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<rss xmlns:atom="http://www.w3.org/2005/Atom" version="2.0">
<channel xml:base="https://www.cms.gov/rss/30686">
<title>List of PRRB Decisions</title>
<link>https://www.cms.gov/rss/30686</link>
<description/>
<atom:link href="https://www.cms.gov/rss/30686" rel="self" type="application/rss+xml" />
<lastBuildDate>Tue, 25 Feb 2025 21:39:20 -0500</lastBuildDate>
<generator>Centers for Medicare and Medicaid Services</generator><item><title>2025D07</title><pubDate>Wed, 18 Dec 2024 14:26:52 -0500</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d07</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d07</guid><description><![CDATA[<p>decision_number: 2025D07</p><p>fiscal_year_end: January 31, 2017</p><p>provider_number: 44-0061</p><p>summary: Whether the Medicare Administrative Contractor, Wisconsin Physicians Service ("WPS") Government Health Administrators, properly calculated the volume decrease adjustment owed to Tennova Healthcare - Volunteer Martin ("Volunteer Martin" or "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending January 31, 2017 ("FY 2017").</p>]]></description></item><item><title>2025D06</title><pubDate>Wed, 18 Dec 2024 14:21:38 -0500</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d06</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d06</guid><description><![CDATA[<p>decision_number: 2025D06</p><p>fiscal_year_end: January 31, 2015</p><p>provider_number: 44-0061</p><p>summary: Whether the Medicare Administrative Contractor, Wisconsin Physicians Service ("WPS") Government Health Administrators, properly calculated the volume decrease adjustment owed to Tennova Healthcare - Volunteer Martin ("Volunteer Martin" or "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending January 31, 2015 ("FY 15").</p>]]></description></item><item><title>2025D05</title><pubDate>Mon, 02 Dec 2024 15:03:34 -0500</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d05</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d05</guid><description><![CDATA[<p>decision_number: 2025D05</p><p>fiscal_year_end: June 30, 2015</p><p>provider_number: 39-0084</p><p>summary: Whether the Medicare Administrative Contractor, Wisconsin Physicians Service ("WPS") Government Health Administrators, properly calculated the volume decrease adjustment owed to Sunbury Community Hospital ("Sunbury" or "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2015.</p>]]></description></item><item><title>2025D04</title><pubDate>Fri, 08 Nov 2024 11:05:33 -0500</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d04</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d04</guid><description><![CDATA[<p>decision_number: 2025D04</p><p>fiscal_year_end: September 30, 2023</p><p>provider_number: 15-3045</p><p>summary: Whether Community Stroke and Rehabilitation Center ("Community Stroke" or "Provider") should be subject to a two (2) percentage point reduction to its federal fiscal year ("FFY") 2023 inpatient rehabilitation facility annual payment update ("APU") for failure to meet the Inpatient Rehabilitation Facility ("IRF") Quality Reporting Program ("QRP") requirements, in accordance with 42 C.F.R. § 412.634(f).</p>]]></description></item><item><title>2024D33</title><pubDate>Fri, 01 Nov 2024 13:58:50 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d33</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d33</guid><description><![CDATA[<p>decision_number: 2024D33</p><p>fiscal_year_end: November 30, 2008</p><p>provider_number: 37-0078</p><p>summary: Whether the fiscal year ("FY") 2008 Medicare Disproportionate Share Hospital ("DSH") payment for the Oklahoma State University Medical Center (the "Provider" or OKSU-MC") was understated because, as required by 42 U.S.C. § 1395ww(d)(5)(F)(vi) and other authorities, the payment did not include the inpatient days for which the patients in OKSU-MC's four child, early adolescent, and adolescent behavioral health units (the "Four Units") were "eligible for medical assistance under a state plan approved under Title 19, but who were not entitled to benefits under Medicare Part A" as required by the statute, HCFA Ruling 97-2, Program Memorandum A99-62, CMS Ruling 1498-R1 and other authorities.</p>]]></description></item><item><title>2024D32</title><pubDate>Fri, 01 Nov 2024 13:37:27 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d32</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d32</guid><description><![CDATA[<p>decision_number: 2024D32</p><p>fiscal_year_end: December 31, 2012; December 31-2013</p><p>provider_number: 34-0113</p><p>summary: 1. Whether the Provider is entitled to pass-through reimbursement for the net costs of its Nursing, Medical Laboratory Science, Radiologic Technology, and Surgical Technology Programs for fiscal years ("FYs") 2012 and 2013.
2. Whether the Medicare Contractor miscalculated the Part C component of the Provider's nursing and allied health ("NAH") payment for FYs 2012 and 2013.
3. Whether the Medicare Contractor failed to account for all of the Provider's Medicaid eligible days in calculating the DSH payment for FY 2013.</p>]]></description></item><item><title>2025D03</title><pubDate>Tue, 29 Oct 2024 14:52:47 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d03</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d03</guid><description><![CDATA[<p>decision_number: 2025D03</p><p>fiscal_year_end: September 30, 2023</p><p>provider_number: 15-0072</p><p>summary: Whether Logansport Memorial Hospital ("Provider" or "Memorial) should be subject to a one-fourth reduction to its Fiscal Year (FY") 2023 Annual Percentage Update ("APU") for failure to meet the hospital inpatient quality reporting program ("IQR") requirements due to extraordinary or extenuating circumstances.</p>]]></description></item><item><title>2025D02</title><pubDate>Tue, 29 Oct 2024 14:42:51 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d02</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d02</guid><description><![CDATA[<p>decision_number: 2025D02</p><p>fiscal_year_end: September 30, 2022</p><p>provider_number: 05-0782</p><p>summary: Whether the payment penalty imposed by the Centers for Medicare &#x26; Medicaid Services ("CMS") under the Inpatient Rehabilitation Facility Quality Reporting Program ("IRF QRP") to reduce Casa Colina Hospital's ("Casa Colina") Inpatient Rehabilitation Facility ("IRF") prospective payment system ("PPS") payment update (i.e., annual increase factor or "AIF") for federal Fiscal Year ("FFY") 2022 by two (2) percentage points was proper.</p>]]></description></item><item><title>2025D01</title><pubDate>Wed, 23 Oct 2024 14:57:16 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d01</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2025d01</guid><description><![CDATA[<p>decision_number: 2025D01</p><p>fiscal_year_end: September 30, 2013</p><p>provider_number: 44-0016</p><p>summary: Whether the Medicare Administrative Contractor, Palmetto GBA ("Palmetto"), properly calculated the volume decrease adjustment ("VDA") owed to Baptist Memorial Hospital Huntingdon ("Baptist Memorial" or "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending September 30, 2013.</p>]]></description></item><item><title>2024D31</title><pubDate>Mon, 30 Sep 2024 14:15:15 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d31</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d31</guid><description><![CDATA[<p>decision_number: 2024D31</p><p>fiscal_year_end: 2021</p><p>provider_number: 52-2005</p><p>summary: Whether the Centers for Medicare &#x26; Medicaid Services ("CMS") properly imposed a two percent reduction to the Provider's payment update for Fiscal Year ("FY") 2021 because the Provider allegedly failed to meet the requirements of the Long-Term Care Hospital Quality Reporting Program ("LTCH QRP").</p>]]></description></item><item><title>2024D30</title><pubDate>Mon, 30 Sep 2024 14:01:15 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d30</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d30</guid><description><![CDATA[<p>decision_number: 2024D30</p><p>fiscal_year_end: 2006-2014</p><p>provider_number: Various</p><p>summary: Whether the Providers may be reimbursed for bad debts incurred by patients who were dually eligible for Medicare and Medicaid.</p>]]></description></item><item><title>2024D29</title><pubDate>Tue, 24 Sep 2024 12:32:12 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d29</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d29</guid><description><![CDATA[<p>decision_number: 2024D29</p><p>fiscal_year_end: September 30, 2015</p><p>provider_number: 44-0039, 44-0053, 44-0082, 44-0133, 44-0218</p><p>summary: Whether the Medicare Contractor and the Centers for Medicare &#x26; Medicaid Services ("CMS") improperly disallowed certain wage data from Vanderbilt University Medical Center ("VUMC") when the wage index for Federal Fiscal Year ("FFY") 2015 was calculated.</p>]]></description></item><item><title>2024D28</title><pubDate>Fri, 06 Sep 2024 15:12:33 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d28</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d28</guid><description><![CDATA[<p>decision_number: 2024D28</p><p>fiscal_year_end: June 30, 2007</p><p>provider_number: 14-0150</p><p>summary: Whether the Medicare Contractor ("Medicare Contractor") determined the Medicare reimbursement of the operating and capital outliers, and the corresponding time value of money ("TVM"), through the outlier reconciliation process properly. This issue relates to the Provider's fiscal year ending June 30, 2007 ("FY 2007") and has the following four (4) subparts:
1. Whether the Medicare Contractor's use of non-patient specific data (which was not run through the Lump Sum Utility in the Fiscal Intermediary Shared System ("FISS") in the calculation of the outlier reconciliation amount and the corresponding TVM amount for FY 2007 was made in accordance with 42 C.F.R. § 412.84(i)(4) and Medicare Claims Processing Manual, CMS Pub. 100-04 ("MCPM"), Ch. 3, § 20.1.2.7;
2. Whether the Medicare Contractor's selection of the Provider for the outlier reconciliation process for FY 2007 and the Medicare Contractor's calculation of the Outlier Reconciliation amount with the corresponding TVM amount was proper and in accordance with 42 C.F.R. § 412.84(i)(4) and MCPM Ch. 3, § 20.1.2;
3. Whether the FY 2007 TVM amount established and assessed under the outlier regulation at 42 C.F.R. § 412.84(m) for FY 2007 is invalid; and
4. Whether the Medicare Contractor's calculation of the FY 2007 TVM was overstated due to the delay of the Centers for Medicare &#x26; Medicaid Services ("CMS") in publishing the Revised 2006 SSI ratios.
</p>]]></description></item><item><title>2024D27</title><pubDate>Fri, 06 Sep 2024 12:23:35 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d27</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d27</guid><description><![CDATA[<p>decision_number: 2024D27</p><p>fiscal_year_end: April 30, 2017</p><p>provider_number: 18-4012</p><p>summary: Whether the Elizabethtown Core Based Statistical Area ("CBSA") 21060 Wage Index was correctly established for Medicare payments made to the Provider during its fiscal year ending April 30, 2017.</p>]]></description></item><item><title>2024D26</title><pubDate>Mon, 26 Aug 2024 10:51:39 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d26</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d26</guid><description><![CDATA[<p>decision_number: 2024D26</p><p>fiscal_year_end: September 30, 2021</p><p>provider_number: 05-0254</p><p>summary: Whether the Centers for Medicare &#x26; Medicaid Services ("CMS") properly determined that the federal fiscal year ("FFY") 2021 payment update to the inpatient prospective payment system ("IPPS") for the hospital should be reduced by one fourth because the hospital allegedly did not meet the quality data submission requirements for the Hospital Inpatient Quality Reporting program.</p>]]></description></item><item><title>2024D25</title><pubDate>Wed, 14 Aug 2024 13:50:08 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d25</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d25</guid><description><![CDATA[<p>decision_number: 2024D25</p><p>fiscal_year_end: September 30, 2015</p><p>provider_number: 17-1358</p><p>summary: Whether the Medicare Contractor properly disallowed the allocated related party costs claimed by Lindsborg Community Hospital ("Provider" or "Lindsborg") for fiscal year ("FY") 2015.</p>]]></description></item><item><title>2024D24</title><pubDate>Mon, 29 Jul 2024 14:33:03 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d24</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d24</guid><description><![CDATA[<p>decision_number: 2024D24</p><p>fiscal_year_end: 2016 &#x26; 2017</p><p>provider_number: 49-4010; 49-4021</p><p>summary: Whether the Medicare Contractor's decision to disallow all professional costs for the Providers' fiscal years ("FYs") 2016 and 2017 was proper, given the Providers are teaching hospitals.</p>]]></description></item><item><title>2024D23</title><pubDate>Fri, 26 Jul 2024 11:06:38 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d23</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d23</guid><description><![CDATA[<p>decision_number: 2024D23</p><p>fiscal_year_end: June 30, 2014</p><p>provider_number: 15-0011</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Marion General Hospital ("Marion General" of the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2014 ("FY 2014").</p>]]></description></item><item><title>2024D22</title><pubDate>Wed, 24 Jul 2024 15:17:49 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d22</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d22</guid><description><![CDATA[<p>decision_number: 2024D22</p><p>fiscal_year_end: September 30, 2022</p><p>provider_number: 15-3045</p><p>summary: Whether the Community Stroke and Rehabilitation Center ("Community Stroke" or "Provider") should be subject to a two (2) percentage point reduction to its federal fiscal year 2022 inpatient rehabilitation facility annual payment update ("APU") for failure to meet the Inpatient Rehabilitation Facility ("IRF") Quality Reporting Program ("QRP") requirements in accordance with 42 C.F.R. § 412.634(f).</p>]]></description></item><item><title>2024D21</title><pubDate>Tue, 16 Jul 2024 10:52:29 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d21</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d21</guid><description><![CDATA[<p>decision_number: 2024D21</p><p>fiscal_year_end: December 31, 2014</p><p>provider_number: 24-0166</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Mayo Clinic Health System - Fairmont ("Mayo Clinic Fairmont" or "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2014 ("FY 2014").</p>]]></description></item><item><title>2024D20</title><pubDate>Tue, 16 Jul 2024 10:46:45 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d20</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d20</guid><description><![CDATA[<p>decision_number: 2024D20</p><p>fiscal_year_end: May 31, 2014</p><p>provider_number: 18-0038</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Owensboro Health Regional Hospital ("Owensboro Health" or the "Provider") for the significant decrease in inpatient discharges that occurred during its fiscal year ending May 31, 2014 ("FY 2014").</p>]]></description></item><item><title>2024D19</title><pubDate>Tue, 16 Jul 2024 10:36:56 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d19</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d19</guid><description><![CDATA[<p>decision_number: 2024D19</p><p>fiscal_year_end: August 31, 2014</p><p>provider_number: 49-0069</p><p>summary: 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&#x26;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.</p>]]></description></item><item><title>2024D18</title><pubDate>Fri, 21 Jun 2024 11:17:19 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d18</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d18</guid><description><![CDATA[<p>decision_number: 2024D18</p><p>fiscal_year_end: December 31, 2016, December 31, 2017</p><p>provider_number: 36-0041</p><p>summary: Did the Medicare Contractor properly determine the Provider's Per Resident Amount ("PRA") for fiscal year ending December 31, 2016 ("FY 2016")?</p>]]></description></item><item><title>2024D17</title><pubDate>Fri, 07 Jun 2024 10:48:21 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d17</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d17</guid><description><![CDATA[<p>decision_number: 2024D17</p><p>fiscal_year_end: June 30, 2010</p><p>provider_number: 43-0012</p><p>summary: Whether the Medicare Contractor appropriately made adjustments, which eliminated pass-through reimbursement of Avera Sacred Heart Hospital's ("Avera" or "the Provider") Nursing Education costs for fiscal year ("FY") 2010, pursuant to 42 C.F.R. § 413.85(g).</p>]]></description></item><item><title>2024D16</title><pubDate>Fri, 31 May 2024 12:24:30 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d16</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d16</guid><description><![CDATA[<p>decision_number: 2024D16</p><p>fiscal_year_end: 2017</p><p>provider_number: 45-2061</p><p>summary: Whether the payment penalty that the Centers for Medicare &#x26; Medicaid Services ("CMS") imposed under the Long-Term Care Hospital Quality Reporting Program ("LTCH QRP") to reduce the Provider's payment update for Fiscal Year ("FY") 2017 by two percentage points was proper.</p>]]></description></item><item><title>2024D15</title><pubDate>Tue, 21 May 2024 14:07:55 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d15</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d15</guid><description><![CDATA[<p>decision_number: 2024D15</p><p>fiscal_year_end: June 30, 2015</p><p>provider_number: 05-0435</p><p>summary: Whether Fallbrook District Hospital (the "Provider") is entitled to a volume decrease adjustment ("VDA") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2015 ("FY 2015").</p>]]></description></item><item><title>2024D14</title><pubDate>Tue, 21 May 2024 14:03:46 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d14</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d14</guid><description><![CDATA[<p>decision_number: 2024D14</p><p>fiscal_year_end: June 30, 2014</p><p>provider_number: 05-0435</p><p>summary: Whether Fallbrook District Hospital (the "Provider") is entitled to a volume decrease adjustment ("VDA") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2014 ("FY 2014").</p>]]></description></item><item><title>2024D13</title><pubDate>Thu, 25 Apr 2024 14:38:42 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d13</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d13</guid><description><![CDATA[<p>decision_number: 2024D13</p><p>fiscal_year_end: December 31, 2013</p><p>provider_number: 33-0250</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Champlain Valley Physicians Hospital ("Champlain Valley" or the "Provider") for the significant decrease in inpatient discharges that occurred during its fiscal year ending December 31, 2013.</p>]]></description></item><item><title>2024D12</title><pubDate>Thu, 25 Apr 2024 14:33:39 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d12</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d12</guid><description><![CDATA[<p>decision_number: 2024D12</p><p>fiscal_year_end: December 31, 2011</p><p>provider_number: 33-0250</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Champlain Valley Physicians Hospital ("Champlain Valley" or the "Provider") for the significant decrease in inpatient discharges that occurred during its fiscal year ending December 31, 2011.</p>]]></description></item><item><title>2024D11</title><pubDate>Thu, 11 Apr 2024 10:48:18 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d11</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d11</guid><description><![CDATA[<p>decision_number: 2024D11</p><p>fiscal_year_end: June 30, 2014</p><p>provider_number: 39-0084</p><p>summary: Whether the Medicare Administrative Contractor, Wisconsin Physicians Service ("WPS"), properly calculated the volume decrease adjustment owed to Sunbury Community Hospital ("Sunbury" or "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2014.</p>]]></description></item><item><title>2024D10</title><pubDate>Wed, 20 Mar 2024 14:13:18 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d10</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d10</guid><description><![CDATA[<p>decision_number: 2024D10</p><p>fiscal_year_end: December 31, 2014</p><p>provider_number: 33-0276</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Nathan Littauer Hospital ("Nathan Littauer" or the "Provider") for the significant decrease in inpatient discharges that occurred during its cost reporting period ending December 31, 2014 ("FY 2014").</p>]]></description></item><item><title>2024D09</title><pubDate>Wed, 20 Mar 2024 14:04:28 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d09</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d09</guid><description><![CDATA[<p>decision_number: 2024D09</p><p>fiscal_year_end: December 31, 2012</p><p>provider_number: 33-0276</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Nathan Littauer Hospital ("Nathan Littauer" or the "Provider") for the significant decrease in inpatient discharges that occurred during its cost reporting period ending December 31, 2012 ("FY 2012").</p>]]></description></item><item><title>2024D08</title><pubDate>Wed, 20 Mar 2024 13:54:13 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d08</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d08</guid><description><![CDATA[<p>decision_number: 2024D08</p><p>fiscal_year_end: December 31, 2011</p><p>provider_number: 33-0276</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Nathan Littauer Hospital ("Nathan Littauer" or the "Provider") for the significant decrease in inpatient discharges that occurred during its cost reporting period ending December 31, 2011 ("FY 2011").</p>]]></description></item><item><title>2024D07</title><pubDate>Wed, 28 Feb 2024 12:32:18 -0500</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d07</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d07</guid><description><![CDATA[<p>decision_number: 2024D07</p><p>fiscal_year_end: December 31, 2013</p><p>provider_number: 23-0130</p><p>summary: This case involves the following three issues for the fiscal year ending December 31, 2013 ("FY 2013"):
1. Whether the Medicare Contractor should have adjusted William Beaumont Hospital - Royal Oak's (hereinafter "Provider" or "Beaumont") nursing school passthrough costs, specifically Cohort Clinical Training.
2. Whether the Medicare Contractor should have adjusted the Provider's square footage attributable to nursing and allied health ("NAH") programs.
