List of PRRB Decisions

The Provider Reimbursement Review Board is an independent panel to which a certified Medicare provider of services may appeal if it is dissatisfied with a final determination by its Medicare contractor or by the Centers for Medicare & Medicaid Services (CMS).  A decision of the Board may be affirmed, modified, reversed, or vacated and remanded by the CMS Administrator within 60 days of notification to the provider of that decision.

 


Showing 1-10 of 1247 entries
Decision # Case # Provider # Issue
2022D21 17-1626 32-0063 Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Carlsbad Regional Medical Center ("Carlsbad" or "Provider") for its cost reporting period ending August 31, 2014 ("FY 2014").
2022D20 17-0981 33-0085 Whether the Medicare Contractor properly calculated the Revised Volume Decrease Adjustment ("VDA") owed to the Provider for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2012 ("FY 2012"), and whether the Medicare Contractor properly reopened the Original VDA approval.
2022D19 15-3335 16-0032 Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Skiff Medical Center ("Skiff" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2011 ("FY 2011").
2022D18 15-1708, 15-1709, 15-1688 20-0041, 20-0050, 20-0037 Whether the Medicare Contractor's adjustment for fiscal year ("FY") 2012, which reduced the Providers' allowable Medicare reasonable costs by offsetting a portion of the Providers' Medicaid payments against the Providers' Maine Hospital Tax expense, was proper.
2022D17 15-3405 39-1544 Whether the Medicare Contractor used the correct data and methodology in calculating and applying a hospice cap on Tender Loving Care for the 2013 Cap Year.
2022D16 17-0848 33-0177 Whether the Medicare Contractor properly calculated the Revised Volume Decrease Adjustment ("VDA") owed to the Provider for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2011 ("FY 2011"), and whether the Medicare Contractor properly reopened the original VDA determination.
2022D15 12-0630 16-0032 Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Skiff Medical Center ("Skiff" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2009 ("FY 2009").
2022D14 11-0501 16-0032 Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Skiff Medical Center ("Skiff" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2008 ("FY 2008").
2022D13 17-0933 33-0033 Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Chenango Memorial Hospital ("Chenango" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2012 ("FY 2012"), and whether the Medicare Contractor properly reopened the Original VDA approval.
2022D12 14-0032 36-0079 Did the Medicare Contractor err when it made an adjustment for fiscal year ("FY") 2009 to remove the Provider's protested item for the addition of Allied Health Program revenue to the accumulated cost allocation statistic, Audit Adjustment No. 26?
Page Last Modified:
12/01/2021 07:02 PM