PRRB Dec. No. 2019-D26

Dynamic List Information
Dynamic List Data
Decision Number
PRRB Dec. No. 2019-D26
Case Name
Novus Health Services, Inc. vs. Palmetto GBA c/o National Government Services
Issue
1. Whether the sequestration amount should be included when calculating the aggregate payment made to the Provider, as the reduction in payment through sequestration does not constitute actual Medicare payments made to the Provider. 2. Whether the Medicare Contractor's reopening(s) is/are invalid, as the Medicare Contractor failed to comply with applicable Medicare statutes, regulations, and guidelines when doing so.