3. Whether the Medicare Contractor should have adjusted Beaumont's kidney acquisition costs.</p>]]></description></item><item><title>2024D06</title><pubDate>Wed, 28 Feb 2024 12:21:32 -0500</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d06</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d06</guid><description><![CDATA[<p>decision_number: 2024D06</p><p>fiscal_year_end: September 30, 2013</p><p>provider_number: 34-0106</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Sandhills Regional Medical Center ("Sandhills" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending September 30, 2013 ("FY 2013").</p>]]></description></item><item><title>2024D05</title><pubDate>Wed, 03 Jan 2024 12:01:59 -0500</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d05</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d05</guid><description><![CDATA[<p>decision_number: 2024D05</p><p>fiscal_year_end: September 30, 2019</p><p>provider_number: 14-1694</p><p>summary: Whether the Medicare Contractor used the correct time-period and calculations for determining the Provider's hospice cap amount for the cap year ending on September 30, 2019.</p>]]></description></item><item><title>2024D04</title><pubDate>Thu, 30 Nov 2023 13:40:16 -0500</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d04</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d04</guid><description><![CDATA[<p>decision_number: 2024D04</p><p>fiscal_year_end: September 30, 2021</p><p>provider_number: 16-1544</p><p>summary: Whether the Centers for Medicare &#x26; Medicaid Services ("CMS") properly imposed a two percentage point reduction to the fiscal year ("FY") 2021 Medicare annual payment update ("APU") for Hospice of Washington County (the "Provider").</p>]]></description></item><item><title>2024D03</title><pubDate>Fri, 17 Nov 2023 15:08:08 -0500</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d03</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d03</guid><description><![CDATA[<p>decision_number: 2024D03</p><p>fiscal_year_end: September 30, 2020</p><p>provider_number: 03-0111</p><p>summary: Whether the Centers for Medicare &#x26; Medicaid Services ("CMS") properly imposed a two percentage point reduction to the Provider's Federal Fiscal Year ("FFY") 2020 Annual Payment Update ("APU") under the Inpatient Psychiatric Facility Quality Reporting ("IPFQR") Program was proper.</p>]]></description></item><item><title>2024D02</title><pubDate>Fri, 27 Oct 2023 17:17:02 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d02</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d02</guid><description><![CDATA[<p>decision_number: 2024D02</p><p>fiscal_year_end: June 30, 2009</p><p>provider_number: 32-0002; 45-0046; 45-0034</p><p>summary: Whether the disproportionate share hospital ("DSH") payments for the fiscal year ending June 30, 2009 ("FY 2009") of each of the Christus Health Providers should be revised to include additional Medicaid labor and delivery room ("LDR") patient days that were excluded from the numerator and denominator of their respective Medicaid fraction.</p>]]></description></item><item><title>2024D01</title><pubDate>Fri, 27 Oct 2023 16:55:52 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d01</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2024d01</guid><description><![CDATA[<p>decision_number: 2024D01</p><p>fiscal_year_end: June 30, 2010</p><p>provider_number: 39-0197</p><p>summary: Whether the Medicare Contractor's determination of the Provider's disproportionate share hospital ("DSH") payment for fiscal year ("FY") 2010 should be revised to include additional Medicaid patient days that were excluded from the numerator of the Medicaid fraction.</p>]]></description></item><item><title>2023D36</title><pubDate>Tue, 03 Oct 2023 11:35:25 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d36</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d36</guid><description><![CDATA[<p>decision_number: 2023D36</p><p>fiscal_year_end: 2002, 2004, 2007-2012</p><p>provider_number: Various</p><p>summary: Whether the Medicare Contractor's disallowance of Medicare Bad Debts claimed by the Providers for the fiscal years at issue, on the grounds that they had not been returned from a collection agency, was proper.</p>]]></description></item><item><title>2023D35</title><pubDate>Thu, 28 Sep 2023 14:26:24 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d35</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d35</guid><description><![CDATA[<p>decision_number: 2023D35</p><p>fiscal_year_end: September 30, 2020</p><p>provider_number: 10-2026</p><p>summary: Whether the payment penalty that the Centers for Medicare &#x26; Medicaid Services ("CMS") imposed under the Long-Term Care Hospital Quality Reporting Program ("LTCH-QRP") which reduced the Provider's payment update for Federal Fiscal Year ("FFY") 2020 by two percent was proper.</p>]]></description></item><item><title>2023D34</title><pubDate>Thu, 28 Sep 2023 14:12:20 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d34</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d34</guid><description><![CDATA[<p>decision_number: 2023D34</p><p>fiscal_year_end: September 30, 2021</p><p>provider_number: 45-0876</p><p>summary: Whether, in connection with the hospital Inpatient Quality Reporting ("IQR") program, the Centers for Medicare &#x26; Medicaid Services' ("CMS") decision to reduce the Annual Percentage Update ("APU") to the Federal Fiscal Year ("FFY") 2021 Inpatient Prospective Payment System ("IPPS") for Lubbock Heart Hospital LP ("Provider" or "LHH") by one-fourth was correct.</p>]]></description></item><item><title>2023D33</title><pubDate>Thu, 28 Sep 2023 14:01:44 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d33</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d33</guid><description><![CDATA[<p>decision_number: 2023D33</p><p>fiscal_year_end: June 30, 2010</p><p>provider_number: 01-0055</p><p>summary: Whether the Medicare Contractor improperly calculated the Provider's Disproportionate Share Hospital ("DSH") reimbursement due to sampling errors in review of the Medicaid-eligible patient days.</p>]]></description></item><item><title>2023D32</title><pubDate>Wed, 20 Sep 2023 11:22:49 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/2023d32</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/2023d32</guid><description><![CDATA[<p>decision_number: 2023D32</p><p>fiscal_year_end: Various (2010 - 2013)</p><p>provider_number: 49-0069</p><p>summary: Whether the Provider is entitled to receive reimbursement for its Medicare Part C Managed Care 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 Statistical and Reimbursement Report ("PS&#x26;R") data for the Provider's fiscal years ("FYs") 2010 through 2013.</p>]]></description></item><item><title>2023D31</title><pubDate>Mon, 11 Sep 2023 14:43:33 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d31</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d31</guid><description><![CDATA[<p>decision_number: 2023D31</p><p>fiscal_year_end: June 30, 2010</p><p>provider_number: 26-0141</p><p>summary: Whether the Centers for Medicare &#x26; Medicaid Services ("CMS") correctly refused to exclude the Missouri Psychiatric Center unit ("MUPC") of the University of Missouri Health Care's ("UMHC" or "Provider") from the inpatient prospective payment system ("IPPS") for the cost reporting period ending June 30, 2010 ("FY 2010"), allowing it to be paid instead under the inpatient psychiatric facility prospective payment system ("IPF-PPS").</p>]]></description></item><item><title>2023D30</title><pubDate>Wed, 06 Sep 2023 14:11:54 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d30</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d30</guid><description><![CDATA[<p>decision_number: 2023D30</p><p>fiscal_year_end: December 31, 2010, December 31, 2012, December 31, 2013, December 31, 2014, December 31, 2015 &#x26; December 31, 2016</p><p>provider_number: 33-0153</p><p>summary: Whether the Medicare Contractor properly determined the Provider's unweighted direct graduate medical education ("GME") and indirect medical education ("IME") full time equivalent ("FTE") resident caps for the fiscal years ("FYs") 2010 and 2012-2016.</p>]]></description></item><item><title>2023D29</title><pubDate>Wed, 23 Aug 2023 16:45:44 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d29</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d29</guid><description><![CDATA[<p>decision_number: 2023D29</p><p>fiscal_year_end: September 30, 2010, September 30, 2011 &#x26; September 30, 2012</p><p>provider_number: 22-0110</p><p>summary: Whether Brigham and Women's Hospital ("Brigham and Women's" or "Provider") timely claimed the $316,565 at issue in the initial fiscal year ("FY") 1989 cost report and, if timely claimed, whether those expenses included Ultrasound and Nuclear Medicine Clinical training costs.
After allowing Brigham and Women's the opportunity to present further relevant evidence as to the question of the programs' licensing for FY 1989, determine whether the non-provider operated Ultrasound and Nuclear Medicine programs at issue were approve in FY 1989.</p>]]></description></item><item><title>2023D28</title><pubDate>Fri, 18 Aug 2023 16:28:47 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d28</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d28</guid><description><![CDATA[<p>decision_number: 2023D28</p><p>fiscal_year_end: December 31, 2014</p><p>provider_number: 31-0058</p><p>summary: Whether the Medicare Contractor properly excluded a lump sum payment of $4,991,315 from the interim payments included on the Provider's notice of program reimbursement ("NPR") for fiscal year ("FY") 2014 and, if so, whether the Provider is entitled to have that lump sum payment returned.</p>]]></description></item><item><title>2023D27</title><pubDate>Fri, 18 Aug 2023 16:19:44 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d27</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d27</guid><description><![CDATA[<p>decision_number: 2023D27</p><p>fiscal_year_end: December 31, 2010 &#x26; December 31, 2011</p><p>provider_number: 19-0046</p><p>summary: Whether the Medicare Contractor's adjustments to remove Full Time Equivalents ("FTEs") from the Graduate Medical Education ("GME") Cap for fiscal years ("FYs") 2010 and 2011 are proper.</p>]]></description></item><item><title>2023D26</title><pubDate>Fri, 18 Aug 2023 16:10:49 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d26</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d26</guid><description><![CDATA[<p>decision_number: 2023D26</p><p>fiscal_year_end: September 30, 2020</p><p>provider_number: 45-0072</p><p>summary: Whether the Provider complied with the Affordable Care Act ("ACA") Inpatient Rehabilitation Facility ("IRF") Quality Reporting Program ("QRP") requirements for submission of quality data for the period at issue and, therefore, is not subject to a 2 percentage point reduction to its Medicare annual payment update ("APU") for fiscal year ("FY") 2020.</p>]]></description></item><item><title>2023D25</title><pubDate>Tue, 15 Aug 2023 14:23:56 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d25</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d25</guid><description><![CDATA[<p>decision_number: 2023D25</p><p>fiscal_year_end: September 30, 2021</p><p>provider_number: 29-2008</p><p>summary: Whether the Centers for Medicare &#x26; Medicaid Services ("CMS") properly imposed the penalty, under the Long Term Care Hospital Quality Reporting Program ("LTCH QRP"), to reduce the Provider's Federal fiscal year 2021 ("FFY 2021") Medicare annual payment update ("APU") by 2.0 percentage points.</p>]]></description></item><item><title>2023D24</title><pubDate>Tue, 15 Aug 2023 14:17:16 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d24</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d24</guid><description><![CDATA[<p>decision_number: 2023D24</p><p>fiscal_year_end: June 30, 2013</p><p>provider_number: 05-0057</p><p>summary: Whether the Provider is entitled to reasonable cost reimbursement for its graduate medical education ("GME") start-up costs for the fiscal year ending ("FYE") June 30, 2013.</p>]]></description></item><item><title>2023D23</title><pubDate>Tue, 01 Aug 2023 18:07:45 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d23</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d23</guid><description><![CDATA[<p>decision_number: 2023D23</p><p>fiscal_year_end: June 30, 2012</p><p>provider_number: 04-0016</p><p>summary: Whether the Provider's disproportionate share hospital ("DSH") payment for the fiscal year ending June 30, 2012 ("FY 2012") should be revised to include additional Medicaid patient days that were excluded from the numerator of the Medicaid faction.</p>]]></description></item><item><title>2023D22</title><pubDate>Tue, 01 Aug 2023 18:03:22 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d22</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d22</guid><description><![CDATA[<p>decision_number: 2023D22</p><p>fiscal_year_end: June 30, 2011</p><p>provider_number: 04-0016</p><p>summary: Whether the Provider's disproportionate share hospital ("DSH") payment for the fiscal year ending June 30, 2011 ("FY 2011") should be revised to include additional Medicaid patient days that were excluded from the numerator of the Medicaid fraction.</p>]]></description></item><item><title>2023D21</title><pubDate>Mon, 31 Jul 2023 12:02:42 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d21</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d21</guid><description><![CDATA[<p>decision_number: 2023D21</p><p>fiscal_year_end: September 30, 2020</p><p>provider_number: 36-1702</p><p>summary: Whether the imposition of a two percentage point reduction to the fiscal year ("FY") 2020 Medicare annual percentage update ("APU") for Comfortbrook Hospice d/b/a Grace Hospital ("Grace Hospice" or "Provider") (Provider No. 36-1702) was proper.</p>]]></description></item><item><title>2023D20</title><pubDate>Mon, 31 Jul 2023 11:56:14 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d20</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d20</guid><description><![CDATA[<p>decision_number: 2023D20</p><p>fiscal_year_end: September 30, 2020</p><p>provider_number: 36-1703</p><p>summary: Whether the imposition of a two percentage point reduction to the fiscal year ("FY") 2020 Medicare annual percentage update ("APU") for Comfortbrook Hospice d/b/a Grace Hospice (Provider No. 36-1703) ("Grace Hospice" or "Provider") was proper.</p>]]></description></item><item><title>2023D19</title><pubDate>Fri, 30 Jun 2023 11:45:41 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d19</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d19</guid><description><![CDATA[<p>decision_number: 2023D19</p><p>fiscal_year_end: June 30, 2010</p><p>provider_number: 38-0027</p><p>summary: Whether the Medicare Contractor properly calculated and denied the volume decrease adjustment ("VDA") owed to Mercy Medical Center ("Mercy" or "Provider") for the significant decrease in inpatient discharges that occurred for its cost report period ending June 30, 2010 ("FY 2010").</p>]]></description></item><item><title>2023D18</title><pubDate>Fri, 30 Jun 2023 10:57:44 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d18</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d18</guid><description><![CDATA[<p>decision_number: 2023D18</p><p>fiscal_year_end: December 31, 2011, December 31, 2012 &#x26; December 31, 2013</p><p>provider_number: 50-1330</p><p>summary: Whether the Provider is entitled to certain emergency room availability costs including costs for mid-level providers ("MLPs") for the fiscal years ending December 31, 2011, December 31, 2012 and December 31, 2013 ("FYs 2011, 2012, and 2013").</p>]]></description></item><item><title>2023D17</title><pubDate>Thu, 01 Jun 2023 16:57:07 -0400</pubDate><link>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d17</link><guid>https://www.cms.gov//medicare/regulations-guidance/provider-reimbursement-review-board/list-prrb-decisions/2023d17</guid><description><![CDATA[<p>decision_number: 2023D17</p><p>fiscal_year_end: June 30, 2012, June 30, 2013, June 30, 2014, June 30, 2015 &#x26; June 30, 2016</p><p>provider_number: 10-0080</p><p>summary: Whether the Medicare Contractor correctly determined the Graduate Medical Education ("GME") and Indirect Medical Education ("IME") full-time equivalent ("FTE") resident caps for the new Internal Medicine residents training program at JFK Medical Center ("JFK" or "Provider") for the fiscal year ("FY") 2012 through 2016 cost reporting periods under appeal.</p>]]></description></item><item><title>2023D16</title><pubDate>Mon, 15 May 2023 11:14:02 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d16</guid><description><![CDATA[<p>decision_number: 2023D16</p><p>fiscal_year_end: March 31, 2010</p><p>provider_number: 32-0014</p><p>summary: Whether the Medicare Contractor properly determined the sole community hospital ("SCH") volume decrease adjustment ("VDA") granted for the fiscal year ending March 31, 2010 ("FY 2010").</p>]]></description></item><item><title>2023D15</title><pubDate>Mon, 08 May 2023 13:58:49 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d15</guid><description><![CDATA[<p>decision_number: 2023D15</p><p>fiscal_year_end: December 31, 2013</p><p>provider_number: 10-0118</p><p>summary: Whether the Medicare Contractor's determination to classify the Provider as a Medicare-dependent hospital ("MDH") effective June 6, 2013, as opposed to October 1, 2012, was proper.</p>]]></description></item><item><title>2023D14</title><pubDate>Thu, 20 Apr 2023 16:50:08 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d14</guid><description><![CDATA[<p>decision_number: 2023D14</p><p>fiscal_year_end: December 31, 2010</p><p>provider_number: 06-0023</p><p>summary: Whether the Medicare Contractor properly calculated and denied the the Volume Decrease Adjustment ("VDA") owed to St. Mary's Hospital &#x26; Medical Center (" St. Mary's" or "Provider") as a sole community hospital ("SCH") for its cost reporting period ending December 31, 2010 ("FY 2010").</p>]]></description></item><item><title>2023D13</title><pubDate>Mon, 17 Apr 2023 11:49:25 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d13</guid><description><![CDATA[<p>decision_number: 2023D13</p><p>fiscal_year_end: June 30, 2014</p><p>provider_number: 53-0014</p><p>summary: Whether the Medicare Contractor properly calculated the sole community hospital ("SCH") volume decrease adjustment ("VDA") owed to Cheyenne Regional Medical Center ("Cheyenne" or "Provider") for its cost reporting period ending June 30, 2014 ("FY 2014").</p>]]></description></item><item><title>2023D12</title><pubDate>Mon, 03 Apr 2023 16:00:51 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d12</guid><description><![CDATA[<p>decision_number: 2023D12</p><p>fiscal_year_end: Federal Fiscal Year 2020</p><p>provider_number: 25-2006</p><p>summary: Whether the payment penalty that the Centers for Medicare &#x26; Medicaid Services ("CMS") imposed under the Long Term Care Hospital Quality Reporting Program ("LTCH-QRP") to reduce the Provider's payment update for Federal Fiscal Year ("FFY") 2020 by two percent was proper.</p>]]></description></item><item><title>2023D11</title><pubDate>Fri, 31 Mar 2023 18:55:33 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d11</guid><description><![CDATA[<p>decision_number: 2023D11</p><p>fiscal_year_end: September 30, 2010</p><p>provider_number: 47-0012</p><p>summary: Whether the Medicare Contractor properly reopened the Original Volume Decrease Adjustment ("VDA") approval and whether the Medicare Contractor properly calculated the Revised VDA owed to the Provider for the significant decrease in inpatient discharges that occurred in its cost reporting period ending September 30, 2010 ("FY 2010").</p>]]></description></item><item><title>2023D10</title><pubDate>Fri, 31 Mar 2023 18:32:57 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d10</guid><description><![CDATA[<p>decision_number: 2023D10</p><p>fiscal_year_end: December 31, 2015</p><p>provider_number: 27-0017</p><p>summary: Whether the Provider has proven that it is entitled to a Sole Community Hospital Volume Decrease Adjustment ("VDA") for the fiscal year ending December 31, 2015 ("FY 2015").</p>]]></description></item><item><title>2023D09</title><pubDate>Fri, 31 Mar 2023 18:26:45 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d09</guid><description><![CDATA[<p>decision_number: 2023D09</p><p>fiscal_year_end: April 30, 2014</p><p>provider_number: 14-0040</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Galesburg Cottage Hospital ("Galesburg" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending April 30, 2014 ("FY 2014").</p>]]></description></item><item><title>2023D08</title><pubDate>Fri, 24 Feb 2023 13:34:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d08</guid><description><![CDATA[<p>decision_number: 2023D08</p><p>fiscal_year_end: 2004 through 2009</p><p>provider_number: 15-1301</p><p>summary: Was the Medicare Contractor's disallowance of the interest expense proper for St. Vincent Randolph Hospital ("St. Vincent Randolph" or "Provider") for the fiscal years ("FYs") 2004 through 2009?</p>]]></description></item><item><title>2023D07</title><pubDate>Fri, 24 Feb 2023 13:26:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d07</guid><description><![CDATA[<p>decision_number: 2023D07</p><p>fiscal_year_end: March 31, 2013</p><p>provider_number: 23-0095</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment owed to West Branch Regional Medical Center ("West Branch" or "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending March 31, 2013.</p>]]></description></item><item><title>2023D06</title><pubDate>Fri, 24 Feb 2023 12:52:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d06</guid><description><![CDATA[<p>decision_number: 2023D06</p><p>fiscal_year_end: March 31, 2011</p><p>provider_number: 23-0095</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment owed to West Branch Regional Medical Center ("West Branch" or "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending March 31, 2011.