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.
| 2010D03 | 07-0793G | Various | Did the Centers for Medicare & Medicaid Services (CMS) err in calculating a budget neutrality adjustment to the PPS standardized amount to account for the effect of the rural floor on the wage index? |
| 2010D02 | 06-1078G; 06-1079G | Various | Whether the Intermediary's adjustments to the Provider's reimbursable capital costs after denying "";new hospital""; status was proper. |
| 2010D01 | 01-2484 | 06-0024 | Whether the Intermediary's determination that the resident time was not spent in the hospital complex was proper and with respect to some residents, the resident time was adequately documented as occurring in the contested area. |
| 2009D42 | Various | 26-2011; 26-2010 | Whether the Intermediary's adjustments treating the Management Services Corporation (MSC) pool payments the Providers received as provider refunds, which were offset against the allowable provider tax expense, were proper. |
| 2009D41 | 05-0350; 06-0452 | 33-0004 | Whether the intermediary properly adjusted the Provider's direct graduate medical education (DGME) and indirect medical education (IME) full-time equivalent (FTE) count for the fiscal years ended December 31, 2000 and December 31, 2001. |
| 2009D40 | 05-1291; 05-1292; 05-1293 | 10-4504; 10-4561; 10-4560 | Whether the Intermediary's adjustments reflected in the revised Notices of Program Reimbursement (NPR), that reduced allowable home office costs, were proper. |
| 2009D39 | 04-1799G | Various | Whether inpatient hospital days attributable to individuals who applied to the Providers for, and received, assistance under Georgia's Indigent Care Trust Fund ("";ICTF"";) should be counted in the number of Medicaid-eligible days in the numerator of the Medicaid fraction used to calculate the Medicare disproportionate share hospital (DSH) payments to the Providers. |
| 2009D38 | 06-0316G; 06-0317G; 06-0318G; 06-0319G | Various | Whether the Intermediary improperly computed the numerator of the Medicaid fractions that were used to calculate the Provider's disproportionate share hospital (DSH) payments for fiscal years 1999, 2000, 2001, and 2002 by excluding inpatient days attributable to individuals who received assistance under the Massachusetts Uncompensated Care pool for such days. |
| 2009D37 | 98-3491 | 39-0160; 39-5580 | Whether the Centers for Medicare and Medicaid Services' methodology for determining the Provider's exception to the hospital-based skill nursing facility (HB-SNF) routine cost limit was proper. |
| 2009D36 | 06-1080G; 06-1081G | Various | Whether the Intermediary"";s adjustments to the Provider's reimbursable capital cost after denying "";new hospital""; status was proper. |
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