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.
| 2005D05 | 94-3085 | 05-0295 | Was the Center For Medicare and Medicaid Services (CMS)' parial denial of the Provider's End Stage Renal Disease (ESRD) atypical service exception request proper? |
| 2007D12 | 03-1464 | 05-0308 | Whether all of the Provider's outpatient total cost, total charges, and Medicare charges for separately billable End Stage Renal Disease (ESRD) drugs should be reported together on line 56 (drugs charges to patients), on line 57 (renal dialysis), or on a separate cost center line of the Medicare cost report. |
| 2001D43 | 89-1522R | 05-0327 | Was the Provider's computation of the self-disallowance amount of investment income offset against interest expense proper? |
| 2006D39 | 01-2871 | 05-0327 | Whether the denial of the Provider's request for an exception to the end stage renal disease (ESRD) composite rate by the Centers for Medicare and Medicaid Services (CMS) was proper. |
| 1998D099 | 89-1522 | 05-0327 | Was the Provider's computation of the self-disallowance amount of investment income offset against interest expense proper? |
| 2008D26 | 02-0326; 03-0730; 04-1130 | 05-0327 | Whether the payment for indirect medical education (IME) and direct graduate medical education (DGME) was understand because not all managed care days and discharges for inpatient services for Medicare beneficiaries were included in the calculation. |
| 1999D31 | 93-1475 | 05-0329 | Was the Intermediary's adjustment offsetting revenue associated with physician and guest meals, while, at the same time, setting up a nonreimbursable cost center for these nonallowable costs, proper? |
| 2005D53 | 97-1198; 99-0246; 99-0247 | 05-0357 | Did the Provider supply sufficient information to enable the Centers for Medicare and Medicaid Services to make a decision regarding the Provider's request for an exemption to Medicare's routine service cost limits for skilled nursing facilities (SNF)? |
| 2002D30 | 95-1515, 95-2428, 99-3520, 99-3125 | 05-0366 | Was the Intermediary's reopening in accordance with Medicare regulations, and did the Intermediary use the proper hospital-specific rate in determining the Provider's reimbursement? |
| 2008D06 | 99-3140 | 05-0369 | Whether the Intermediary improperly allowed 0.54 intern and resident full time equivalent (FTE) for indirect medical education (IME) purposes on the Provider's fiscal year ended December 31. 1996 cost report. |
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