</p>]]></description></item><item><title>2023D05</title><pubDate>Fri, 24 Feb 2023 12:45:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d05</guid><description><![CDATA[<p>decision_number: 2023D05</p><p>fiscal_year_end: 2007</p><p>provider_number: Various</p><p>summary: Whether to include Medicaid days of children and adolescents for the hospital's inpatient behavioral health departments in the Medicaid fraction of the Medicare disproportionate share hospital ("DSH") calculation for fiscal year ("FY") 2007 for each of the participants in this common issue related party ("CIRP") group.</p>]]></description></item><item><title>2023D04</title><pubDate>Wed, 25 Jan 2023 15:56:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d04</guid><description><![CDATA[<p>decision_number: 2023D04</p><p>fiscal_year_end: December 31, 2009</p><p>provider_number: 20-0031</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Cary Medical Center ("Cary" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2009 ("FY 2009") and whether the Medicare Contractor properly reopened the Original VDA approval.</p>]]></description></item><item><title>2023D03</title><pubDate>Wed, 25 Jan 2023 15:04:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-prrb-decisions/2023d03</guid><description><![CDATA[<p>decision_number: 2023D03</p><p>fiscal_year_end: December 31, 2007</p><p>provider_number: 20-0031</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Cary Medical Center ("Cary" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2007 ("FY 2007") and whether the Medicare Contractor properly reopened the Original VDA approval.</p>]]></description></item><item><title>2023D02</title><pubDate>Mon, 24 Oct 2022 15:54:09 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2023d02</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2023d02</guid><description><![CDATA[<p>decision_number: 2023D02</p><p>fiscal_year_end: April 30, 2016</p><p>provider_number: 14-0040</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Galesburg Cottage Hospital ("Galesburg" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending April 30, 2016 ("FY 2016").</p>]]></description></item><item><title>2023D01</title><pubDate>Mon, 24 Oct 2022 15:48:28 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2023d01</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2023d01</guid><description><![CDATA[<p>decision_number: 2023D01</p><p>fiscal_year_end: April 30, 2015</p><p>provider_number: 14-0040</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Galesburg Cottage Hospital ("Galesburg" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending April 30, 2015 ("FY 2015").</p>]]></description></item><item><title>2022D40</title><pubDate>Fri, 30 Sep 2022 15:55:49 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d40</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d40</guid><description><![CDATA[<p>decision_number: 2022D40</p><p>fiscal_year_end: December 31, 2013</p><p>provider_number: 49-0037</p><p>summary: Whether the Medicare Contractor properly calculated and denied the Volume Decrease Adjustment ("VDA") owed to Riverside Shore Memorial Hospital ("Riverside" or "Provider") for its cost reporting period ending December 31, 2013 ("FY 2013").</p>]]></description></item><item><title>2022D39</title><pubDate>Fri, 30 Sep 2022 15:38:07 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d39</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d39</guid><description><![CDATA[<p>decision_number: 2022D39</p><p>fiscal_year_end: December 31, 2010</p><p>provider_number: 49-0037</p><p>summary: Whether the Medicare Contractor properly calculated and denied the Volume Decrease Adjustment ("VDA") owed to Riverside Shore Memorial Hospital ("Riverside" or "Provider") for its cost reporting period ending December 31, 2010 ("FY 2010").</p>]]></description></item><item><title>2022D38</title><pubDate>Thu, 29 Sep 2022 15:54:43 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d38</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d38</guid><description><![CDATA[<p>decision_number: 2022D38</p><p>fiscal_year_end: June 30, 2011</p><p>provider_number: 37-0089</p><p>summary: Whether the Provider has proven that it is entitled to the Volume Decrease Adjustment ("VDA") that it seeks for fiscal year ("FY") 2011.</p>]]></description></item><item><title>2022D37</title><pubDate>Wed, 28 Sep 2022 11:55:20 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d37</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d37</guid><description><![CDATA[<p>decision_number: 2022D37</p><p>fiscal_year_end: May 31, 2008</p><p>provider_number: 32-0006</p><p>summary: Whether the Provider is entitled to a volume decrease adjustment ("VDA") payment for a sole community hospital ("SCH").</p>]]></description></item><item><title>2022D36</title><pubDate>Tue, 27 Sep 2022 16:36:07 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d36</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d36</guid><description><![CDATA[<p>decision_number: 2022D36</p><p>fiscal_year_end: June 30, 2013</p><p>provider_number: 45-0165</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Methodist Hospital South, formerly known as South Texas Regional Medical Center, ("Methodist Hospital" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2013 ("FY 2013").</p>]]></description></item><item><title>2022D35</title><pubDate>Tue, 27 Sep 2022 16:30:42 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d35</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d35</guid><description><![CDATA[<p>decision_number: 2022D35</p><p>fiscal_year_end: September 30, 2006, December 31, 2006</p><p>provider_number: 34-0091, 50-0044</p><p>summary: Whether the Centers for Medicare &#x26; Medicaid Services ("CMS") was arbitrary and capricious in establishing a 10 percent threshold in 2003 and whether CMS was arbitrary and capricious in using the same 10 percent threshold in 2006 to determine whether the Providers would be subject to outlier reconciliation adjustments for fiscal year ("FY") 2006?</p>]]></description></item><item><title>2022D34</title><pubDate>Tue, 27 Sep 2022 16:25:05 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d34</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d34</guid><description><![CDATA[<p>decision_number: 2022D34</p><p>fiscal_year_end: Various 2009-2016</p><p>provider_number: Various</p><p>summary: Whether it is appropriate to offset the tuition revenue for Nursing and Allied Health ("NAH") programs on Worksheet A-8 or whether it is appropriate to offset the tuition revenue only after the stepdown process.</p>]]></description></item><item><title>2022D33</title><pubDate>Tue, 27 Sep 2022 16:04:11 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d33</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d33</guid><description><![CDATA[<p>decision_number: 2022D33</p><p>fiscal_year_end: April 30, 2013</p><p>provider_number: 14-0040</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Galesburg Cottage Hospital ("Galesburg" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending April 30, 2013 ("FY 2013").</p>]]></description></item><item><title>2022D32</title><pubDate>Tue, 27 Sep 2022 15:59:07 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d32</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d32</guid><description><![CDATA[<p>decision_number: 2022D32</p><p>fiscal_year_end: April 30, 2009</p><p>provider_number: 14-0040</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Galesburg Cottage Hospital ("Galesburg" or the "Provider") for the greater than five percent decrease in inpatient discharges that occurred in its cost reporting period ending April 30, 2009 ("FY 2009").</p>]]></description></item><item><title>2022D31</title><pubDate>Mon, 26 Sep 2022 11:42:30 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d31</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d31</guid><description><![CDATA[<p>decision_number: 2022D31</p><p>fiscal_year_end: October 31, 2013, October 31, 2014</p><p>provider_number: Various</p><p>summary: Whether the sequestration amount reported on the Provider Statistical and Reimbursement ("PS&#x26;R") report for each hospice should be added to the net reimbursement amount in the Aggregate Cap Limitation Calculation to determine payments in excess of the hospice cap amount and resulting overpayment liability.</p>]]></description></item><item><title>2022D30</title><pubDate>Mon, 26 Sep 2022 11:36:46 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d30</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d30</guid><description><![CDATA[<p>decision_number: 2022D30</p><p>fiscal_year_end: December 31, 2012</p><p>provider_number: 15-0030</p><p>summary: Whether the Provider is entitled to receive a volume decrease adjustment ("VDA") for a Medicare dependent hospital ("MDH").</p>]]></description></item><item><title>2022D29</title><pubDate>Tue, 20 Sep 2022 16:08:05 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d29</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d29</guid><description><![CDATA[<p>decision_number: 2022D29</p><p>fiscal_year_end: December 31, 2006</p><p>provider_number: 37-0037</p><p>summary: Should Medicaid days attributed to child and adolescent patients who received services in three of the Provider's inpatient behavioral health units licensed as psychiatric residential treatment facilities ("PRTFs"), namely ACCENTS (Unit 1929), Human Restorations (Unit 1930), and the Positive Outcomes (Unit 4519), during fiscal year ending December 31, 2006 ("FY 2006") be included in the Medicaid fraction of the Provider's Medicare disproportionate share hospital ("DSH") payment?</p>]]></description></item><item><title>2022D28</title><pubDate>Thu, 15 Sep 2022 16:24:30 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d28</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d28</guid><description><![CDATA[<p>decision_number: 2022D28</p><p>fiscal_year_end: June 30, 2009</p><p>provider_number: 05-0625</p><p>summary: Whether the reasonable compensation equivalent ("RCE") limits should have been applied at all to pre-transplant time spent by physicians working for the Provider on organ acquisition-related activities and, if the RCE does apply, whether the Medicare Contractor has applied the wrong RCE limit in its calculation for fiscal year ("FY") 2009.</p>]]></description></item><item><title>2022D27</title><pubDate>Thu, 15 Sep 2022 16:19:32 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d27</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d27</guid><description><![CDATA[<p>decision_number: 2022D27</p><p>fiscal_year_end: August 7, 2012</p><p>provider_number: 05-0448</p><p>summary: Whether the Medicare Contractor properly determined the sole community hospital ("SCH") volume decrease adjustment ("VDA") granted for the short fiscal year ending August 7, 2012 ("Short Period 2012").</p>]]></description></item><item><title>2022D26</title><pubDate>Thu, 15 Sep 2022 16:12:00 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d26</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d26</guid><description><![CDATA[<p>decision_number: 2022D26</p><p>fiscal_year_end: January 31, 2012</p><p>provider_number: 05-0448</p><p>summary: Whether the Medicare Contractor properly determined the sole community hospital ("SCH") volume decrease adjustment ("VDA") granted for the fiscal year ending January 31, 2012 ("FY 2012").</p>]]></description></item><item><title>2022D25</title><pubDate>Thu, 15 Sep 2022 15:54:20 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d25</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d25</guid><description><![CDATA[<p>decision_number: 2022D25</p><p>fiscal_year_end: December 31, 2011</p><p>provider_number: 36-0123</p><p>summary: Whether the Medicare Contractor erred in disallowing Medicare managed care payments associated with the Provider's operation of its pastoral care allied health education program.</p>]]></description></item><item><title>2022D24</title><pubDate>Thu, 15 Sep 2022 15:50:02 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d24</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d24</guid><description><![CDATA[<p>decision_number: 2022D24</p><p>fiscal_year_end: December 31, 2008</p><p>provider_number: 31-0039</p><p>summary: Whether the Medicare Contractor's determination of the Provider's disproportionate share hospital ("DSH") payment [was accurate] and whether that calculation should be revised to include additional Medicaid patient days that were excluded from the numerator of the Medicaid fraction.</p>]]></description></item><item><title>2022D23</title><pubDate>Thu, 15 Sep 2022 15:41:45 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d23</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d23</guid><description><![CDATA[<p>decision_number: 2022D23</p><p>fiscal_year_end: September 30, 2021</p><p>provider_number: 19-2022</p><p>summary: Whether the payment penalty that the Centers for Medicare &#x26; Medicaid Services ("CMS") imposed under the Long Term Care Hospital Quality Reporting Program ("LTCH-QRP") to reduce the Provider's payment update for federal fiscal year ("FFY") 2020 by two percent was proper.</p>]]></description></item><item><title>2022D22</title><pubDate>Thu, 15 Sep 2022 15:28:06 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d22</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d22</guid><description><![CDATA[<p>decision_number: 2022D22</p><p>fiscal_year_end: December 31, 2010</p><p>provider_number: 15-0030</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Henry County Memorial Hospital ("Henry County" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2010 ("FY 2010").</p>]]></description></item><item><title>2022D21</title><pubDate>Tue, 09 Aug 2022 14:44:35 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d21</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d21</guid><description><![CDATA[<p>decision_number: 2022D21</p><p>fiscal_year_end: August 31, 2014</p><p>provider_number: 32-0063</p><p>summary: 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").</p>]]></description></item><item><title>2022D20</title><pubDate>Wed, 04 May 2022 13:06:03 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d20</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d20</guid><description><![CDATA[<p>decision_number: 2022D20</p><p>fiscal_year_end: December 31, 2012</p><p>provider_number: 33-0085</p><p>summary: 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.</p>]]></description></item><item><title>2022D19</title><pubDate>Wed, 04 May 2022 12:59:52 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d19</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d19</guid><description><![CDATA[<p>decision_number: 2022D19</p><p>fiscal_year_end: June 30, 2011</p><p>provider_number: 16-0032</p><p>summary: 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").</p>]]></description></item><item><title>2022D18</title><pubDate>Wed, 04 May 2022 12:53:32 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d18</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d18</guid><description><![CDATA[<p>decision_number: 2022D18</p><p>fiscal_year_end: September 29, 2012, June 30, 2012 &#x26; June 30, 2012</p><p>provider_number: 20-0041, 20-0050, 20-0037</p><p>summary: 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.</p>]]></description></item><item><title>2022D17</title><pubDate>Mon, 11 Apr 2022 17:31:09 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d17</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d17</guid><description><![CDATA[<p>decision_number: 2022D17</p><p>fiscal_year_end: October 31, 2013</p><p>provider_number: 39-1544</p><p>summary: 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.</p>]]></description></item><item><title>2022D16</title><pubDate>Mon, 21 Mar 2022 15:30:00 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d16</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d16</guid><description><![CDATA[<p>decision_number: 2022D16</p><p>fiscal_year_end: December 31, 2011</p><p>provider_number: 33-0177</p><p>summary: 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.</p>]]></description></item><item><title>2022D15</title><pubDate>Mon, 21 Mar 2022 14:58:26 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d15</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d15</guid><description><![CDATA[<p>decision_number: 2022D15</p><p>fiscal_year_end: June 30, 2009</p><p>provider_number: 16-0032</p><p>summary: 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").</p>]]></description></item><item><title>2022D14</title><pubDate>Mon, 21 Mar 2022 14:53:35 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d14</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d14</guid><description><![CDATA[<p>decision_number: 2022D14</p><p>fiscal_year_end: June 30, 2008</p><p>provider_number: 16-0032</p><p>summary: 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").</p>]]></description></item><item><title>2022D13</title><pubDate>Mon, 21 Mar 2022 14:48:32 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d13</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d13</guid><description><![CDATA[<p>decision_number: 2022D13</p><p>fiscal_year_end: December 31, 2012</p><p>provider_number: 33-0033</p><p>summary: 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.</p>]]></description></item><item><title>2022D12</title><pubDate>Wed, 02 Mar 2022 15:51:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d12</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d12</guid><description><![CDATA[<p>decision_number: 2022D12</p><p>fiscal_year_end: December 31, 2009</p><p>provider_number: 36-0079</p><p>summary: 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?</p>]]></description></item><item><title>2022D11</title><pubDate>Wed, 02 Mar 2022 15:39:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d11</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d11</guid><description><![CDATA[<p>decision_number: 2022D11</p><p>fiscal_year_end: March 31, 2010</p><p>provider_number: 23-0095</p><p>summary: Whether the West Branch Regional Medical Center ("West Branch" or "Provider") is entitled to a volume decrease adjustment ("VDA") payment for a sole community hospital ("SCH") for the fiscal year ending March 31, 2010 ("FY 2010").</p>]]></description></item><item><title>2022D10</title><pubDate>Wed, 02 Mar 2022 15:20:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d10</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d10</guid><description><![CDATA[<p>decision_number: 2022D10</p><p>fiscal_year_end: March 31, 2009</p><p>provider_number: 23-0095</p><p>summary: Whether the West Branch Regional Medical Center ("West Branch" or "Provider") is entitled to a volume decrease adjustment ("VDA") payment for a sole community hospital ("SCH") for the fiscal year ending March 31, 2009 ("FY 2009").</p>]]></description></item><item><title>2022D09</title><pubDate>Wed, 23 Feb 2022 15:58:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d09</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d09</guid><description><![CDATA[<p>decision_number: 2022D09</p><p>fiscal_year_end: March 31, 2012</p><p>provider_number: 45-0489</p><p>summary: Whether Medical Arts Hospital ("Medical Arts" or the "Provider") is entitled to a volume decrease adjustment ("VDA") for the fiscal year ending March 31, 2012 ("FY 2012").</p>]]></description></item><item><title>2022D08</title><pubDate>Wed, 23 Feb 2022 15:53:05 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d08</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d08</guid><description><![CDATA[<p>decision_number: 2022D08</p><p>fiscal_year_end: December 31, 2015, December 31, 2016</p><p>provider_number: 23-0055</p><p>summary: Whether the Medicare Contractor erred in its determination that the Provider did not qualify for the exception to the per-visit upper payment limit ("UPL") for rural health clinics ("RHCs") for fiscal years ending December 31, 2015 and December 31, 2016 ("FYs 2015 and 2016").</p>]]></description></item><item><title>2022D07</title><pubDate>Wed, 23 Feb 2022 15:47:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d07</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d07</guid><description><![CDATA[<p>decision_number: 2022D07</p><p>fiscal_year_end: September 30, 2009</p><p>provider_number: 34-0040</p><p>summary: Whether the Provider's disproportionate share hospital ("DSH") payment for fiscal year ending September 30, 2009 ("FY 2009") should be revised to include additional patient days that were excluded from the numerator of the Medicaid fraction.</p>]]></description></item><item><title>2022D06</title><pubDate>Wed, 23 Feb 2022 15:41:53 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d06</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d06</guid><description><![CDATA[<p>decision_number: 2022D06</p><p>fiscal_year_end: March 31, 2012</p><p>provider_number: 37-0030</p><p>summary: Whether the Provider is entitled to a Volume Decrease Adjustment ("VDA") for Fiscal Year End ("FYE") 03/31/2012.</p>]]></description></item><item><title>2022D05</title><pubDate>Thu, 20 Jan 2022 16:17:30 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d05</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d05</guid><description><![CDATA[<p>decision_number: 2022D05</p><p>fiscal_year_end: December 31, 2013</p><p>provider_number: 14-0294</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Crossroads Community Hospital ("Crossroads" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2013 ("FY 2013").</p>]]></description></item><item><title>2022D04</title><pubDate>Thu, 20 Jan 2022 16:11:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d04</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d04</guid><description><![CDATA[<p>decision_number: 2022D04</p><p>fiscal_year_end: April 30, 2011</p><p>provider_number: 14-0184</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Marion Memorial Hospital ("Marion" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending April 30, 2011 ("FY 2011").