REVISED PRRB RULES - (Revised/Effective July 1, 2015)
The Board has made revisions to the PRRB Rules (See ALERT 11 under Current Alerts). These instructions are effective July 1, 2015 and supersede previous instructions [Issued August 21, 2008; Revised July 1, 2009, March 1, 2013, and July 1, 2015]. The specific changes to the PRRB Rules have been highlighted and dated with the effective date of the change. The Board may further revise these Rules to reflect changes in the law, regulations or the Board's policy and procedures.
PRRB model forms are available in a fillable PDF format for ease of use. Please begin using the revised model forms as soon as possible to ensure all documentation requirements have been met.
In addition, there are supplemental instructions which set forth hearing procedures specific to End Stage Renal Disease (ESRD) appeals [Issued March 15, 2001] and Children's Hospital Graduate Medical Education (CHGME) appeals [Issued May 03, 2004].
The PRRB often sends official correspondence via e-mail (including the Acknowledgment and Critical Due Dates letter, Notice of Hearing, Notice of Record Hearing, etc.). The representative is responsible for informing the Board of changes in his or her contact information (including e-mail address), for meeting the Board’s deadlines and for timely responding to correspondence or requests from the Board or the opposing party. Therefore, it is imperative that the Provider maintain current contact information on file with the Board. Also, please modify your spam filter to accept e-mail from the PRRB. This will help ensure that you receive the Board's correspondence and it is not sent to an obsolete address or to your spam or junk e-mail box.
NEW REGULATIONS - 2008
The Centers for Medicare & Medicaid Services issued new appeal regulations for Medicare Part A provider appeals on May 23, 2008. These regulations at 42 C.F.R. § 405, Subpart R, affected Provider Reimbursement Review Board (PRRB) appeals pending as of or filed on or after August 21, 2008.
We welcome written suggestions regarding these Rules. Please send your suggestions to PRRB@cms.hhs.gov. We will consider every suggestion but may not respond to each one.
- PRRB Rules - July 1, 2015 [PDF, 2MB]
- Model Form A - Fillable (2013) [PDF, 60KB]
- Model From B - Fillable (2013) [PDF, 49KB]
- Model Form C - Fillable (2013) [PDF, 39KB]
- Model Form D - Fillable (2013) [PDF, 56KB]
- Model Form E - Fillable (2013) [PDF, 61KB]
- Model Form F - Fillable (2013) [PDF, 43KB]
- Model Form G - Fillable [PDF, 49KB]
- Supplemental Instructions for ESRD Appeals [PDF, 7KB]
- Supplemental Instructions for CHGME [PDF, 62KB]
- Frequently Asked Questions [PDF, 14KB]
- Prior PRRB Rules - March 1, 2013 [PDF, 1MB]
- Prior PRRB Rules - July 1, 2009 [PDF, 2MB]
- Prior PRRB Rules - March 2002 [PDF, 159KB]
- Page last Modified: 06/29/2015 9:23 PM
- Help with File Formats and Plug-Ins