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 Admistrator within 60 days of notification to the provider of that decision.
Showing 1 – 10 of 1,342 entries
Decision # | Case # | Provider # | Issue |
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20-2075
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44-0061
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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
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44-0061
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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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18-1207
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39-0084
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Whether the Medicare Administrative Contractor, Wisconsin Physicians Service ("WPS") Government Health Administrators, properly calculated the volume decrease adjustment owed to Sunbury Community Hospital ("Sunbury" or "Provider") for the significant decr...
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23-1218
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15-3045
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Whether Community Stroke and Rehabilitation Center ("Community Stroke" or "Provider") should be subject to a two (2) percentage point reduction to its federal fiscal year ("FFY") 2023 inpatient rehabilitation facility annual payment update ("APU") for fai...
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23-0216
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15-0072
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Whether Logansport Memorial Hospital ("Provider" or "Memorial) should be subject to a one-fourth reduction to its Fiscal Year (FY") 2023 Annual Percentage Update ("APU") for failure to meet the hospital inpatient quality reporting program ("IQR") requirem...
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22-0373
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05-0782
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Whether the payment penalty imposed by the Centers for Medicare & Medicaid Services ("CMS") under the Inpatient Rehabilitation Facility Quality Reporting Program ("IRF QRP") to reduce Casa Colina Hospital's ("Casa Colina") Inpatient Rehabilitation Facilit...
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18-1311
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44-0016
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Whether the Medicare Administrative Contractor, Palmetto GBA ("Palmetto"), properly calculated the volume decrease adjustment ("VDA") owed to Baptist Memorial Hospital Huntingdon ("Baptist Memorial" or "Provider") for the significant decrease in inpatient...
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16-2092
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37-0078
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Whether the fiscal year ("FY") 2008 Medicare Disproportionate Share Hospital ("DSH") payment for the Oklahoma State University Medical Center (the "Provider" or OKSU-MC") was understated because, as required by 42 U.S.C. § 1395ww(d)(5)(F)(vi) and other a...
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19-2175, 19-2176
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34-0113
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1. Whether the Provider is entitled to pass-through reimbursement for the net costs of its Nursing, Medical Laboratory Science, Radiologic Technology, and Surgical Technology Programs for fiscal years ("FYs") 2012 and 2013.
2. Whether the Medicare Cont...
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21-0995
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52-2005
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Whether the Centers for Medicare & Medicaid Services ("CMS") properly imposed a two percent reduction to the Provider's payment update for Fiscal Year ("FY") 2021 because the Provider allegedly failed to meet the requirements of the Long-Term Care Hospita...
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Page Last Modified:
11/01/2024 02:27 PM