</p>]]></description></item><item><title>2022D03</title><pubDate>Tue, 07 Dec 2021 16:57:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d03</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d03</guid><description><![CDATA[<p>decision_number: 2022D03</p><p>fiscal_year_end: Fiscal Year 2019</p><p>provider_number: 22-2007</p><p>summary: Whether the payment penalty that the Centers for Medicare &#x26; Medicaid Services ("CMS") imposed under the Long Term Care Hospital Quality Reporting Program ("LTCH-QRP") which reduced the Provider's payment update for Fiscal Year ("FY") 2019 by two percent was proper?</p>]]></description></item><item><title>2022D02</title><pubDate>Wed, 01 Dec 2021 13:18:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d02</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2022d02</guid><description><![CDATA[<p>decision_number: 2022D02</p><p>fiscal_year_end: 12/31/2010</p><p>provider_number: 45-0073</p><p>summary: Whether D.M. Cogdell Memorial Hospital ("Cogdell" or the "Provider") is entitled to a Volume Decrease Adjustment ("VDA") from the Medicare Contractor for the fiscal year ending December 31, 2010 ("FY 2010").</p>]]></description></item><item><title>2022D01</title><pubDate>Wed, 17 Nov 2021 13:01:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions2021d44/2022d01</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions2021d44/2022d01</guid><description><![CDATA[<p>decision_number: 2022D01</p><p>fiscal_year_end: 12/31/2012</p><p>provider_number: 45-0073</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment owed to D.M. Cogdell Memorial Hospital ("Cogdell" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2012 ("FY 2012").</p>]]></description></item><item><title>2021D44</title><pubDate>Fri, 08 Oct 2021 11:09:01 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d44</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d44</guid><description><![CDATA[<p>decision_number: 2021D44</p><p>fiscal_year_end: 04/30/2014</p><p>provider_number: 45-0370</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Columbus Community Hospital ("Columbus" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending April 30, 2014 ("FY 2014").</p>]]></description></item><item><title>2021D43</title><pubDate>Fri, 08 Oct 2021 11:04:22 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d43</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d43</guid><description><![CDATA[<p>decision_number: 2021D43</p><p>fiscal_year_end: 05/31/2014</p><p>provider_number: 27-0003</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment owed to St. Peter's Hospital ("St. Peter's" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending May 31, 2014 ("FY 2014").</p>]]></description></item><item><title>2021D42</title><pubDate>Thu, 30 Sep 2021 15:11:06 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d42</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d42</guid><description><![CDATA[<p>decision_number: 2021D42</p><p>fiscal_year_end: 12/31/2009</p><p>provider_number: 37-0059</p><p>summary: Whether the Medicare Administrative Contractor, Novitas Solutions, Inc. ("Medicare Contractor"), properly calculated the volume decrease adjustment ("VDA") owed to Stillwater Medical Center ("Stillwater" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2009 ("FY 2009").</p>]]></description></item><item><title>2021D41</title><pubDate>Thu, 30 Sep 2021 15:03:49 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d41</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d41</guid><description><![CDATA[<p>decision_number: 2021D41</p><p>fiscal_year_end: 12/31/2013</p><p>provider_number: 33-0223</p><p>summary: 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, 2013 ("FY 2013"), and whether the Medicare Contractor properly reopened the Original VDA approval.</p>]]></description></item><item><title>2021D40</title><pubDate>Thu, 30 Sep 2021 14:58:37 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d40</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d40</guid><description><![CDATA[<p>decision_number: 2021D40</p><p>fiscal_year_end: 12/31/2012</p><p>provider_number: 33-0223</p><p>summary: 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.</p>]]></description></item><item><title>2021D39</title><pubDate>Thu, 30 Sep 2021 14:52:33 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d39</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d39</guid><description><![CDATA[<p>decision_number: 2021D39</p><p>fiscal_year_end: 12/31/2009</p><p>provider_number: 33-0223</p><p>summary: 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, 2009 ("FY 2009"), and whether the Medicare Contractor properly reopened the Original VDA approval.</p>]]></description></item><item><title>2021D38</title><pubDate>Thu, 30 Sep 2021 14:44:13 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d38</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d38</guid><description><![CDATA[<p>decision_number: 2021D38</p><p>fiscal_year_end: 12/31/2012</p><p>provider_number: 45-0615</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Atlanta Memorial Hospital ("Atlanta Memorial" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2012 ("FY 2012").</p>]]></description></item><item><title>2021D37</title><pubDate>Thu, 30 Sep 2021 14:32:24 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d37</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d37</guid><description><![CDATA[<p>decision_number: 2021D37</p><p>fiscal_year_end: 12/31/2011</p><p>provider_number: 45-0615</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Atlanta Memorial Hospital ("Atlanta Memorial" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2011 ("FY 2011").</p>]]></description></item><item><title>2021D36</title><pubDate>Thu, 30 Sep 2021 14:26:01 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d36</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d36</guid><description><![CDATA[<p>decision_number: 2021D36</p><p>fiscal_year_end: 12/31/2010</p><p>provider_number: 45-0615</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Atlanta Memorial Hospital ("Atlanta Memorial" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending December 31, 2010 ("FY 2010").</p>]]></description></item><item><title>2021D35</title><pubDate>Thu, 30 Sep 2021 14:13:03 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d35</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d35</guid><description><![CDATA[<p>decision_number: 2021D35</p><p>fiscal_year_end: 04/30/2014</p><p>provider_number: 26-0186</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment owed to Lake Regional Health System ("Lake" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending April 30, 2014 ("FY 2014").</p>]]></description></item><item><title>2021D34</title><pubDate>Thu, 30 Sep 2021 13:58:59 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d34</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d34</guid><description><![CDATA[<p>decision_number: 2021D34</p><p>fiscal_year_end: 04/30/2013</p><p>provider_number: 26-0186</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjusted owed to Lake Regional Health System ("Lake" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending April 30, 2013 ("FY 2013").</p>]]></description></item><item><title>2021D33</title><pubDate>Tue, 21 Sep 2021 16:51:34 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d33</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d33</guid><description><![CDATA[<p>decision_number: 2021D33</p><p>fiscal_year_end: 06/30/2015</p><p>provider_number: 28-0077</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Fremont Area Medical Center ("Fremont" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2015 ("FY 2015").</p>]]></description></item><item><title>2021D32</title><pubDate>Tue, 21 Sep 2021 16:46:42 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d32</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d32</guid><description><![CDATA[<p>decision_number: 2021D32</p><p>fiscal_year_end: 06/30/2013</p><p>provider_number: 28-0077</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Fremont Area Medical Center ("Fremont" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2013 ("FY 2013").</p>]]></description></item><item><title>2021D31</title><pubDate>Tue, 21 Sep 2021 16:42:21 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d31</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d31</guid><description><![CDATA[<p>decision_number: 2021D31</p><p>fiscal_year_end: 06/30/2010</p><p>provider_number: 28-0077</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Fremont Area Medical Center ("Fremont" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2010 ("FY 2010").</p>]]></description></item><item><title>2021D30</title><pubDate>Tue, 21 Sep 2021 16:37:23 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d30</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d30</guid><description><![CDATA[<p>decision_number: 2021D30</p><p>fiscal_year_end: 12/31/2014</p><p>provider_number: 45-0653</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") payment for Scenic Mountain Medical Center for the cost reporting period ending December 31, 2014 ("FY 2014").</p>]]></description></item><item><title>2021D29</title><pubDate>Tue, 21 Sep 2021 16:32:55 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d29</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d29</guid><description><![CDATA[<p>decision_number: 2021D29</p><p>fiscal_year_end: 12/31/2013</p><p>provider_number: 45-0653</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") payment for Scenic Mountain Medical Center for the cost reporting period ending December 31, 2013 ("FY 2013").</p>]]></description></item><item><title>2021D28</title><pubDate>Tue, 21 Sep 2021 16:10:34 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d28</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d28</guid><description><![CDATA[<p>decision_number: 2021D28</p><p>fiscal_year_end: 12/31/2012</p><p>provider_number: 45-0653</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") payment for Scenic Mountain Medical Center for the cost reporting period ending December 31, 2012 ("FY 2012").</p>]]></description></item><item><title>2021D27</title><pubDate>Mon, 20 Sep 2021 18:23:41 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d27</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d27</guid><description><![CDATA[<p>decision_number: 2021D27</p><p>fiscal_year_end: 9/30/2019</p><p>provider_number: 34-5522</p><p>summary: Whether the payment penalty imposed by the Centers for Medicare &#x26; Medicaid Services ("CMS") to reduce Universal Health Care's ("Provider" or "Universal") Fiscal Year ("FY") 2019 Medicare payment by two percent was proper.</p>]]></description></item><item><title>2021D26</title><pubDate>Mon, 20 Sep 2021 17:32:38 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d26</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d26</guid><description><![CDATA[<p>decision_number: 2021D26</p><p>fiscal_year_end: 12/31/2011</p><p>provider_number: 33-0218</p><p>summary: 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 approval.</p>]]></description></item><item><title>2021D25</title><pubDate>Mon, 20 Sep 2021 17:24:28 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d25</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d25</guid><description><![CDATA[<p>decision_number: 2021D25</p><p>fiscal_year_end: 12/31/2012</p><p>provider_number: 33-0263</p><p>summary: 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.</p>]]></description></item><item><title>2021D24</title><pubDate>Mon, 20 Sep 2021 17:19:37 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d24</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d24</guid><description><![CDATA[<p>decision_number: 2021D24</p><p>fiscal_year_end: 12/31/2011</p><p>provider_number: 33-0263</p><p>summary: 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 approval.</p>]]></description></item><item><title>2021D23</title><pubDate>Mon, 20 Sep 2021 15:45:10 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d23</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d23</guid><description><![CDATA[<p>decision_number: 2021D23</p><p>fiscal_year_end: 11/30/2014</p><p>provider_number: Various</p><p>summary: Whether the Medicare Contractor's inclusion of sequestered payments in the determination of the Providers' cap on overall Medicare reimbursement was proper.</p>]]></description></item><item><title>2021D22</title><pubDate>Fri, 23 Jul 2021 12:54:02 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d22</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d22</guid><description><![CDATA[<p>decision_number: 2021D22</p><p>fiscal_year_end: 09/30/2018</p><p>provider_number: 14-1694</p><p>summary: Whether the Medicare Contractor used the correct number of Medicare beneficiaries in calculating the Cap Year 2018 Hospice Cap.</p>]]></description></item><item><title>2021D21</title><pubDate>Fri, 23 Jul 2021 12:49:16 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d21</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d21</guid><description><![CDATA[<p>decision_number: 2021D21</p><p>fiscal_year_end: 12/31/2011</p><p>provider_number: 33-0215</p><p>summary: 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 approval.</p>]]></description></item><item><title>2021D20</title><pubDate>Fri, 23 Jul 2021 12:09:19 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d20</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d20</guid><description><![CDATA[<p>decision_number: 2021D20</p><p>fiscal_year_end: 08/31/2010</p><p>provider_number: 32-0003</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to the Provider for the significant decrease in inpatient discharges that occurred in its cost reporting period ending August 31, 2010 ("FY 2010").</p>]]></description></item><item><title>2021D19</title><pubDate>Fri, 23 Jul 2021 11:40:16 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d19</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d19</guid><description><![CDATA[<p>decision_number: 2021D19</p><p>fiscal_year_end: 08/31/2008</p><p>provider_number: 32-0003</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to the Provider for the significant decrease in inpatient discharges that occurred in its cost reporting period ending August 31, 2008 ("FY 2008").</p>]]></description></item><item><title>2021D18</title><pubDate>Mon, 14 Jun 2021 14:28:11 -0400</pubDate><link>https://www.cms.gov//httpswwwcmsgovregulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d18</link><guid>https://www.cms.gov//httpswwwcmsgovregulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d18</guid><description><![CDATA[<p>decision_number: 2021D18</p><p>fiscal_year_end: 09/30/2012</p><p>provider_number: 45-0055</p><p>summary: Whether Rolling Plains Memorial Hospital ("Rolling Plains" or "Provider") is entitled to a Volume Decrease Adjustment ("VDA") for Fiscal Year End September 30, 2012 ("FY 2021"), greater than the amount determined by the Medicare Contractor.</p>]]></description></item><item><title>2021D17</title><pubDate>Mon, 14 Jun 2021 13:47:05 -0400</pubDate><link>https://www.cms.gov//httpswwwcmsgovregulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d17</link><guid>https://www.cms.gov//httpswwwcmsgovregulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d17</guid><description><![CDATA[<p>decision_number: 2021D17</p><p>fiscal_year_end: 09/30/2010</p><p>provider_number: 45-0055</p><p>summary: Whether Rolling Plains Memorial Hospital ("Rolling Plains" or "Provider") is entitled to a Volume Decrease Adjustment ("VDA") for Fiscal Year End September 30, 2010.</p>]]></description></item><item><title>2021D16</title><pubDate>Thu, 29 Apr 2021 16:25:53 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d16</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d16</guid><description><![CDATA[<p>decision_number: 2021D16</p><p>fiscal_year_end: 12/31/2019</p><p>provider_number: 22-7515</p><p>summary: Whether the payment penalty imposed on the Provider's home health prospective payment system Annual Payment Update ("APU") for calendar year ("CY") 2019 was proper.</p>]]></description></item><item><title>2021D15</title><pubDate>Thu, 29 Apr 2021 16:21:11 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d15</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d15</guid><description><![CDATA[<p>decision_number: 2021D15</p><p>fiscal_year_end: 09/30/2012</p><p>provider_number: 45-0698</p><p>summary: Whether the Provider is entitled to a Volume Decrease Adjustment ("VDA") for Fiscal Year End September 30, 2012 ("FY 2012") greater than the amount determined by the Medicare Contractor.</p>]]></description></item><item><title>2021D14</title><pubDate>Thu, 29 Apr 2021 16:14:22 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d14</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d14</guid><description><![CDATA[<p>decision_number: 2021D14</p><p>fiscal_year_end: Fiscal Year 2018, Calendar Year 2018, Fiscal Year 2019</p><p>provider_number: 18-0029</p><p>summary: 1. For Case No. 18-1454, whether CMS' decision to reduce the Provider's Fiscal Year ("FY") 2018 Inpatient Psychiatric Facility Prospective Payment System annual payment update ("APU") by 2 percentage points proper? 2. For Case No. 18-1669, whether CMS' decision to reduce the Provider's Calendar Year ("CY") 2018 Outpatient Prospective Payment System APU by 2 percentage points was proper? 3. For Case No. 18-1802, a.) Whether CMS' decision to reduce the Provider's FY 2019 hospital Inpatient Quality Reporting Prospective Payment System APU by one-quarter was correct; and b.) Whether CMS' decision to exclude the Provider from participating in a hospital value based purchasing program for FY 2019 was proper?</p>]]></description></item><item><title>2021D13</title><pubDate>Thu, 29 Apr 2021 16:04:36 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d13</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d13</guid><description><![CDATA[<p>decision_number: 2021D13</p><p>fiscal_year_end: 09/30/2019</p><p>provider_number: 92-1588</p><p>summary: Whether the two-percentage point reduction to the Annual Percentage Update ("APU") of ProHealth Home Care, Inc. ("ProHealth" or "Provider") for Fiscal Year ("FY") 2019 was proper.</p>]]></description></item><item><title>2021D12</title><pubDate>Thu, 18 Mar 2021 11:40:14 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d12</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d12</guid><description><![CDATA[<p>decision_number: 2021D12</p><p>fiscal_year_end: 09/30/2016</p><p>provider_number: 45-0587</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to the Provider for the significant decrease in inpatient discharges that occurred in its cost reporting period ending September 30, 2016 ("FY 2016").</p>]]></description></item><item><title>2021D11</title><pubDate>Thu, 18 Mar 2021 11:32:06 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d11</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d11</guid><description><![CDATA[<p>decision_number: 2021D11</p><p>fiscal_year_end: 09/30/2015</p><p>provider_number: 45-0587</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to the Provider for the significant decrease in inpatient discharges that occurred in its cost reporting period ending September 30, 2015 ("FY 2015").</p>]]></description></item><item><title>2021D10</title><pubDate>Thu, 18 Mar 2021 11:26:21 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d10</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d10</guid><description><![CDATA[<p>decision_number: 2021D10</p><p>fiscal_year_end: 09/30/2014</p><p>provider_number: 45-0587</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to the Provider for the significant decrease in inpatient discharges that occurred in its cost reporting period ending September 30, 2014 ("FY 2014").</p>]]></description></item><item><title>2021D09</title><pubDate>Thu, 18 Mar 2021 11:21:35 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d09</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d09</guid><description><![CDATA[<p>decision_number: 2021D09</p><p>fiscal_year_end: 09/30/2013</p><p>provider_number: 45-0587</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to the Provider for the significant decrease in inpatient discharges that occurred in its cost reporting period ending September 30, 2013 ("FY 2013").</p>]]></description></item><item><title>2021D08</title><pubDate>Thu, 18 Mar 2021 11:14:54 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d08</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d08</guid><description><![CDATA[<p>decision_number: 2021D08</p><p>fiscal_year_end: 09/30/2012</p><p>provider_number: 45-0587</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to the Provider for the significant decrease in inpatient discharges that occurred in its cost reporting period ending September 30, 2012 ("FY 2012").</p>]]></description></item><item><title>2021D07</title><pubDate>Thu, 18 Mar 2021 11:09:16 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d07</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d07</guid><description><![CDATA[<p>decision_number: 2021D07</p><p>fiscal_year_end: 09/30/2007</p><p>provider_number: 45-0587</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to the Provider for the significant decrease in inpatient discharges that occurred in its cost reporting period ending September 30, 2007 ("FY 2007").</p>]]></description></item><item><title>2021D06</title><pubDate>Thu, 18 Mar 2021 11:02:01 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d06</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d06</guid><description><![CDATA[<p>decision_number: 2021D06</p><p>fiscal_year_end: 06/30/2015</p><p>provider_number: 39-0072</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to the Provider for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2015 ("FY 2015").</p>]]></description></item><item><title>2021D05</title><pubDate>Fri, 19 Feb 2021 16:05:26 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d05</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d05</guid><description><![CDATA[<p>decision_number: 2021D05</p><p>fiscal_year_end: 09/30/2012</p><p>provider_number: 45-0565</p><p>summary: Whether Palo Pinto General Hospital ("Palo Pinto" or "Provider") is entitled to a Volume Decrease Adjustment ("VDA") for the Fiscal Year Ended September 30, 2012 ("FY 2012"), greater than the amount determined by the Medicare Contractor.