Dynamic List Information
Dynamic List Data
Decision Number
PRRB Dec. No. 2024-D19
Case Name
Bon Secours Memorial Regional Medical Center vs. Palmetto GBA c/o National Government Services, Inc.
Issue
1. Whether the Provider is entitled to receive reimbursement for its Medicare Managed Care (Medicare Part C) costs incurred through its nursing and allied health (NAH) program, based on the requirements in 42 C.F.R § 413.87, when the Provider submitted no-pay bills to the Medicare Contractor in the UB-92 format but the claimed costs in those bills were not captured in the Provider’s Statistical and Reimbursement Report (PS&R) data for the Provider’s fiscal year (FY) 2014.
2. Whether the Medicare Contractor erred in disallowing Medicare bad debts claimed by the Provider for allegedly not having 120 days of continuous collection efforts.
2. Whether the Medicare Contractor erred in disallowing Medicare bad debts claimed by the Provider for allegedly not having 120 days of continuous collection efforts.