediary's denial of the Provider's request for an exception to its End-Stage Renal Disease ("";ESRD"";) composite rate proper? |
1998D087 | 97-0682G | Various | Were the Intermediary's adjustments to occupational and speech therapy costs proper? |
1998D088 | 90-1201;91-1310 | 45-0021 | 1. Was the Intermediary's adjustment offsetting intercompany interest income proper?; 2. Was the Intermediary's adjustment disallowing staff physician Part A salary costs proper?; 3. Was the Intermediary's adjustment offsetting investment income earned on loans to physicians proper?; 4. Was the Intermediary's adjustment disallowing intercompany interest expense proper? |
1998D089 | 91-2907M | 39-0196 | 1. Did the Intermediary improperly exclude physician compensation costs, attributable to teaching and supervision of interns and residents in the departments of surgery, from the graduate medical education ("";GME"";) costs used to compute the Provider's average per resident amount?: 2. Did the Intermediary improperly exclude physician compensation costs, attributable to teaching and supervision of interns and residents in the departments of radiation therapy, from the GME costs used to compute the Provider's average per resident amount?: |
1998D090 | 92-0948 | 50-0064 | 1. Did the Provider maintain adequate documentation to properly determine the paramedical education costs claimed for the physical therapy clinical training program and did those costs qualify as paramedical education costs reimbursable on a pass-through basis?; 2. Was the Provider's inclusion of foreign medical graduates in its resident count proper?; 3. Was the Provider's documentation adequate to support additional claimed costs related to the County Treasurer's costs of services performed for the Provider? |