</p>]]></description></item><item><title>2021D04</title><pubDate>Tue, 08 Dec 2020 15:18:47 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d04</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d04</guid><description><![CDATA[<p>decision_number: 2021D04</p><p>fiscal_year_end: 06/30/2013, 06/30/2014, 06/30/2015</p><p>provider_number: 16-1356</p><p>summary: Whether the Medicare Contractor improperly disallowed certain related party costs claimed by Henry County Health Center ("Henry Center" or "Provider") based on its determination that Henry Center had not incurred the claimed costs.</p>]]></description></item><item><title>2021D03</title><pubDate>Tue, 17 Nov 2020 10:48:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d03</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d03</guid><description><![CDATA[<p>decision_number: 2021D03</p><p>fiscal_year_end: 06/30/2014</p><p>provider_number: 39-0072</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Berwick Hospital Center ("Berwick" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2014 ("FY 2014").</p>]]></description></item><item><title>2021D02</title><pubDate>Tue, 17 Nov 2020 10:39:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d02</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d02</guid><description><![CDATA[<p>decision_number: 2021D02</p><p>fiscal_year_end: 06/30/2013</p><p>provider_number: 39-0072</p><p>summary: Whether the Medicare Contractor properly calculated the volume decrease adjustment ("VDA") owed to Berwick Hospital Center ("Berwick" or the "Provider") for the significant decrease in inpatient discharges that occurred in its cost reporting period ending June 30, 2013 ("FY 2013").</p>]]></description></item><item><title>2021D01</title><pubDate>Tue, 17 Nov 2020 10:21:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d01</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2021d01</guid><description><![CDATA[<p>decision_number: 2021D01</p><p>fiscal_year_end: 10/31/2013, 10/31/2014</p><p>provider_number: 11-1719, 11-1728</p><p>summary: Whether the Medicare Contractor used the correct data and methodology in calculating and applying the "hospice cap" for Cap Years 2013 (Provider No. 11-1719) and 2014 (Provider Nos. 11-1719 and 11-1728).</p>]]></description></item><item><title>2020D25</title><pubDate>Fri, 09 Oct 2020 12:17:30 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d25</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d25</guid><description><![CDATA[<p>decision_number: 2020D25</p><p>fiscal_year_end: 12/31/2014</p><p>provider_number: 16-1362</p><p>summary: Whether the Medicare Contractor improperly disallowed certain related party costs claimed by Cherokee Regional Medical Center ("Cherokee" or "Provider") based on its determination that Cherokee Regional Medical Center had not incurred the claimed costs.</p>]]></description></item><item><title>2020D24</title><pubDate>Fri, 09 Oct 2020 12:01:04 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d24</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d24</guid><description><![CDATA[<p>decision_number: 2020D24</p><p>fiscal_year_end: 01/31/2011</p><p>provider_number: 19-2037</p><p>summary: Whether the Medicare Contractor's adjustment to the outlier reconciliation adjustment determination was proper.</p>]]></description></item><item><title>2020D23</title><pubDate>Fri, 09 Oct 2020 11:54:38 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d23</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d23</guid><description><![CDATA[<p>decision_number: 2020D23</p><p>fiscal_year_end: 09/30/2011</p><p>provider_number: 38-0002</p><p>summary: Whether the contractor was correct in calculating the Provider's Sole Community Hospital Volume Decrease Adjustment.</p>]]></description></item><item><title>2020D22</title><pubDate>Fri, 11 Sep 2020 12:15:13 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d22</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d22</guid><description><![CDATA[<p>decision_number: 2020D22</p><p>fiscal_year_end: Discharges on or after August 25, 2017</p><p>provider_number: 42-0027</p><p>summary: Whether the denial of the Provider's request for sole community hospital ("SCH") designation by the Centers for Medicare &#x26; Medicaid Services ("CMS") and the Medicare Contractor was proper.</p>]]></description></item><item><title>2020D21</title><pubDate>Fri, 11 Sep 2020 12:08:12 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d21</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d21</guid><description><![CDATA[<p>decision_number: 2020D21</p><p>fiscal_year_end: 12/31/2018</p><p>provider_number: 03-7450</p><p>summary: Whether the Medicare Contractor's reduction to the Provider's home health prospective payment system (" HHA PPS") payments for calendar year ("CY") 2018 by two percent was proper.</p>]]></description></item><item><title>2020D20</title><pubDate>Fri, 11 Sep 2020 12:03:58 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d20</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d20</guid><description><![CDATA[<p>decision_number: 2020D20</p><p>fiscal_year_end: 2006-2009</p><p>provider_number: Various</p><p>summary: Whether the Providers' Medicare bad debts pending at outside collection agencies are allowable.</p>]]></description></item><item><title>2020D19</title><pubDate>Fri, 11 Sep 2020 11:57:20 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d19</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d19</guid><description><![CDATA[<p>decision_number: 2020D19</p><p>fiscal_year_end: 6/30/2006, 6/30/2007</p><p>provider_number: 14-0276</p><p>summary: Whether the Medicare Contractor should adjust the direct graduate medical education ("GME") cap for Loyola University Medical Center ("Loyola" or "Provider") on Worksheet E-3, Part VI of the Provider's cost reports for fiscal years ("FYs") 2006 and 2007, for the addition of new programs.</p>]]></description></item><item><title>2020D18</title><pubDate>Fri, 11 Sep 2020 11:49:27 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d18</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d18</guid><description><![CDATA[<p>decision_number: 2020D18</p><p>fiscal_year_end: 10/31/2014</p><p>provider_number: 26-1595</p><p>summary: Whether the Medicare Contractor's amended hospice cap calculation properly calculated the Provider's hospice aggregate cap overpayment when it included in "the amount of payment made" certain funds that were sequestered and never paid to the Provider.</p>]]></description></item><item><title>2020D17</title><pubDate>Fri, 11 Sep 2020 11:44:22 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d17</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d17</guid><description><![CDATA[<p>decision_number: 2020D17</p><p>fiscal_year_end: 2010, 2011, 2012, 2013</p><p>provider_number: Various</p><p>summary: Whether the Medicare Administrative Contractor improperly denied Medicare reimbursement for the Providers' Medicare bad debt for indigent patients.</p>]]></description></item><item><title>2020D16</title><pubDate>Fri, 11 Sep 2020 11:38:50 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d16</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d16</guid><description><![CDATA[<p>decision_number: 2020D16</p><p>fiscal_year_end: 12/31/2010, 12/31/2011, 12/31/2012</p><p>provider_number: 36-0037</p><p>summary: Issue 1 - Whether the Medicare Contractor's adjustments for disallowing pass-through costs and managed care payments associated with the Provider's operation of its pastoral care allied health education program were proper. Issue 2 - Whether the Medicare Contractor's proposed adjustment entries related to the Provider's operation of its pastoral care allied health education program were proper.</p>]]></description></item><item><title>2020D15</title><pubDate>Fri, 11 Sep 2020 11:30:11 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d15</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d15</guid><description><![CDATA[<p>decision_number: 2020D15</p><p>fiscal_year_end: 12/31/2004</p><p>provider_number: 35-0070</p><p>summary: Whether the Medicare Contractor's adjustment to reconcile outlier payments was proper and, since the Contractor waited 5 years after discovering the error before notifying the Provider, whether the law bars recovery of the overpayment.</p>]]></description></item><item><title>2020D14</title><pubDate>Fri, 11 Sep 2020 11:23:57 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d14</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d14</guid><description><![CDATA[<p>decision_number: 2020D14</p><p>fiscal_year_end: 12/31/2010, 12/31/2011</p><p>provider_number: 04-1331</p><p>summary: Issue 1 - Whether the use of total costs, rather than patient days, as a statistic to allocate home office pooled costs was proper. Issue 2 - Whether the use of gross revenues, rather than patient days, as a statistic to functionally allocate business office costs was proper; alternatively, whether business office costs should be in the home office pooled costs. Issue 3 - Whether the use of gross revenues, rather than patient days, to functionally allocate transcription costs was proper; alternatively, whether transcription costs should be in the home office pooled costs.</p>]]></description></item><item><title>2020D13</title><pubDate>Fri, 11 Sep 2020 11:16:02 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d13</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d13</guid><description><![CDATA[<p>decision_number: 2020D13</p><p>fiscal_year_end: 12/31/2013</p><p>provider_number: 17-1582</p><p>summary: Whether the Medicare Contractor's amended hospice cap calculation issued pursuant to the Notice of Reopening properly calculated the Provider's hospice aggregate cap overpayment when it included in "the amount of payment made" certain funds that were sequestered and never paid to the Provider.</p>]]></description></item><item><title>2020D12</title><pubDate>Fri, 11 Sep 2020 11:10:13 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d12</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d12</guid><description><![CDATA[<p>decision_number: 2020D12</p><p>fiscal_year_end: 9/30/2013</p><p>provider_number: 24-0052</p><p>summary: Whether the Medicare Contractor's final determination of the Provider's Sole Community Hospital ("SCH") Volume Decrease Adjustment ("VDA") was properly calculated.</p>]]></description></item><item><title>2020D11</title><pubDate>Fri, 11 Sep 2020 11:05:28 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d11</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d11</guid><description><![CDATA[<p>decision_number: 2020D11</p><p>fiscal_year_end: 12/31/2012</p><p>provider_number: 50-0072</p><p>summary: Whether the Medicare Contractor was correct in calculating the Provider's Sole Community Hospital ("SCH") Volume Decrease Adjustment ("VDA").</p>]]></description></item><item><title>2020D10</title><pubDate>Fri, 11 Sep 2020 10:59:35 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d10</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d10</guid><description><![CDATA[<p>decision_number: 2020D10</p><p>fiscal_year_end: 9/30/2011</p><p>provider_number: 25-0044</p><p>summary: Whether the Medicare Administrative Contractor ("MAC") determination of the Provider's Medicare Dependent Hospital ("MDH") Volume Decrease Adjustment ("VDA") was calculated in accordance with the regulations at 42 C.F.R. § 412.108 (d) and Program Reimbursement Manual, CMS Pub. 15-1 ("PRM 15-1"), § 2810.1.</p>]]></description></item><item><title>2020D09</title><pubDate>Fri, 11 Sep 2020 10:47:11 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d09</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d09</guid><description><![CDATA[<p>decision_number: 2020D09</p><p>fiscal_year_end: 9/30/2012</p><p>provider_number: 25-0044</p><p>summary: Whether the Medicare Administrative Contractor's ("MAC") determination of the Provider's Medicare Dependent Hospital ("MDH") Volume Decrease Adjustment ("VDA") was calculated in accordance with the regulations at 42 C.F.R. § 412.108(d) and Program Reimbursement Manual, CMS Pub. No. 15-1 ("PRM 15-1"), § 2810.1 calculation</p>]]></description></item><item><title>2020D08</title><pubDate>Wed, 15 Jul 2020 11:20:16 -0400</pubDate><link>https://www.cms.gov//httpswwwcmsgovregulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d08</link><guid>https://www.cms.gov//httpswwwcmsgovregulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d08</guid><description><![CDATA[<p>decision_number: 2020D08</p><p>fiscal_year_end: 6/30/2011, 6/30/2012, 6/30/2013, 6/30/2014, 6/30/2015</p><p>provider_number: 02-0008</p><p>summary: Whether the contributions made by the state of Alaska can be counted as "reasonable cost" by the Bartlett Regional Hospital ("Bartlett" or "Provider") for purposes of reimbursement under the Medicare Rural Demonstration Project?</p>]]></description></item><item><title>2020D07</title><pubDate>Wed, 15 Jul 2020 11:13:35 -0400</pubDate><link>https://www.cms.gov//httpswwwcmsgovregulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d07</link><guid>https://www.cms.gov//httpswwwcmsgovregulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d07</guid><description><![CDATA[<p>decision_number: 2020D07</p><p>fiscal_year_end: May 31, 2011</p><p>provider_number: 37-0002</p><p>summary: The dispute in this appeal relates to the methodology and calculations used to determine the Provider's fiscal year ("FY") 2011 Volume Decrease Adjustment ("VDA") payment.</p>]]></description></item><item><title>2020D06</title><pubDate>Wed, 15 Jul 2020 11:04:40 -0400</pubDate><link>https://www.cms.gov//httpswwwcmsgovregulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d06</link><guid>https://www.cms.gov//httpswwwcmsgovregulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d06</guid><description><![CDATA[<p>decision_number: 2020D06</p><p>fiscal_year_end: May 31, 2010</p><p>provider_number: 37-0002</p><p>summary: The sole disputed issue in this appeal is the methodology used to calculate the Volume Decrease Adjustment ("VDA") payment.</p>]]></description></item><item><title>2020D05</title><pubDate>Mon, 27 Apr 2020 11:02:07 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d05</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d05</guid><description><![CDATA[<p>decision_number: 2020D05</p><p>fiscal_year_end: September 30, 2010, September 30, 2011, September 30, 2012</p><p>provider_number: 22-0110</p><p>summary: Issue 1 – Whether the Medicare Contractor improperly disallowed the Provider’s reasonable cost for the Ultrasound Allied Health Clinical Training Program that is not operated by the Provider. Issue 2 – Whether the Medicare Contractor improperly disallowed the Provider’s reasonable cost for the Nuclear Medicine Allied Health Clinical Training Program not operated by the Provider.</p>]]></description></item><item><title>2020D04</title><pubDate>Mon, 27 Apr 2020 10:49:36 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d04</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d04</guid><description><![CDATA[<p>decision_number: 2020D04</p><p>fiscal_year_end: May 31, 2009</p><p>provider_number: 26-0022</p><p>summary: Whether Northeast Regional Medical Center (“Northeast” or the “Provider”), as a Sole Community hospital (“SCH”), was properly reimbursed for indirect medical education costs for services provided to Medicare Advantage (“MA”) patients for the fiscal year ending May 31, 2009. In particular, whether cost report Worksheet E Part A properly calculates the settlement for indirect medical education (“IME” or “indirect GME”) on Medicare Managed Care (“Part C”) claim, for an SCH whose hospital specific rate (“HSR”) exceeds the hospital’s inpatient prospective payment system (“IPPS”) federal rate.</p>]]></description></item><item><title>2020D03</title><pubDate>Fri, 27 Mar 2020 12:07:49 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d03</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d03</guid><description><![CDATA[<p>decision_number: 2020D03</p><p>fiscal_year_end: October 31, 2013, October 31, 2014, October 31, 2015</p><p>provider_number: 05-1770, 05-1746</p><p>summary: Whether the MAC’s inclusion of sequestered payments in the determination of the Providers’ Cap on Overall Medicare Reimbursement was proper.</p>]]></description></item><item><title>2020D02</title><pubDate>Fri, 27 Mar 2020 12:02:45 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d02</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d02</guid><description><![CDATA[<p>decision_number: 2020D02</p><p>fiscal_year_end: September 30, 2012</p><p>provider_number: 34-0151</p><p>summary: The sole disputed issue in this appeal is the methodology used to calculate the Volume Decrease Adjustment (“VDA”) payment.</p>]]></description></item><item><title>2020D2</title><pubDate>Fri, 27 Mar 2020 12:01:55 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d2-0</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d2-0</guid><description><![CDATA[<p>decision_number: 2020D2</p><p>fiscal_year_end: September 30, 2012</p><p>provider_number: 34-0151</p><p>summary: The sole disputed issue in this appeal is the methodology used to calculate the Volume Decrease Adjustment (“VDA”) payment.</p>]]></description></item><item><title>2020D2</title><pubDate>Fri, 27 Mar 2020 11:59:37 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d2</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d2</guid><description><![CDATA[<p>decision_number: 2020D2</p><p>fiscal_year_end: September 30, 2012</p><p>provider_number: 34-0151</p><p>summary: The sole disputed issue in this appeal is the methodology used to calculate the Volume Decrease Adjustment (“VDA”) payment.</p>]]></description></item><item><title>2020D01</title><pubDate>Fri, 27 Mar 2020 11:45:19 -0400</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d01</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2020d01</guid><description><![CDATA[<p>decision_number: 2020D01</p><p>fiscal_year_end: September 30, 2013</p><p>provider_number: 34-0151</p><p>summary: The sole disputed issue in this appeal is the methodology used to calculate the Volume Decrease Adjustment (“VDA”) payment.</p>]]></description></item><item><title>2019D38</title><pubDate>Tue, 14 Jan 2020 14:53:47 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2019d38</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2019d38</guid><description><![CDATA[<p>decision_number: 2019D38</p><p>fiscal_year_end: May 31, 2011</p><p>provider_number: 26-0022</p><p>summary: Whether Northeast Regional Medical Center ("Northeast" or "Provider"), as a Sole Community Hospital ("SCH"), was properly reimbursed for indirect medical education costs for services provided to Medicare Advantage patients for the fiscal year ending May 31, 2011. In particular, whether the Cost Report Worksheet E Part A properly calculates the indirect medical education ("IME" or "indirect GME") settlement on Medicare Managed Care claims for a SCH whose hospital specific rate ("HSR") exceeds the hospital's inpatient prospective payment system ("IPPS") federal rate.</p>]]></description></item><item><title>2019D37</title><pubDate>Tue, 14 Jan 2020 14:44:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2019d37</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2019d37</guid><description><![CDATA[<p>decision_number: 2019D37</p><p>fiscal_year_end: October 31, 2012</p><p>provider_number: 10-1543</p><p>summary: Whether the Medicare Contractor incorrectly determined the cap year 2012 aggregate cap amount for Seasons Hospice &#x26; Palliative Care of Southern Florida ("Seasons" or "Hospice") when the Medicare Contractor used the patient-by-patient proportional method ("proportional method") instead of the streamlined method.</p>]]></description></item><item><title>2019D36</title><pubDate>Mon, 13 Jan 2020 18:29:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2019d36</link><guid>https://www.cms.gov//regulations-and-guidancereview-boardsprrbreviewlist-prrb-decisions/2019d36</guid><description><![CDATA[<p>decision_number: 2019D36</p><p>fiscal_year_end: June 30, 2005; June 30, 2006; June 30, 2007; June 30, 2008; and June 30, 2010</p><p>provider_number: 52-0098</p><p>summary: Issue 1: Whether the Medicare Contractor's adjustments, decreasing the Provider's direct Graduate Medical Education ("GME") and Indirect Medical Education ("IME") Full Time Equivalent ("FTE") Caps to a level below the Provider's audited and adjusted fiscal year ending June 30, 1996 ("FY 1996") GME and IME Medicare resident counts should be reversed. Issue 2: Whether the Medicare Contractor's adjustments disallowing certain bad debt claims with respect to indigent patients whose indigency was determined through the Save Our Seniors ("SOS") Program should be reversed.</p>]]></description></item><item><title>2019D34</title><pubDate>Mon, 04 Nov 2019 02:48:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d34</guid><description><![CDATA[<p>decision_number: 2019D34</p><p>fiscal_year_end: FYEs 2004, 2005 and 2006</p><p>provider_number: Various</p><p>summary: Whether the Providers engaged in "reasonable collection efforts," notwithstanding their differential treatment of Medicare and non-Medicare bad debts, in light of the Board's decisions in Reed City Hosp. v. BlueCross BlueShield Ass'n ("Reed City") and St. Francis Hosp. &#x26; Med. Ctr. v. BlueCross BlueShield Ass'n ("St. Francis").</p>]]></description></item><item><title>2019D32</title><pubDate>Mon, 04 Nov 2019 02:48:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d32</guid><description><![CDATA[<p>decision_number: 2019D32</p><p>fiscal_year_end: 9-30-2008</p><p>provider_number: 11-0032</p><p>summary: The sole issue in this appeal is the methodology used to calculate the Volume Decrease Adjustment ("VDA") payment.</p>]]></description></item><item><title>2019D31</title><pubDate>Mon, 04 Nov 2019 02:48:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d31</guid><description><![CDATA[<p>decision_number: 2019D31</p><p>fiscal_year_end: 9-30-2012</p><p>provider_number: 11-0032</p><p>summary: The sole disputed issue in this appeal is the methodology used to calculate the Volume Decrease Adjustment ("VDA") payment.