PRRB Dec. No. 2015-D07

1. Whether the Board has jurisdiction to review the MAC’s determination that the days of patients who were eligible for medical assistance under an approved Medicaid State plan and enrolled in a Medicaid plus Choice plan under Part C of Medicare should be excluded from the Medicaid fraction of the low-income percentage (LIP) adjustment for the Provider’s inpatient rehabilitation facility (IRF). 2. Whether the Medicare Administrative Contractor properly determined the Provider’s LIP adjustment under the prospective payment system for IRFs for the Provider’s cost reporting periods ending in 2002, 2003, and 2004.