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.
| 2000D83 | Various | Various | Was the Intermediary's inclusion of maintenance treatments in the Provider's cost aportionment statistics for Medicare reimbursement proper? |
| 2005D49 | Various | 36-0125; 36-0187; 36-0027; 36-0009; 36-0068 | Whether the Intermediary improperly excluded patient days related to Ohio's Hospital Care Assurance Program (HCAP) in the providers' disproportionate share calculations. |
| 2005D16 | Various | Various | What relief is available through appeal to thre Provider Reimbursement Review Board (Board) for failure of the Intermediaries to timely settle the Provider's cost reports, especially where prejudice will result from the failure to settle such cost report? |
| 2003D66 | 99-4073 | 49-5280 | Was the Intermediary's adjustment disallowing Medicare Part A and Part B bad debts proper? |
| 2003D20 | 99-4064 | 52-0089 | Was the Intermediary's determination of the TEFRA exception request proper? |
| 2005D44 | 99-4061 | 50-5504 | Whether CMS' denial of the Provider's request for an exemption to the routine cost limits for skilled nursing facilities as a new provider was proper. |
| 2005D41 | 99-4038 | 36-0066 | Whether for purposes of the Provider's disproportionate share (DSH) calculation, the Provider is entitled to an increased number of days of care rendered to eligible Medicaid beneficiaries. |
| 2002D27 | 99-3872 | 55-7633 | 1. Was the Intermediary's adjustment disallowing unsupported compensation paid to the Medical Director proper?; 2. Was the Intermediary's adjustment reducing compensation paid to the Director of Nursing to a reasonable amount proper?; 3. Was the Intermediary's adjustment to the Administrator's salary proper? |
| 2003D25 | 99-3866; 01-0764 | 39-5742 | 1. Was the Intermediary's reclassification of Staff Development/ Quality Assurance Coordinator salaries proper?; 2. Was the Intermediary's adjustment allocating social service costs proper? |
| 2003D57 | 99-3821 | 40-0098 | Was the Intermediary's adjustment to bad debts proper? |
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