</p>]]></description></item><item><title>2019D33</title><pubDate>Mon, 04 Nov 2019 02:48:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d33</guid><description><![CDATA[<p>decision_number: 2019D33</p><p>fiscal_year_end: 2013</p><p>provider_number: Various</p><p>summary: Whether the Medicare Contractor's adjustments disallowing the administrative and general costs ("A&#x26;G") that Mercy Medical Center - Sioux City ("MMC-SC") allocated to the appealing group members (Baum Harmon Mercy Hospital and Oakland Mercy Hospital) were proper.</p>]]></description></item><item><title>2019D35</title><pubDate>Mon, 04 Nov 2019 02:48:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d35</guid><description><![CDATA[<p>decision_number: 2019D35</p><p>fiscal_year_end: 9-30-2019</p><p>provider_number: 06-0107</p><p>summary: Whether the Provider should be subject to a one-fourth reduction in its Federal Fiscal Year ("FFY") 2019 Annual Percentage Update ("APU") for noncompliance with the Hospital Inpatient Quality Reporting ("IQR") Program requirements.</p>]]></description></item><item><title>2019D30</title><pubDate>Mon, 04 Nov 2019 02:48:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d30</guid><description><![CDATA[<p>decision_number: 2019D30</p><p>fiscal_year_end: Fisal Year - 2018</p><p>provider_number: 29-1502</p><p>summary: Whether the imposition of a two percent reduction in the fiscal year ("FY") 2018 Medicare payments for Southwest Medical Associates Hospice and Palliative Care ("SMA" or "Provider") was proper.</p>]]></description></item><item><title>2019D29</title><pubDate>Mon, 04 Nov 2019 02:48:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d29</guid><description><![CDATA[<p>decision_number: 2019D29</p><p>fiscal_year_end: Cost Reporting Period Ended - 2011</p><p>provider_number: Various</p><p>summary: Whether the Medicare Contractor's must-bill policy applies to the Providers' dual eligible bad debts when the Providers did not participate in the Medicaid program.</p>]]></description></item><item><title>2019D28</title><pubDate>Mon, 04 Nov 2019 02:47:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d28</guid><description><![CDATA[<p>decision_number: 2019D28</p><p>fiscal_year_end: 10-31-2013</p><p>provider_number: Various</p><p>summary: Whether the Medicare administrative contractor's inclusion of the sequestered payments never actually paid to the Providers in its calculation of the Providers' hospice cap liabilities was improper.</p>]]></description></item><item><title>2019D26</title><pubDate>Mon, 04 Nov 2019 02:47:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d26</guid><description><![CDATA[<p>decision_number: 2019D26</p><p>fiscal_year_end: 10-31-2013</p><p>provider_number: 67-1710</p><p>summary: 1.) Whether the sequestration amount should be included when calculating the aggregate payment made to Novus Health Services ("Novus" or "Provider") as the reduction in payment through sequestration does not constitute actual Medicare payments made to Novus. 2.) Whether Palmetto GBA c/o National Government Services' ("Medicare Contractor" or "NGS")reopening(s) is/are invalid, as the Medicare Contractor failed to comply with applicable Medicare statutes, regulations, and guidelines when doing so.</p>]]></description></item><item><title>2019D27</title><pubDate>Mon, 04 Nov 2019 02:47:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d27</guid><description><![CDATA[<p>decision_number: 2019D27</p><p>fiscal_year_end: 6-30-2014</p><p>provider_number: 23-0092</p><p>summary: Did the Medicare Contractor properly calculate the per-resident amount ("PRA") for Medicare payment of direct graduate medical education ("DGME")?</p>]]></description></item><item><title>2019D25</title><pubDate>Mon, 04 Nov 2019 02:47:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d25</guid><description><![CDATA[<p>decision_number: 2019D25</p><p>fiscal_year_end: 2017</p><p>provider_number: 45-7803</p><p>summary: Whether the Centers for Medicare &#x26; Medcaid Services properly reduced Abundant Home Health, LLC's home health market basket percentage increase by two percentage points for Calendar Year ("CY") 2017.</p>]]></description></item><item><title>2019D24</title><pubDate>Mon, 04 Nov 2019 02:47:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d24</guid><description><![CDATA[<p>decision_number: 2019D24</p><p>fiscal_year_end: 11-30-1997, 11-30-1998, 11-30-2000</p><p>provider_number: 42-0036</p><p>summary: Whether the Medicare Contractor properly disallowed all costs and removed all therapy charges relating to the Provider's use of a Therapy and Management Services subcontractor for its Skilled Nursing Facility ("SNF") and Inpatient Rehabilitation Facility ("IRF") units.</p>]]></description></item><item><title>2019D21</title><pubDate>Mon, 04 Nov 2019 02:47:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d21</guid><description><![CDATA[<p>decision_number: 2019D21</p><p>fiscal_year_end: 12-31-2018</p><p>provider_number: 10-8422</p><p>summary: Whether RX Home Health Services, Inc. ("RX" or "Provider") should be subject to a two percentage point reduction to its Calendar Year ("CY") 2018 Annual Payment Update ("APU") for failure to meet Home Health Quality Reporting Program requirements in accordance with 42 C.F.R. § 484.225(i) (2015).</p>]]></description></item><item><title>2019D23</title><pubDate>Mon, 04 Nov 2019 02:47:41 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d23</guid><description><![CDATA[<p>decision_number: 2019D23</p><p>fiscal_year_end: 9-30-2017</p><p>provider_number: 05-0205</p><p>summary: Whether the payment penalty imposed by CMS [Centers for Medicare &#x26; Medicaid Services] under the Hospital Inpatient Quality Reporting ("IQR") program to reduce the Provider's payment update for federal fiscal year 2017 by one-fourth of the annual market basket update was proper.</p>]]></description></item><item><title>2019D22</title><pubDate>Mon, 04 Nov 2019 02:47:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d22</guid><description><![CDATA[<p>decision_number: 2019D22</p><p>fiscal_year_end: 9-30-2012, 9-30-2013, 9-30-2014</p><p>provider_number: 10-1313</p><p>summary: Whether the Medicare Contractor improperly disallowed costs incurred by the Provider under its service agreements with emergency and anesthesiologist physicians groups for availability, standby, and administrative services furnished to the hospital.</p>]]></description></item><item><title>2019D20</title><pubDate>Mon, 04 Nov 2019 02:47:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d20</guid><description><![CDATA[<p>decision_number: 2019D20</p><p>fiscal_year_end: 10-31-2014</p><p>provider_number: Various</p><p>summary: Whether National Government Services ("Medicare Contractor" or "NGS") erred in calculating the hospice aggregate cap overpayments when it included, in "the amount of payment made," certain funds that were sequestered and never paid to the Providers.</p>]]></description></item><item><title>2019D15</title><pubDate>Mon, 04 Nov 2019 02:47:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d15</guid><description><![CDATA[<p>decision_number: 2019D15</p><p>fiscal_year_end: 6-30-2007, 6-30-2008</p><p>provider_number: 42-0004</p><p>summary: Issue 1: Whether the Medicare Administrative Contractor's decision to reclassify the costs and statistics out of the paramedical pass-through cost center was proper. This issue applies to the fiscal years ending June 30, 2007 ("FY 2007") and June 30, 2008 ("FY 2008"). Issue 2: Whether the Medicare Administrative Contractor's decision to classify certain Cornea tissue expenses, charges, statistics and program charges on Line 59.04 rather than Line 60.05 on several worksheets was proper. This issue applies to FYs 2007 and 2008. Issue 3: Whether the Medicare Administrative Contractor's decision to classify certain Bone Marrow expenses, charges, statistics and program charges on Line 86 (as an organ acquisition cost) rather than Line 60.07 on serval worksheets was proper. This issue applies to FY 2008.</p>]]></description></item><item><title>2019D16</title><pubDate>Mon, 04 Nov 2019 02:47:30 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d16</guid><description><![CDATA[<p>decision_number: 2019D16</p><p>fiscal_year_end: 9-30-2017</p><p>provider_number: 46-2006</p><p>summary: Whether the payment penalty that the Centers for Medicare &#x26; Medicaid Services ("CMS") imposed under the Long Term Care Hospital Quality Reporting Program ("LTCH-QRP") to reduce the Provider's payment update for Fiscal Year ("FY") 2017 by 2-percent was proper.</p>]]></description></item><item><title>2019D18</title><pubDate>Mon, 04 Nov 2019 02:47:28 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d18</guid><description><![CDATA[<p>decision_number: 2019D18</p><p>fiscal_year_end: 10-31-2013, 12-31-2013</p><p>provider_number: Various</p><p>summary: Whether National Government Services ("Medicare Contractor" or "NGS")erred in calculating the hospice aggregate cap overpayments when it included, in "the amount of payment made," certain funds that were sequestered and never paid to the Providers.</p>]]></description></item><item><title>2019D17</title><pubDate>Mon, 04 Nov 2019 02:47:28 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d17</guid><description><![CDATA[<p>decision_number: 2019D17</p><p>fiscal_year_end: 9-30-2017</p><p>provider_number: 11-2018</p><p>summary: Whether the payment penalty that the Centers for Medicare &#x26; Medicaid Services ("CMS") imposed under the Long Term Care Hospital Quality Reporting Program ("LTCH-QRP") to reduce the Provider's payment update for Fiscal Year ("FY") 2017 by 2-percent was proper.</p>]]></description></item><item><title>2019D19</title><pubDate>Mon, 04 Nov 2019 02:47:28 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d19</guid><description><![CDATA[<p>decision_number: 2019D19</p><p>fiscal_year_end: 9-30-2018</p><p>provider_number: 17-4020</p><p>summary: Whether Cottonwood Springs, LLC ("Cottonwood" or "Provider") is entitled to the full market basket adjustment to its Inpatient Psychiatric Facility Prospective Payment System ("IPF PPS") rate for fiscal year 2018.</p>]]></description></item><item><title>2019D11</title><pubDate>Mon, 04 Nov 2019 02:47:25 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d11</guid><description><![CDATA[<p>decision_number: 2019D11</p><p>fiscal_year_end: 2001 - 2009</p><p>provider_number: Various</p><p>summary: Whether the Medicare Contractor's determination to reduce the Providers' indirect medical education ("IME") and graduate medical education ("GME") full-time equivalent ("FTE") resident counts to exclude certain resident rotations in nonhospital clinics was proper.</p>]]></description></item><item><title>2019D12</title><pubDate>Mon, 04 Nov 2019 02:47:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d12</guid><description><![CDATA[<p>decision_number: 2019D12</p><p>fiscal_year_end: 12-31-2009 &#x26; 12-31-2010</p><p>provider_number: 15-1318</p><p>summary: Whether the Medicare Contractor appropriately disallowed costs to the Provider claimed for physician compensation for emergency room availibility services (frequently referred to as "standby services"), administrative/management services, and on-call costs.</p>]]></description></item><item><title>2019D14</title><pubDate>Mon, 04 Nov 2019 02:47:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d14</guid><description><![CDATA[<p>decision_number: 2019D14</p><p>fiscal_year_end: 2018</p><p>provider_number: 36-0245</p><p>summary: Whether the fiscal year ("FY") 2018 penalty imposed under the hospital inpatient quality reporting ("IQR") program was proper.</p>]]></description></item><item><title>2019D13</title><pubDate>Mon, 04 Nov 2019 02:47:18 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d13</guid><description><![CDATA[<p>case_name: Rehabilitation Hospital of the Pacific</p><p>case_numbers: 17-1238</p><p>decision_date: Wed, 30 Jan 2019 12:00:00 -0500</p><p>decision_number: 2019D13</p><p>fiscal_year_end: 9-30-2017</p><p>provider_number: 12-3025</p><p>summary: Whether the reduction to the Provider's Market Basket Update for the fiscal year ("FY") 2017 under the Inpatient Rehabilitation Facility ("IRF") Quality Reporting Program ("QRP") was proper.</p>]]></description></item><item><title>2019D07</title><pubDate>Mon, 04 Nov 2019 02:47:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d07</guid><description><![CDATA[<p>decision_number: 2019D07</p><p>fiscal_year_end: Cost Reporting Period Ended - 2017</p><p>provider_number: 25-T004</p><p>summary: Whether the reduction of the Provider's Annual Payment Update ("APU") by 2 percent for fiscal year ("FY") 2017 was proper.</p>]]></description></item><item><title>2019D09</title><pubDate>Mon, 04 Nov 2019 02:47:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d09</guid><description><![CDATA[<p>decision_number: 2019D09</p><p>fiscal_year_end: 2017</p><p>provider_number: 31-4019</p><p>summary: Whether Christian Health Care Center (d/b/a Ramapo Ridge Psychiatric Hospital ("Ramapo Ridge" or "Provider")) is entitled to the full market basket adjustment to its rate for fiscal year ("FY") 2017.</p>]]></description></item><item><title>2019D10</title><pubDate>Mon, 04 Nov 2019 02:47:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d10</guid><description><![CDATA[<p>decision_number: 2019D10</p><p>fiscal_year_end: 2018</p><p>provider_number: 24-1582</p><p>summary: Whether the Centers for Medicare &#x26; Medicaid Services properly reduced Minnesota Hospice, LLC's annual payment update ("APU") for Fiscal Year ("FY") 2018 by 2 percentage points.</p>]]></description></item><item><title>2019D08</title><pubDate>Mon, 04 Nov 2019 02:47:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d08</guid><description><![CDATA[<p>decision_number: 2019D08</p><p>fiscal_year_end: 09-30-2012, 12-31-2012</p><p>provider_number: Various</p><p>summary: Whether the Federal Fiscal Year ("FFY") 2012 wage index factor and capital geographic adjustment factor for Core Based Statistical Area ("CBSA") No. 40900 used in the calculation of Medicare inpatient and outpatient prospective payments is properly stated.</p>]]></description></item><item><title>2019D05</title><pubDate>Mon, 04 Nov 2019 02:47:05 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d05</guid><description><![CDATA[<p>decision_number: 2019D05</p><p>fiscal_year_end: 06-30-2008, 06-30-2009</p><p>provider_number: 14-0224</p><p>summary: Did National Government Services, the Medicare Administrative Contractor, properly determine the count of full-time equivalent residents ("FTEs"), used for the purposes of calculating payments for direct graduate medical education ("DGME"), indirect medical education ("IME") and IME capital?</p>]]></description></item><item><title>2019D06</title><pubDate>Mon, 04 Nov 2019 02:47:05 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d06</guid><description><![CDATA[<p>decision_number: 2019D06</p><p>fiscal_year_end: 09-30-2018</p><p>provider_number: 45-0152</p><p>summary: Whether the payment penalty under the Hospital Inpatient Quality Reporting Program was properly applied to the Provider.</p>]]></description></item><item><title>2019D03</title><pubDate>Mon, 04 Nov 2019 02:47:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d03</guid><description><![CDATA[<p>decision_number: 2019D03</p><p>fiscal_year_end: 12-31-2005, 12-31-2006, 12-31-2007, 12-31-2008</p><p>provider_number: 05-1317</p><p>summary: Issue 1 - Whether the costs incurred by the Provider for its physician on-call expenses should be allowed for the four cost reporting periods at issue (2005, 2006, 2007 and 2008).
Issue 2 - Whether the Provider's costs of meals furnished to outpatients (sometimes referred to as non-allowable patient statistics) during the 2006, 2007 and 2008 cost reporting periods should be allowed.</p>]]></description></item><item><title>2019D02</title><pubDate>Mon, 04 Nov 2019 02:47:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d02</guid><description><![CDATA[<p>decision_number: 2019D02</p><p>fiscal_year_end: 08-31-2008</p><p>provider_number: 45-0044</p><p>summary: Whether the Medicare Contractor's audit adjustments to remove Medicare Usable Organs (Heart &#x26; Kidney) were fair and proper.</p>]]></description></item><item><title>2018D47</title><pubDate>Mon, 04 Nov 2019 02:47:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d47</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d47</guid><description><![CDATA[<p>case_name: Post Acute Medical Specialty Hospital of Texarkana North</p><p>case_numbers: 17-1018</p><p>decision_date: Thu, 06 Sep 2018 12:00:00 -0400</p><p>decision_number: 2018D47</p><p>fiscal_year_end: 09/30/2017</p><p>provider_number: 45-2061</p><p>summary: Whether the payment penalty that CMS imposed under the Long-Term Care Hospital Quality Reporting Program to reduce the Provider's payment update for the federal fiscal year of 2017 by two percent was proper.</p>]]></description></item><item><title>2019D04</title><pubDate>Mon, 04 Nov 2019 02:47:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d04</guid><description><![CDATA[<p>decision_number: 2019D04</p><p>fiscal_year_end: 09-30-2014</p><p>provider_number: 42-8960</p><p>summary: Whether the Medicare Administrative Contractor's ("Medicare Contractor") disallowance of the Medicare bad debts claimed by Mackey Family Practice was proper.</p>]]></description></item><item><title>2019D01</title><pubDate>Mon, 04 Nov 2019 02:47:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2019d01</guid><description><![CDATA[<p>decision_number: 2019D01</p><p>fiscal_year_end: 09-30-2017</p><p>provider_number: 51-0006</p><p>summary: Whether the reduction by one-fourth of the Provider's fiscal year ("FY") 2017 Inpatient Prospective Payment System annual payment update for the failure to meet all of the inpatient quality reporting requirements is proper.</p>]]></description></item><item><title>2018D51</title><pubDate>Mon, 04 Nov 2019 02:46:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d51</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d51</guid><description><![CDATA[<p>case_name: Rice Memorial Hospital</p><p>case_numbers: 14-3941</p><p>decision_date: Fri, 28 Sep 2018 12:00:00 -0400</p><p>decision_number: 2018D51</p><p>fiscal_year_end: 12-31-2008</p><p>provider_number: 24-0088</p><p>summary: Whether the Medicare Administrative Contractor was correct when it calculated the Provider's volume decrease adjustment ("VDA") by prorating the amount of the VDA according to the portion of the year during which the Provider maintained sole community hospital ("SCH") status.</p>]]></description></item><item><title>2018D50</title><pubDate>Mon, 04 Nov 2019 02:46:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d50</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d50</guid><description><![CDATA[<p>case_name: Pomona Valley Hospital Medical Center</p><p>case_numbers: 13-0430, 13-0628, 13-0680</p><p>decision_date: Fri, 21 Sep 2018 12:00:00 -0400</p><p>decision_number: 2018D50</p><p>fiscal_year_end: 12-31-2006, 12-31-2007, 12-31-2008</p><p>provider_number: 05-0231</p><p>summary: Whether the Medicare Administrative Contractor properly calculated Pomona Valley Hospital Medical Center's disproportionate share hospital reimbursement with respect to the Provider's Supplemental Security Income percentage.</p>]]></description></item><item><title>2018D49</title><pubDate>Mon, 04 Nov 2019 02:46:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d49</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d49</guid><description><![CDATA[<p>case_name: Akin Gump 2006-2008 Florida Low Income Pool Waiver Days Groups</p><p>case_numbers: 13-1460GC, 14-0565GC, 14-0773GC &#x26; 14-3216GC</p><p>decision_date: Fri, 21 Sep 2018 12:00:00 -0400</p><p>decision_number: 2018D49</p><p>fiscal_year_end: 2006 - 2008</p><p>provider_number: Various</p><p>summary: Whether a certain category of Medicaid waiver days should be included in the numerator of the Medicaid fraction used to calculate the Providers' disproportionate share hospital ("DSH") payments. The specific days at issue are attributable to patients who received assistance under Florida's Low-Income Pool Medicaid waiver.</p>]]></description></item><item><title>2018D52</title><pubDate>Mon, 04 Nov 2019 02:46:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d52</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d52</guid><description><![CDATA[<p>case_name: St. Mary's Regional Hospital</p><p>case_numbers: 14-3942</p><p>decision_date: Fri, 28 Sep 2018 12:00:00 -0400</p><p>decision_number: 2018D52</p><p>fiscal_year_end: 06-30-2009</p><p>provider_number: 24-0101</p><p>summary: Whether the Medicare Administrative Contractor was correct when it calculated the Provider's volume decrease adjustment ("VDA") by prorating the amount of the VDA according to the portion of the year during which the Provider maintained sole community hospital ("SCH") status.</p>]]></description></item><item><title>2018D48</title><pubDate>Mon, 04 Nov 2019 02:46:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d48</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d48</guid><description><![CDATA[<p>case_name: Providence Health &#x26; Services 10-01-2004 - 12-31-2007 Dual Eligible Days CIRP Group</p><p>case_numbers: 09-0937GC</p><p>decision_date: Fri, 07 Sep 2018 12:00:00 -0400</p><p>decision_number: 2018D48</p><p>fiscal_year_end: 10-01-2004 - 2007</p><p>provider_number: Various</p><p>summary: Should patient days associated with Medicare Part A and Title XIX eligible patients that were not included in the SSI percentage factor of the Medicare Disproportionate Share formula be included in the Medicaid fraction of the Medicare DSH formula?</p>]]></description></item><item><title>2018D43</title><pubDate>Mon, 04 Nov 2019 02:46:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d43</guid><description><![CDATA[<p>case_name: Medicare Part A Title XIX Eligible Days Groups</p><p>case_numbers: 08-2598G; 08-2955GC; 13-0016G</p><p>decision_date: Thu, 05 Jul 2018 12:00:00 -0400</p><p>decision_number: 2018D43</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Should patient days associated with Medicare Part A, Title XIX eligible patients that were not included in the Supplemental Security Income ("SSI") percentage factor of the Medicare Disproportionate Share Hospital ("DSH") formula be included in the Medicaid days factor or the SSI percentage factor used in the Medicare DSH formula?