PRRB Dec. No. 2011-D08

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Decision Number
PRRB Dec. No. 2011-D08
Case Name
Autumn Bridge LLC vs. BlueCross BlueShield Association/Palmetto Government Benefits Administrators
Issue
1. Whether the Provider demonstrated that it is entitled to a hearing before the Board because there is at least $10,000 in controversy. 2. To what extent, if at all, Medicare's $397,228 demand for repayment from the Provider for fiscal year 2007, calculated pursuant to the existing regulation, would be decreased if the Provider's proposed manner of calculation is adopted.

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