List of PRRB Decisions
List of PRRB Decisions
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 by its Medicare contractor or by the Centers for Medicare & Medicaid 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.
Showing 1 – 10 of 1,350 entries
Decision # | Case # | Provider # | Issue |
---|---|---|---|
17-1917
|
16-0112
|
Whether the Medicare Administrative Contractor, Wisconsin Physicians Service Government Health Administrators (“WPS”), correctly applied the proper method to calculate the volume decrease adjustment (“VDA”) owed to Spencer Hospital (“Spencer” ...
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|
16-0109
|
16-0112
|
Whether the Medicare Administrative Contractor, Wisconsin Physicians Service Government Health Administrators (“WPS”), correctly applied the proper method to calculate the volume decrease adjustment (“VDA”) owed to Spencer Hospital (“Spencer” ...
|
|
15-3329
|
16-0112
|
Whether the Medicare Administrative Contractor, Wisconsin Physicians Service Government Health Administrators (“WPS”), correctly applied the proper method to calculate the volume decrease adjustment (“VDA”) owed to Spencer Hospital (“Spencer” ...
|
|
23-1250
|
05-9488
|
Whether the Centers for Medicare and Medicaid Services (“CMS”) properly imposed a two (2)
percentage point reduction to the Provider’s calendar year 2023 market basket percentage
increase for failure to meet Home Health Quality Reporting Program r...
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|
23-0983
|
10-7747
|
Whether Anchor Home Health Services LLC should be subject to a two (2) percentage point
reduction to its calendar year 2023 Market Basket Update for failure to meet Home Health
Quality Reporting Program requirements in accordance with 42 C.F.R. Part 484...
|
|
17-0904
|
20-0032
|
Whether the Medicare Contractor 1 1) properly reopened the original volume decrease
adjustment (“VDA”) approval, and 2) properly calculated the revised VDA payment owed to
Stephens Memorial Hospital (“Stephens” or the “Provider”) for the sig...
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21-0997
|
11-2012
|
Whether Columbus Specialty Hospital, Inc. (“Columbus Specialty” or “Provider”) complied with
the Affordable Care Act Long Term Care Hospital Quality Reporting Program requirements for
submission of quality data for C. diff infection or CDI for t...
|
|
23-1401
|
44-0073
|
Whether Maury Regional Medical Center (“Provider” or “Maury Regional”) should be subject to
a one-fourth reduction to its fiscal year (“FY”) 2024 annual payment update (“APU”) for failure
to meet the Hospital Inpatient Quality Reporting ...
|
|
20-2075
|
44-0061
|
Whether the Medicare Administrative Contractor, Wisconsin Physicians Service ("WPS") Government Health Administrators, properly calculated the volume decrease adjustment owed to Tennova Healthcare - Volunteer Martin ("Volunteer Martin" or "Provider") for ...
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|
18-1201
|
44-0061
|
Whether the Medicare Administrative Contractor, Wisconsin Physicians Service ("WPS") Government Health Administrators, properly calculated the volume decrease adjustment owed to Tennova Healthcare - Volunteer Martin ("Volunteer Martin" or "Provider") for ...
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Page Last Modified:
04/18/2025 12:33 PM