</p>]]></description></item><item><title>2018D44</title><pubDate>Mon, 04 Nov 2019 02:46:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d44</guid><description><![CDATA[<p>case_name: Garden City Hospital</p><p>case_numbers: 17-0196</p><p>decision_date: Fri, 27 Jul 2018 12:00:00 -0400</p><p>decision_number: 2018D44</p><p>fiscal_year_end: September 30, 2017</p><p>provider_number: 23-0244/23-T244</p><p>summary: Whether the Provider timely submitted required quality data during the required timeframes, and is entitled to the full Market Basket Update for Fiscal Year ("FY") 2017?</p>]]></description></item><item><title>2018D42</title><pubDate>Mon, 04 Nov 2019 02:46:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d42</guid><description><![CDATA[<p>case_name: Conway Regional Rehabilitation Hospital</p><p>case_numbers: 17-1167</p><p>decision_date: Thu, 28 Jun 2018 12:00:00 -0400</p><p>decision_number: 2018D42</p><p>fiscal_year_end: September 30, 2017</p><p>provider_number: 04-3033</p><p>summary: Conway Regional Rehabilitation Hospital ("Conway" or the "Provider") challenges the reduction of its Annual Payment Update ("APU") for the federal fiscal year ("FFY") 2017 by the Centers for Medicare &#x26; Medicaid Services ("CMS") under the Inpatient Rehabilitation Facility ("IRF") Quality Reporting Program ("QRP").</p>]]></description></item><item><title>2018D46</title><pubDate>Mon, 04 Nov 2019 02:46:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d46</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d46</guid><description><![CDATA[<p>case_name: Our Lady of the Lake Regional Medical Center</p><p>case_numbers: 13-2321; 13-2323; 13-3154; 15-3191</p><p>decision_date: Tue, 31 Jul 2018 12:00:00 -0400</p><p>decision_number: 2018D46</p><p>fiscal_year_end: June 30, 2007; June 30, 2008; June 30, 2009; June 30, 2010</p><p>provider_number: 19-0064</p><p>summary: When the Medicare Contractor recalculates the Provider's per-resident amount ("PRA"), whether it is consistent with the law to use 1998 census region hospital data to determine the cap on the Provider's recalculated PRA?</p>]]></description></item><item><title>2018D41</title><pubDate>Mon, 04 Nov 2019 02:46:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d41</guid><description><![CDATA[<p>case_name: University Medical Center</p><p>case_numbers: 13-1588</p><p>decision_date: Wed, 27 Jun 2018 12:00:00 -0400</p><p>decision_number: 2018D41</p><p>fiscal_year_end: October 31, 2008</p><p>provider_number: 44-0193</p><p>summary: Whether the Medicare Administrative Contractor ("Medicare Contractor") determined Medicare reimbursement for Disproportionate Share Hospital ("DSH") payments in accordance with the Medicare statute, 42 U.S.C. § 1395ww(d)(5)(F)(vi). Specifically, whether the numerator of the "Medicaid fraction" properly includes all "eligible" Medicaid days, regardless of whether such days were paid days. Whether the Provider Reimbursement Review Board("Board") has jurisdiction over this issue.</p>]]></description></item><item><title>2018D45</title><pubDate>Mon, 04 Nov 2019 02:46:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d45</guid><description><![CDATA[<p>case_name: Faxton-St. Luke's Healthcare</p><p>case_numbers: 13-0489</p><p>decision_date: Tue, 31 Jul 2018 12:00:00 -0400</p><p>decision_number: 2018D45</p><p>fiscal_year_end: December 31, 2007</p><p>provider_number: 33-0044</p><p>summary: The Provider contends that the disallowance of the bad debts claimed is not in accordance with the Medicare regulations and manual provisions as described in the Centers for Medicare &#x26; Medicaid Services' ("CMS") Provider Reimbursement Manual ("PRM"), CMS Pub. 15-1 §§ 310 and 312. The Medicare Contractor has disallowed all bad debt claims for patients deemed indigent.</p>]]></description></item><item><title>2018D37</title><pubDate>Mon, 04 Nov 2019 02:46:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d37</guid><description><![CDATA[<p>case_name: Hospice Care in Westchester and Putnam, Inc.</p><p>case_numbers: 16-0828</p><p>decision_date: Tue, 22 May 2018 12:00:00 -0400</p><p>decision_number: 2018D37</p><p>fiscal_year_end: September 30, 2016</p><p>provider_number: 33-1542</p><p>summary: Hospice Care in Westchester and Putnam, Inc. (“Hospice Care” or the “Provider”) challenges the Centers for Medicare &#x26; Medicaid Services’ (“CMS’”) reduction to the Provider’s Annual Payment Update (“APU”) for Fiscal Year (“FY”) 2016.</p>]]></description></item><item><title>2018D39</title><pubDate>Mon, 04 Nov 2019 02:46:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d39</guid><description><![CDATA[<p>case_name: Grace Community Home Health, Inc.</p><p>case_numbers: 17-0854</p><p>decision_date: Mon, 04 Jun 2018 12:00:00 -0400</p><p>decision_number: 2018D39</p><p>fiscal_year_end: December 31, 2017</p><p>provider_number: 05-9656</p><p>summary: Whether Grace Community Home Health, Inc., (“Grace Community” or “Provider”) should be subject to a two percentage point reduction to its calendar year (“CY”) 2017 home health market basket percentage increase1 for failure to meet the Home Health Quality Reporting Program requirements in accordance with 42 C.F.R. § 484.225(i).</p>]]></description></item><item><title>2018D40</title><pubDate>Mon, 04 Nov 2019 02:46:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d40</guid><description><![CDATA[<p>case_name: Guardian Homecare, LLC</p><p>case_numbers: 17-1266</p><p>decision_date: Thu, 07 Jun 2018 12:00:00 -0400</p><p>decision_number: 2018D40</p><p>fiscal_year_end: December 31, 2017</p><p>provider_number: 49-7591</p><p>summary: Whether the imposition of a two percent reduction in the appealing home health agency’s (“HHA’s”) Medicare payments for calendar year (“CY”) 2017 was proper.</p>]]></description></item><item><title>2018D38</title><pubDate>Mon, 04 Nov 2019 02:46:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d38</guid><description><![CDATA[<p>case_name: North Carolina Baptist Hospital</p><p>case_numbers: 17-0866</p><p>decision_date: Fri, 25 May 2018 12:00:00 -0400</p><p>decision_number: 2018D38</p><p>fiscal_year_end: September 30, 2017</p><p>provider_number: 34-0047/34-T047</p><p>summary: Whether a two percentage point reduction in the Provider’s fiscal year (“FY”) 2017 annual increase factor, due to failure to meet Inpatient Rehabilitation Facility Quality Reporting Program (“IRF-QRP”) requirements, was proper?</p>]]></description></item><item><title>2018D35</title><pubDate>Mon, 04 Nov 2019 02:45:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d35</guid><description><![CDATA[<p>case_name: Riverside Methodist Hospital Columbus, Ohio</p><p>case_numbers: 15-3416</p><p>decision_date: Wed, 02 May 2018 12:00:00 -0400</p><p>decision_number: 2018D35</p><p>fiscal_year_end: December 31, 2015</p><p>provider_number: 36-0006</p><p>summary: Whether the determination that the Riverside Methodist Hospital (“Riverside” or “Provider”) failed to meet the validation requirements for the Calendar Year (“CY”) 2015 Hospital Outpatient Quality Reporting (“HOQR”) Program was proper.</p>]]></description></item><item><title>2018D36</title><pubDate>Mon, 04 Nov 2019 02:45:35 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d36</guid><description><![CDATA[<p>case_name: Covenant Medical Center, Inc.</p><p>case_numbers: 13-1575; 13-2481; 13-2518</p><p>decision_date: Thu, 03 May 2018 12:00:00 -0400</p><p>decision_number: 2018D36</p><p>fiscal_year_end: June 30, 2007; June 30, 2008; June 30, 2009</p><p>provider_number: 23-0070</p><p>summary: Whether, for purposes of the graduate medical education (“GME”) payment and indirect medical education (“IME”) adjustments for FYE’s 06/30/2007, 06/30/2008 and 06/30/2009, the Provider is entitled to count full time equivalent (“FTE”) residents training in the non-provider
setting.</p>]]></description></item><item><title>2018D33</title><pubDate>Mon, 04 Nov 2019 02:45:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d33</guid><description><![CDATA[<p>case_name: Beaumont Hospital, Wayne (formerly known as Oakwood Annapolis Hospital)</p><p>case_numbers: 14-3449; 14-3627 and 15-3186</p><p>decision_date: Tue, 17 Apr 2018 12:00:00 -0400</p><p>decision_number: 2018D33</p><p>fiscal_year_end: December 31, 2008; December 31, 2009;
December 31, 2012</p><p>provider_number: 23-0142</p><p>summary: Whether the Provider is entitled to higher Graduate Medical Education (“GME”) and Indirect Medical Education (“IME”) full-time equivalent (“FTE”) resident caps for a new Family Medicine residents training Program?</p>]]></description></item><item><title>2018D34</title><pubDate>Mon, 04 Nov 2019 02:45:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d34</guid><description><![CDATA[<p>case_name: Northern Utah Healthcare d/b/a St. Mark’s Hospital</p><p>case_numbers: 15-3197</p><p>decision_date: Wed, 25 Apr 2018 12:00:00 -0400</p><p>decision_number: 2018D34</p><p>fiscal_year_end: December 31, 2015</p><p>provider_number: 46-0047</p><p>summary: Whether the Provider is entitled to the full Outpatient Prospective Payment System (“OPPS”) market basket rate for Calendar Year (“CY”) 2015 based on its reported Hospital Outpatient Quality Reporting (“HOQR”) validation data?</p>]]></description></item><item><title>2018D32</title><pubDate>Mon, 04 Nov 2019 02:45:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d32</guid><description><![CDATA[<p>case_name: Lightbridge Hospice</p><p>case_numbers: 16-0159</p><p>decision_date: Tue, 17 Apr 2018 12:00:00 -0400</p><p>decision_number: 2018D32</p><p>fiscal_year_end: 2016</p><p>provider_number: 05-1763</p><p>summary: Whether the imposition of a two percent reduction in Lightbridge Hospice?s (?Lightbridge? or ?Provider?) fiscal year (FY) 2016 Medicare payments was proper.</p>]]></description></item><item><title>2018D31</title><pubDate>Mon, 04 Nov 2019 02:45:30 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d31</guid><description><![CDATA[<p>case_name: Mary Free Bed Hospital &#x26; Rehab Center</p><p>case_numbers: 17-1253</p><p>decision_date: Tue, 10 Apr 2018 12:00:00 -0400</p><p>decision_number: 2018D31</p><p>fiscal_year_end: September 30, 2017</p><p>provider_number: 23-3026</p><p>summary: Whether the Provider is entitled to the full market basket update for Fiscal Year (“FY”) 2017.</p>]]></description></item><item><title>2018D30</title><pubDate>Mon, 04 Nov 2019 02:45:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d30</guid><description><![CDATA[<p>case_name: Horizon Home Care &#x26; Hospice</p><p>case_numbers: 16-0143</p><p>decision_date: Thu, 29 Mar 2018 12:00:00 -0400</p><p>decision_number: 2018D30</p><p>fiscal_year_end: 2016</p><p>provider_number: 52-1531</p><p>summary: Whether the imposition of a two percent reduction in Horizon Home Care &#x26; Hospice, Inc.’s (“Horizon” or “Provider”) fiscal year (“FY”) 2016 Medicare payments was proper.</p>]]></description></item><item><title>2018D29</title><pubDate>Mon, 04 Nov 2019 02:45:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d29</guid><description><![CDATA[<p>case_name: Doctors Hospital of Stark County</p><p>case_numbers: 04-1447; 05-2052; 06-1034</p><p>decision_date: Wed, 28 Mar 2018 12:00:00 -0400</p><p>decision_number: 2018D29</p><p>fiscal_year_end: June 30, 2001; June 30, 2002;
June 30, 2003</p><p>provider_number: 36-0151</p><p>summary: Whether the Medicare Contractor’s adjustments to the Provider’s available beds and bed days and prior-year resident-to-bed ratio for cost reporting periods ending 6/30/2001, 6/30/2002 and 6/30/2003 were proper.</p>]]></description></item><item><title>2018D27</title><pubDate>Mon, 04 Nov 2019 02:45:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d27</guid><description><![CDATA[<p>case_name: Central Iowa Healthcare</p><p>case_numbers: 17-0564</p><p>decision_date: Fri, 16 Mar 2018 12:00:00 -0400</p><p>decision_number: 2018D27</p><p>fiscal_year_end: 2017</p><p>provider_number: 16-0001</p><p>summary: Whether the Provider is entitled to the full Market Basket Update for the fiscal year (?FY?) 2017.</p>]]></description></item><item><title>2018D28</title><pubDate>Mon, 04 Nov 2019 02:45:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d28</guid><description><![CDATA[<p>case_name: Providence Sacred Heart Medical Center</p><p>case_numbers: 08-1553, 09-1533, 09-2222</p><p>decision_date: Tue, 20 Mar 2018 12:00:00 -0400</p><p>decision_number: 2018D28</p><p>fiscal_year_end: December 31, 2004, December 31, 2005, December 31, 2006</p><p>provider_number: 50-0054</p><p>summary: Whether the Medicare Contractor improperly disallowed reimbursement for direct graduate medical education (“GME”) and indirect medical education (“IME”) costs in the non-hospital setting by reducing the Provider’s full-time equivalent (“FTE”) resident counts to exclude resident time spent training in non-hospital settings.</p>]]></description></item><item><title>2018D25</title><pubDate>Mon, 04 Nov 2019 02:44:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d25</guid><description><![CDATA[<p>case_name: The Mary Imogene Bassett Hospital</p><p>case_numbers: 13-2696; 14-0033; 14-0031; 15-0072; 15-0827; 15-3347</p><p>decision_date: Tue, 27 Feb 2018 12:00:00 -0500</p><p>decision_number: 2018D25</p><p>fiscal_year_end: 2007 - 2012</p><p>provider_number: 33-0136</p><p>summary: Whether Mary Imogene Bassett Hospital (“Mary Imogene” or “Hospital”), as a Sole Community Hospital (“SCH”), was properly reimbursed for Indirect Medical Education (“IME”) costs for services provided to Medicare Advantage (“MA” or “Part C”) patients for the cost reporting years at issue. In particular, should the interim IME payments received for MA patients, as reported on the Provider Statistical &#x26; Reimbursement (“PS&#x26;R”) Report 118, be included in the total interim payments on Worksheet E-1 when determining the final settlement amounts owed
to the Hospital?</p>]]></description></item><item><title>2018D26</title><pubDate>Mon, 04 Nov 2019 02:44:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d26</guid><description><![CDATA[<p>case_name: Greenwood Leflore Hospital</p><p>case_numbers: 17-0301</p><p>decision_date: Wed, 28 Feb 2018 12:00:00 -0500</p><p>decision_number: 2018D26</p><p>fiscal_year_end: September 30, 2017</p><p>provider_number: 25-0099</p><p>summary: Whether the reduction of the Provider’s Market Basket Update for federal fiscal year (“FY”) 2017 under the Hospital Inpatient Quality Reporting (“IQR”) Program was proper?</p>]]></description></item><item><title>2018D23</title><pubDate>Mon, 04 Nov 2019 02:44:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d23</guid><description><![CDATA[<p>case_name: Momence Meadows Nursing and Rehabilitation Center, LLC</p><p>case_numbers: 13-0043</p><p>decision_date: Mon, 12 Feb 2018 12:00:00 -0500</p><p>decision_number: 2018D23</p><p>fiscal_year_end: December 31, 2010</p><p>provider_number: 14-5713</p><p>summary: Whether the Medicare Administrative Contractor’s (“Medicare Contractor’s”) adjustment that eliminated $183,879 of claimed Medicare reimbursable bad debts was proper and in accordance with Medicare regulations and the Centers for Medicare and Medicaid Services’ (“CMS”) Provider Reimbursement Manual (PRM)?</p>]]></description></item><item><title>2018D17</title><pubDate>Mon, 04 Nov 2019 02:44:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d17</guid><description><![CDATA[<p>case_name: St. Anthony North Hospital</p><p>case_numbers: 07-1015</p><p>decision_date: Thu, 25 Jan 2018 12:00:00 -0500</p><p>decision_number: 2018D17</p><p>fiscal_year_end: June 30, 2005</p><p>provider_number: 06-0104</p><p>summary: Did the Medicare Contractor improperly reduce the Provider’s adjusted indirect medical education (“IME”) full time equivalent (“FTE”) count from 6.48 to zero?</p>]]></description></item><item><title>2018D24</title><pubDate>Mon, 04 Nov 2019 02:44:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d24</guid><description><![CDATA[<p>case_name: Westchester General Hospital</p><p>case_numbers: 15-0414</p><p>decision_date: Mon, 12 Feb 2018 12:00:00 -0500</p><p>decision_number: 2018D24</p><p>fiscal_year_end: September 30, 2015</p><p>provider_number: 10-0284</p><p>summary: Whether the payment reduction to the market basket update that the Centers for Medicare and Medicaid Services (“CMS”) imposed under the Hospital Inpatient Quality Reporting (“IQR”) program for fiscal year (“FY”) 2015 was proper?</p>]]></description></item><item><title>2018D19</title><pubDate>Mon, 04 Nov 2019 02:44:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d19</guid><description><![CDATA[<p>case_name: Sutter Health 2001-2003 Regular Bad Debts – Collection Agency CIRP Group</p><p>case_numbers: 09-2156GC</p><p>decision_date: Tue, 30 Jan 2018 12:00:00 -0500</p><p>decision_number: 2018D19</p><p>fiscal_year_end: December 31, 2001; December 31, 2002;
December 31, 2003</p><p>provider_number: Various</p><p>summary: Whether the Providers are entitled to reimbursement of their Medicare bad debts for the fiscal years ending December 31, 2001, 2002 and 2003.</p>]]></description></item><item><title>2018D18</title><pubDate>Mon, 04 Nov 2019 02:44:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d18</guid><description><![CDATA[<p>case_name: Mountain States Health Alliance 05 Bad Debt – Passive Collection CIRP Group</p><p>case_numbers: 08-0105GC</p><p>decision_date: Fri, 26 Jan 2018 12:00:00 -0500</p><p>decision_number: 2018D18</p><p>fiscal_year_end: June 30, 2004; June 30, 2005</p><p>provider_number: 44-0176 and 44-0063</p><p>summary: Whether the Providers engaged in “reasonable collection efforts” notwithstanding their differential treatment of Medicare and non-Medicare bad debt, in light of the Reed City and St. Francis Board decisions?</p>]]></description></item><item><title>2018D21</title><pubDate>Mon, 04 Nov 2019 02:44:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d21</guid><description><![CDATA[<p>case_name: Florida Section 1115 DSH Waiver Days Groups</p><p>case_numbers: 09-0580GC; 13-3376G; 14-0871GC; 14-3832GC;15-0446G; 15-3474GC; 14-0645G</p><p>decision_date: Thu, 08 Feb 2018 12:00:00 -0500</p><p>decision_number: 2018D21</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Low-Income Pool Section 1115 waiver days should be included in the Medicaid fraction of the disproportionate share hospital (?DSH?) calculations.</p>]]></description></item><item><title>2018D16</title><pubDate>Mon, 04 Nov 2019 02:44:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d16</guid><description><![CDATA[<p>case_name: St. Joseph?s Hospital</p><p>case_numbers: 16-2080</p><p>decision_date: Wed, 24 Jan 2018 12:00:00 -0500</p><p>decision_number: 2018D16</p><p>fiscal_year_end: 2017</p><p>provider_number: 33-0108</p><p>summary: Whether the Provider should be subjected to a reduction of one quarter of the market basket update to the fiscal year (?FY?) 2017 Inpatient Prospective Payment System (?IPPS?) rates for the failure to meet the Hospital Inpatient Quality Reporting (?IQR?) Program requirements.</p>]]></description></item><item><title>2018D20</title><pubDate>Mon, 04 Nov 2019 02:44:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d20</guid><description><![CDATA[<p>case_name: Wyatt FFY 08 Wage Index (Occupational Mix Adj.) Group</p><p>case_numbers: 08-1052G</p><p>decision_date: Tue, 06 Feb 2018 12:00:00 -0500</p><p>decision_number: 2018D20</p><p>fiscal_year_end: 2008</p><p>provider_number: 18-0038, 18-0130, 18-0138, 18-0104, 18-0103, 18-0080</p><p>summary: Whether the inclusion of surgical technicians, mental health technicians, and heart center recovery technicians in the “All other occupations” category instead of the “Nursing aides, orderlies and attendants” category in the Provider’s occupational-mix survey was correct?</p>]]></description></item><item><title>2018D22</title><pubDate>Mon, 04 Nov 2019 02:44:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d22</guid><description><![CDATA[<p>case_name: Florida Section 1115 LIP Rehab DSH Waiver Days Groups</p><p>case_numbers: 14-0682G; 14-1124G</p><p>decision_date: Thu, 08 Feb 2018 12:00:00 -0500</p><p>decision_number: 2018D22</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Low-Income Pool Section 1115 waiver days should be included in the Medicaid fraction of the Low Income Patient (?LIP?) calculations.</p>]]></description></item><item><title>2018D15</title><pubDate>Mon, 04 Nov 2019 02:44:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d15</guid><description><![CDATA[<p>case_name: Nassau Suffolk FFY 2007, 2008, 2009 Wage Index Calculation Groups</p><p>case_numbers: 07-1589G, 08-1344G and 09-1283G</p><p>decision_date: Fri, 19 Jan 2018 12:00:00 -0500</p><p>decision_number: 2018D15</p><p>fiscal_year_end: December 31, 2003; December 31, 2004;
December 31, 2005</p><p>provider_number: Various</p><p>summary: Whether the Medicare Contractor should have excluded the aberrant wage index data from Brunswick Hospital Center (“Brunswick”) when calculating the Nassau-Suffolk Core-Based Statistical Area (“CBSA”) wage index calculations for fiscal years (“FYs”) 2007, 2008 and 2009.</p>]]></description></item><item><title>2018D14</title><pubDate>Mon, 04 Nov 2019 02:44:47 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d14</guid><description><![CDATA[<p>case_name: High Ridge House, Inc.</p><p>case_numbers: 15-1033</p><p>decision_date: Wed, 10 Jan 2018 12:00:00 -0500</p><p>decision_number: 2018D14</p><p>fiscal_year_end: December 31, 2010</p><p>provider_number: 33-1990</p><p>summary: Whether the Medicare Administrative Contractor (“Medicare Contractor”), Cahaba Safeguard Administrators, LLC (“Cahaba”) improperly reclassified Provider costs related to providing housing free of charge for temporary, on-call and other staff, and for housing leasing at market value to the Director of Christian Science Nursing (“DCSN”), to a nonreimbursable
