PRRB Dec. No. 2020-D04

Whether the Provider, as a Sole Community Hospital (SCH), was properly reimbursed for indirect medical education costs for services provided to Medicare Advantage (MA or Part C) patients for fiscal year ending May 31, 2009. In particular, whether the Cost Report Worksheet E Part A properly calculates the indirect medical education (IME or indirect GME) settlement on Medicare Manage Care claims, for a SCH whose hospital-specific rate (HSR) exceeds the hospital’s inpatient prospective payment (IPPS) Federal rate.