Dynamic List Information
Dynamic List Data
Decision Number
PRRB Dec. No. 2014-D23
Case Name
Mary Greeley Medical Center vs. Blue Cross Blue Shield Association/Wisconsin Physicians Service
Issue
1. Whether the MAC and CMS Regional Office for Region VII evaluated market share for the Provider for the correct geographic area when they denied the Provider’s request for classification as a sole community hospital (SCH) on the grounds that the Provider failed to meet the market share criteria under 42 C.F.R. §412.92(a)(1)(i). 2.)Whether the Regional Office used the correct denominator in its market share calculation.