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.
| 1998D061 | 91-2894M; 92-1709; 94-1277; 94-1278; 94-1702; 94-2063 | 36-0152 | 1. Should the costs incurred by the Provider's General Practice Center ("";GPC"";) for the Family Practice Residency Program be costs of a separate outpatient cost center or costs of the interns and residents medical education cost center and included in the graduate medical education ("";GME"";) base year cost and "";rate""; year per resident amounts?; 2. Should the salaryand incentive compensation of GPC's director and assistant director be costs of a separate outpatient ancillary cost center or costs of the interns and residents medical education cost center and included in the graduate medical education ("";GME"";) base year cost and "";rate""; year per resident amounts? |
| 1998D062 | 94-3278 | 23-0132 | Was the denial of the TEFRA exception request proper? |
| 1998D063 | 96-0535 | 18-0127 | Were the Intermediary's adjustments to Medicare bad debts proper? |
| 1998D064 | 96-0340 | 36-5946 | Was HCFA's denial of the Provider's request for an exemption fron the routine cost limit ("";RCL"";) as a new provider proper? |
| 1998D065 | 96-1352; 96-1353 | 14-7472 | Were the Intermediary's adjustments to disallow legal fees deemed not related to patient care proper? |
| 1998D066 | 94-0070 | 36-0054 | Does the Provider meet the criteria for receiving disproportionate share payments based on application of undisputed facts? |
| 1998D067 | 94-1389E; 94-1390E; 94-1525E | 39-4001 | Did the Intermediary err in reopening the Provider's cost reports to calculate Graduate Medical Education reimbursement? |
| 1998D068 | 92-1805; 93-0196; 94-0366; 95-0672; 96-0750; 97-0104 | 14-7407 | 1. Was the Intermediary's adjustments offsetting key employees' compensation proper?; 2. Was the Intermediary's adjustments to disallow Christmas gifts made to employees and third parties proper?; 3. Was the Intermediary's adjustments to offset charitable contributions proper?; 4. Was the Intermediary's adjustments to the Board of Directors' fee proper?; 5. Was the Intermediary's adjustments to coinsurance amounts proper?; 6. Was the Intermediary's adjustments to Medicare program visits proper?; 7. Was the Intermediary's adjustments to medical supply charges proper?; 8. Was the Intermediary's adjustments offsetting legal service fees proper?; 9. Was the Intermediary's adjustments offsetting auto expense proper?; 10. Was the Intermediary's adjustments applying sequestration factors proper? |
| 1998D069 | 90-0989 | 41-0001 | Was the Health Care Financing Administration's ( 'HCFA' ) denial of the Provider's request for reconsideration of the TEFRA exception request proper? |
| 1998D070 | 94-1740 | 05-0183 | Did the Intermediary's Notice of Reopening (NPR) and issuance of a revised NPR meet the requirements of 42 C.F.R. Sections 405.1885 and 405.1887? |
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