PRRB Dec. No. 2015-D03

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Decision Number
PRRB Dec. No. 2015-D03
Case Name
Rural Family DGME Group Appeals vs. BlueCross BlueShield Association
Issue
1. Was the use of CMS' sequential geography methodology (SGM) for setting the Providers' base year per resident amounts for Medicare reimbursement of certain graduate medical education costs valid and consistent with 42 U.S.C. Section 1395ww(h)(2)(F) and 42 C.F.R. Section 413.86(e)(4)(i) (1989)? 2. If the SGM is invalid, what relief can or should the Board order?

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