cost center.</p>]]></description></item><item><title>2018D09</title><pubDate>Mon, 04 Nov 2019 02:44:35 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d09</guid><description><![CDATA[<p>case_name: TLC Health Network ? Lake Shore Hospital</p><p>case_numbers: 16-0395</p><p>decision_date: Fri, 22 Dec 2017 12:00:00 -0500</p><p>decision_number: 2018D09</p><p>fiscal_year_end: 2016</p><p>provider_number: 33-0132</p><p>summary: Whether the reduction of the Provider?s Market Basket Update for federal fiscal year (?FY?) 2016 under the Hospital Inpatient Quality Reporting (?IQR?) Program was proper?</p>]]></description></item><item><title>2018D12</title><pubDate>Mon, 04 Nov 2019 02:44:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d12</guid><description><![CDATA[<p>case_name: St. Anthony Hospital</p><p>case_numbers: 14-2968</p><p>decision_date: Fri, 29 Dec 2017 12:00:00 -0500</p><p>decision_number: 2018D12</p><p>fiscal_year_end: December 31, 2006</p><p>provider_number: 37-0037</p><p>summary: Whether the Medicaid days attributable to child and adolescent patients who received services in three of the Provider’s inpatient behavioral health units (namely the ACCENTS Unit, the Human Restoration Unit, and the Positive Outcomes Unit) can be included in the Medicaid fraction of the formula used to calculate the Provider’s Medicare disproportionate share hospital (“DSH”) payment.</p>]]></description></item><item><title>2018D13</title><pubDate>Mon, 04 Nov 2019 02:44:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d13</guid><description><![CDATA[<p>case_name: Mercy Hospital, Inc. dba Carolinas Healthcare System -Pineville</p><p>case_numbers: 17-1310</p><p>decision_date: Wed, 03 Jan 2018 12:00:00 -0500</p><p>decision_number: 2018D13</p><p>fiscal_year_end: 2017</p><p>provider_number: 34-0098</p><p>summary: Whether the full reduction of the Provider’s annual increase factor by 2 percent for fiscal year (“FY”) 2017 for failing to timely submit one of the six required data under the Inpatient Rehabilitation Facility (“IRF”) Quality Reporting Program (“QRP”) was proper.</p>]]></description></item><item><title>2018D10</title><pubDate>Mon, 04 Nov 2019 02:44:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d10</guid><description><![CDATA[<p>case_name: Progressive Health Center, Inc.</p><p>case_numbers: 09-0233</p><p>decision_date: Thu, 28 Dec 2017 12:00:00 -0500</p><p>decision_number: 2018D10</p><p>fiscal_year_end: December 31, 2006</p><p>provider_number: 19-4653</p><p>summary: Was the Medicare Contractor’s adjustment to the Provider’s bad debts claimed proper?</p>]]></description></item><item><title>2018D11</title><pubDate>Mon, 04 Nov 2019 02:44:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d11</guid><description><![CDATA[<p>case_name: Progressive Health Center, Inc.</p><p>case_numbers: 11-0142</p><p>decision_date: Thu, 28 Dec 2017 12:00:00 -0500</p><p>decision_number: 2018D11</p><p>fiscal_year_end: December 31, 2008</p><p>provider_number: 19-4653</p><p>summary: Was the Medicare Contractor’s adjustment to the Provider’s bad debts claimed proper?</p>]]></description></item><item><title>2018D08</title><pubDate>Mon, 04 Nov 2019 02:44:24 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d08</guid><description><![CDATA[<p>case_name: Toyon 2002-2006 LIP SSI Realignment Group</p><p>case_numbers: 09-0915G</p><p>decision_date: Tue, 05 Dec 2017 12:00:00 -0500</p><p>decision_number: 2018D08</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Supplemental Security Income (?SSI?) ratio used to calculate the Medicare Low Income Patient (?LIP?) adjustment for inpatient rehabilitation facilities (?IRFs?) accurately reflects the number of patient days corresponding to the IRF cost reporting period?</p>]]></description></item><item><title>2018D07</title><pubDate>Mon, 04 Nov 2019 02:44:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d07</guid><description><![CDATA[<p>case_name: Montgomery General Hospital</p><p>case_numbers: 10-0033</p><p>decision_date: Wed, 29 Nov 2017 12:00:00 -0500</p><p>decision_number: 2018D07</p><p>fiscal_year_end: December 31, 2007</p><p>provider_number: 51-1318</p><p>summary: Whether the Medicare Contractor improperly calculated and adjusted Montgomery General Hospital’s (“Montgomery” or “Provider”) defined benefit pension plan contribution cost that the Provider claimed on its fiscal year 2007 cost report.</p>]]></description></item><item><title>2018D06</title><pubDate>Mon, 04 Nov 2019 02:44:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d06</guid><description><![CDATA[<p>case_name: HealthEast 2007 Paramed Ed–CPE CIRP Group
HealthEast 2008 Paramed Ed–CPE CIRP Group</p><p>case_numbers: 10-0991GC; 10-1158GC</p><p>decision_date: Tue, 21 Nov 2017 12:00:00 -0500</p><p>decision_number: 2018D06</p><p>fiscal_year_end: August 31, 2007; August 31, 2008</p><p>provider_number: Various</p><p>summary: Whether the Medicare Contractor’s adjustment to the Clinical Pastoral Education (“CPE”) costs from being reported as an allied health educational activity to an administrative and general expense is correct.</p>]]></description></item><item><title>2018D05</title><pubDate>Mon, 04 Nov 2019 02:44:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d05</guid><description><![CDATA[<p>case_name: Kindred 2006-2014 LTCH/SNF Bad Debts CIRP Groups</p><p>case_numbers: 08-0585GC; 09-1589GC;
10-0090GC; 11-0028GC;
12-0147GC; 13-2822GC;
14-1622GC; 15-3239GC
and 16-1252GC</p><p>decision_date: Mon, 20 Nov 2017 12:00:00 -0500</p><p>decision_number: 2018D05</p><p>fiscal_year_end: 2006-2014</p><p>provider_number: Various</p><p>summary: Whether the Providers may be reimbursed for bad debts incurred by patients who were dually eligible for Medicare and Medicaid.</p>]]></description></item><item><title>2018D04</title><pubDate>Mon, 04 Nov 2019 02:44:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d04</guid><description><![CDATA[<p>case_name: Pomerene Hospital (F.K.A. Joel Pomerene
Memorial Hospital)</p><p>case_numbers: 16-1544 and 17-0193</p><p>decision_date: Thu, 16 Nov 2017 12:00:00 -0500</p><p>decision_number: 2018D04</p><p>fiscal_year_end: December 31, 2012; December 31, 2013</p><p>provider_number: 36-0148</p><p>summary: Whether the Medicare Contractor’s adjustments to the Provider’s Electronic Health Record (“EHR”) incentive payment based on the exclusion of inpatient days for which the Provider provided covered services to Medicare Advantage (“MA”) patients is correct?</p>]]></description></item><item><title>2018D02</title><pubDate>Mon, 04 Nov 2019 02:44:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d02</guid><description><![CDATA[<p>case_name: Desert Star Home Health</p><p>case_numbers: 17-0865</p><p>decision_date: Mon, 06 Nov 2017 12:00:00 -0500</p><p>decision_number: 2018D02</p><p>fiscal_year_end: December 31, 2017</p><p>provider_number: 74-7761</p><p>summary: Whether Canine Friendly Coalition, Inc. d/b/a Desert Star Home Health (“Desert Star” or
“Provider”) should be subject to a two percent reduction to its calendar year (“CY”) 2017 home
health market basket percentage increase for failure to meet Home Health Quality Reporting
Program requirements in accordance with 42 C.F.R. § 484.225(i).</p>]]></description></item><item><title>2018D03</title><pubDate>Mon, 04 Nov 2019 02:44:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d03</guid><description><![CDATA[<p>case_name: Hillcrest Specialty Hospital</p><p>case_numbers: 09-0890 and 10-1102</p><p>decision_date: Mon, 06 Nov 2017 12:00:00 -0500</p><p>decision_number: 2018D03</p><p>fiscal_year_end: August 31, 2007 and August 31, 2008</p><p>provider_number: 37-2007</p><p>summary: Whether the Centers for Medicare and Medicaid (“CMS”) must-bill policy applies to the Provider’s crossover bad debts where the Provider did not participate in the Medicaid Program.</p>]]></description></item><item><title>2018D01</title><pubDate>Mon, 04 Nov 2019 02:44:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2018d01</guid><description><![CDATA[<p>case_name: Greene County Medical Center</p><p>case_numbers: 14-1248 and 15-1445</p><p>decision_date: Thu, 26 Oct 2017 12:00:00 -0400</p><p>decision_number: 2018D01</p><p>fiscal_year_end: June 30, 2012 and June 30, 2013</p><p>provider_number: 16-1325</p><p>summary: Whether the Wisconsin Physician Services (“Medicare Contractor”) improperly disallowed certain home office costs claimed by Greene County Medical Center (“Greene” or “Provider”) on the grounds that it was not related to the entity that had furnished the services.</p>]]></description></item><item><title>2017D28</title><pubDate>Mon, 04 Nov 2019 02:43:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d28</guid><description><![CDATA[<p>case_name: Valley Hospital Medical Center
Las Vegas, Nevada</p><p>case_numbers: 09-0454</p><p>decision_date: Tue, 19 Sep 2017 12:00:00 -0400</p><p>decision_number: 2017D28</p><p>fiscal_year_end: 12/31/2006</p><p>provider_number: 29-0021</p><p>summary: Whether the Medicare Contractor’s exclusion of Medicare Advantage/HMO charges and days from the calculation of the direct graduate medical education (“DGME”) payment for Valley Hospital Medical Center (“Valley” or “Provider”) for its fiscal year ending December 31, 2006 (“FY 2006”) was proper.</p>]]></description></item><item><title>2017D31</title><pubDate>Mon, 04 Nov 2019 02:43:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d31</guid><description><![CDATA[<p>case_name: Pocahontas Community Hospital</p><p>case_numbers: 13-3331, 14-1269 and 14-3176</p><p>decision_date: Fri, 29 Sep 2017 12:00:00 -0400</p><p>decision_number: 2017D31</p><p>fiscal_year_end: June 30, 2010; June 30, 2011 and June 30 2012</p><p>provider_number: 16-1305</p><p>summary: Whether the Wisconsin Physician Services (“Medicare Contractor”)1 improperly disallowed certain home office costs claimed by Pocahontas Community Hospital (“Pocahontas or Provider”) on the grounds that it was not related to the entity that had furnished the services.</p>]]></description></item><item><title>2017D30</title><pubDate>Mon, 04 Nov 2019 02:43:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d30</guid><description><![CDATA[<p>case_name: Mercy Medical Center</p><p>case_numbers: 13-0633</p><p>decision_date: Thu, 28 Sep 2017 12:00:00 -0400</p><p>decision_number: 2017D30</p><p>fiscal_year_end: September 30, 2013</p><p>provider_number: 22-0066</p><p>summary: Whether Center for Medicare and Medicaid Services’ (“CMS”) June 27, 2012 determination that Mercy Medical Center (“Mercy” or “Provider”) did not meet the quality reporting program requirements for Fiscal Year (“FY”) 2013 and that its failure to meet these requirements would result in a two percent (2.0%) reduction in the FY 2013 market basket update was proper; and whether CMS’s August 28, 2012 denial of the Provider’s request for reconsideration of the market basket update penalty was arbitrary and capricious or otherwise improper.</p>]]></description></item><item><title>2017D29</title><pubDate>Mon, 04 Nov 2019 02:43:53 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d29</guid><description><![CDATA[<p>case_name: Doctor?s Memorial Hospital</p><p>case_numbers: 15-2800</p><p>decision_date: Tue, 26 Sep 2017 12:00:00 -0400</p><p>decision_number: 2017D29</p><p>fiscal_year_end: 09/30/2016</p><p>provider_number: 10-0106</p><p>summary: Whether the payment penalty that the Centers for Medicare &#x26; Medicaid Services (?CMS?) imposed under the Hospital Inpatient Quality Reporting (?IQR?) program to reduce the Provider?s payment update for fiscal year (?FY?) 2016 by twenty-five percent of the 2.7 percent Market Basket update was proper?</p>]]></description></item><item><title>2017D27</title><pubDate>Mon, 04 Nov 2019 02:43:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d27</guid><description><![CDATA[<p>case_name: Rochester General Hospital</p><p>case_numbers: 05-0202 and 06-0933</p><p>decision_date: Tue, 19 Sep 2017 12:00:00 -0400</p><p>decision_number: 2017D27</p><p>fiscal_year_end: 12/31/2001, 12/31/2002</p><p>provider_number: 33-0125</p><p>summary: Whether the Provider is entitled to a temporary increase in its resident full time equivalent (“FTE”) count due to the closing of one of the other three hospitals in a medical education training program.</p>]]></description></item><item><title>2017D23</title><pubDate>Mon, 04 Nov 2019 02:43:47 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d23</guid><description><![CDATA[<p>case_name: Millennium Home Care, LLC</p><p>case_numbers: 15-2948</p><p>decision_date: Wed, 02 Aug 2017 12:00:00 -0400</p><p>decision_number: 2017D23</p><p>fiscal_year_end: 12/31/2015</p><p>provider_number: 10-9401</p><p>summary: Whether Millennium Home Care, LLC (“Provider” or “MHC”) should be subject to a 2 percent reduction in home health prospective payment system payments for calendar year (“CY”) 2015 in accordance with 42 C.F.R. § 484.225(i) (2013).</p>]]></description></item><item><title>2017D26</title><pubDate>Mon, 04 Nov 2019 02:43:47 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d26</guid><description><![CDATA[<p>case_name: Santa Rosa Memorial Hospital</p><p>case_numbers: 13-3169</p><p>decision_date: Fri, 08 Sep 2017 12:00:00 -0400</p><p>decision_number: 2017D26</p><p>fiscal_year_end: June 30, 2008</p><p>provider_number: 05-0174</p><p>summary: Whether Santa Rosa Memorial Hospital’s (“Santa Rosa” or Provider”) Medicaid eligible days for the low-income patient (“LIP”) adjustment for FY 2008 are correctly stated?</p>]]></description></item><item><title>2017D25</title><pubDate>Mon, 04 Nov 2019 02:43:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d25</guid><description><![CDATA[<p>case_name: Florida Hospital</p><p>case_numbers: 13-1196, 13-1198 and 13-0900</p><p>decision_date: Thu, 07 Sep 2017 12:00:00 -0400</p><p>decision_number: 2017D25</p><p>fiscal_year_end: 12/31/2006, 12/31/2007 and 12/31/2008 </p><p>provider_number: 10-0007</p><p>summary: Whether the Medicare Administrative Contractor properly disallowed a portion of the Hospital’s indigent bad debts claimed for the cost reporting periods for fiscal years (“FYs”) ending December 31, 2006, December 31, 2007 and December 31, 2008, on the basis that the Hospital did not adequately document patient indigence even though the Hospital obtained a signed witness patient/financial statement in accordance with the [charity] policy and with the minimum documentation requirements specified under Florida law.</p>]]></description></item><item><title>2017D24</title><pubDate>Mon, 04 Nov 2019 02:43:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d24</guid><description><![CDATA[<p>case_name: Twin Lakes Regional Medical Center</p><p>case_numbers: 13-0009</p><p>decision_date: Fri, 25 Aug 2017 12:00:00 -0400</p><p>decision_number: 2017D24</p><p>fiscal_year_end: 2013</p><p>provider_number: 18-0070</p><p>summary: Whether the decision by the Centers for Medicare and Medicaid Services (“CMS”) to impose a 2 percent reduction to the Market Basket Update for fiscal year (“FY”) 2013 for Twin Lakes Regional Medical Center (“Provider” or “Twin Lakes”) , which also resulted in the ineligibility of Twin Lakes to participate in the Hospital Value Based Purchasing Program, was proper.</p>]]></description></item><item><title>2017D19</title><pubDate>Mon, 04 Nov 2019 02:43:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d19</guid><description><![CDATA[<p>case_name: Clarke County Hospital</p><p>case_numbers: 14-3177, 14-1331 and 15-0165</p><p>decision_date: Tue, 11 Jul 2017 12:00:00 -0400</p><p>decision_number: 2017D19</p><p>fiscal_year_end: 06/30/2010, 06/30/2012 and 06/30/2013</p><p>provider_number: 16-1348</p><p>summary: Whether the Medicare Administrative Contractor (“Medicare Contractor”),1 Wisconsin Physicians Service (“WPS”), improperly disallowed certain home office costs claimed by the Provider, Clarke County Hospital (“Clarke”), on the grounds that it was not related to the entity that had furnished the services.</p>]]></description></item><item><title>2017D21</title><pubDate>Mon, 04 Nov 2019 02:43:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d21</guid><description><![CDATA[<p>case_name: Vibra Hospital of Amarillo, Vibra Hospital of Richmond</p><p>case_numbers: 15-1873, 15-1880</p><p>decision_date: Thu, 13 Jul 2017 12:00:00 -0400</p><p>decision_number: 2017D21</p><p>fiscal_year_end: 09/30/2015</p><p>provider_number: 45-2060, 49-2009</p><p>summary: Whether the payment penalty that the Centers for Medicare and Medicaid Services (“CMS”) imposed under the Long-Term Care Hospital Quality Reporting Program (“LTCH QRP”) to reduce the Provider’s payment update for Fiscal Year (“FY”) 2015 by 2 percent was proper?</p>]]></description></item><item><title>2017D20</title><pubDate>Mon, 04 Nov 2019 02:43:28 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d20</guid><description><![CDATA[<p>case_name: Stormont-Vail Healthcare, Inc.
Topeka, Kansas</p><p>case_numbers: 13-1203</p><p>decision_date: Tue, 11 Jul 2017 12:00:00 -0400</p><p>decision_number: 2017D20</p><p>fiscal_year_end: 09/30/2009</p><p>provider_number: 17-0086</p><p>summary: Whether the Provider, Stormont-Vail Healthcare, Inc. (“Stormont-Vail”), was the legal operator of Baker University Nursing School pursuant to 42 C.F.R. § 413.85(f)(1) (2008), thus qualifying under the Medicare program for pass-through reimbursement for the reasonable costs of its operation.</p>]]></description></item><item><title>2017D22</title><pubDate>Mon, 04 Nov 2019 02:43:28 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d22</guid><description><![CDATA[<p>case_name: Mercy Des Moines/Mercy Health Network 2008-2010 Home Office Cost Report Related Party Groups</p><p>case_numbers: 13-2636GC, 13-2637GC,13-2640GC</p><p>decision_date: Tue, 18 Jul 2017 12:00:00 -0400</p><p>decision_number: 2017D22</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Medicare Contractor’s revised determination that the Iowa Critical Access Hospitals (“Iowa CAHs” or “Providers”) are not related to Mercy Medical Center-Des Moines (“Mercy”), and all cost report adjustments stemming from that determination, were appropriate.</p>]]></description></item><item><title>2017D18</title><pubDate>Mon, 04 Nov 2019 02:43:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d18</guid><description><![CDATA[<p>case_name: Vibra Hospital of Fort Wayne</p><p>case_numbers: 15-1879</p><p>decision_date: Tue, 06 Jun 2017 12:00:00 -0400</p><p>decision_number: 2017D18</p><p>fiscal_year_end: 09/30/2015</p><p>provider_number: 15-2027</p><p>summary: Whether the payment penalty that the Centers for Medicare and Medicaid Services (?CMS?) imposed under the Long-Term Care Hospital Quality Reporting Program (?LTCH QRP?) to reduce the Provider?s payment update for Fiscal Year (?FY?) 2015 by 2 percent was proper.</p>]]></description></item><item><title>2017D16</title><pubDate>Mon, 04 Nov 2019 02:43:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d16</guid><description><![CDATA[<p>case_name: West Carroll Memorial Hospital</p><p>case_numbers: 15-2721</p><p>decision_date: Thu, 04 May 2017 12:00:00 -0400</p><p>decision_number: 2017D16</p><p>fiscal_year_end: December 31, 2015</p><p>provider_number: 19-0081</p><p>summary: Whether the reduction of West Carroll Memorial Hospital’s (“West Carroll” or “Provider”)annual payment update for calendar year (“CY”) 2015 under the hospital outpatient quality reporting (“Hospital OQR”) program was proper.</p>]]></description></item><item><title>2017D17</title><pubDate>Mon, 04 Nov 2019 02:43:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d17</guid><description><![CDATA[<p>case_name: BBL 2006-2007 Direct GME PRA Adj. Grp.
BBL 2008 Direct GME PRA Adj. Grp.
BBL 2009 Direct GME PRA Adj. Grp.
BBL 2011 Direct GME PRA Adj. Grp</p><p>case_numbers: 13-0196G, 13-3892G,14-1723G and 15-1946G</p><p>decision_date: Fri, 19 May 2017 12:00:00 -0400</p><p>decision_number: 2017D17</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Was the use of Centers for Medicare and Medicaid Services’ (“CMS”) sequential geography methodology (“SGM”) for setting the Providers’ base year per resident amounts (“PRAs”) for Medicare reimbursement of certain graduate medical education (“GME”) costs, which flow through and affect subsequent year cost determinations, valid and consistent with 42 U.S.C. § 1395ww(h)(2)(F) and 42 C.F.R. § 413.86(e)(4)(i)(1989)?</p>]]></description></item><item><title>2017D13</title><pubDate>Mon, 04 Nov 2019 02:43:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d13</guid><description><![CDATA[<p>case_name: La Cheim Schools, Inc.</p><p>case_numbers: 10-1018GC</p><p>decision_date: Wed, 29 Mar 2017 12:00:00 -0400</p><p>decision_number: 2017D13</p><p>fiscal_year_end: June 30, 2008; June 30, 2009 and
June 30, 2010</p><p>provider_number: Various</p><p>summary: Whether the Providers can claim Medicare and Medicaid crossover bad debts for reimbursement without billing the appropriate state agency.</p>]]></description></item><item><title>2017D14</title><pubDate>Mon, 04 Nov 2019 02:43:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d14</guid><description><![CDATA[<p>case_name: Portia Bell Hume Behavioral Health &#x26; Training Center</p><p>case_numbers: 10-1036</p><p>decision_date: Wed, 29 Mar 2017 12:00:00 -0400</p><p>decision_number: 2017D14</p><p>fiscal_year_end: June 30, 2008</p><p>provider_number: 05-4662</p><p>summary: Whether Portia Bell Hume Behavioral Health &#x26; Training Center (“Hume Center”) can be paid by the Medicare program for certain dual eligible Medicare and Medicaid crossover bad debts without billing and obtaining a remittance advice (“RA”) from the appropriate state Medicaid agency?</p>]]></description></item><item><title>2017D12</title><pubDate>Mon, 04 Nov 2019 02:43:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d12</guid><description><![CDATA[<p>case_name: Hall Render Individual, Optional and CIRP DSH
Dual/SSI Eligible Group Appeals – Medicare Fraction</p><p>case_numbers: 07-0413, 07-2872G, 09-1039GC,
09-1830G, 09-1863GC, 12-0365GC,
12-0373GC, 12-0412, 13-0140GC,
13-0591, 15-0266 and 15-0270</p><p>decision_date: Tue, 28 Mar 2017 12:00:00 -0400</p><p>decision_number: 2017D12</p><p>fiscal_year_end: December 31, 2004 – June 30, 2009</p><p>provider_number: Various</p><p>summary: Whether Medicare Disproportionate Share Hospital (“DSH”) reimbursement calculations for the Providers (“Hospitals”) were understated due to the failure of the Centers for Medicare &#x26; Medicaid Services (“CMS”) and the relevant Medicare administrative contractors (“Medicare
Contractors”)1 to include all supplementary security income (“SSI”) eligible patient days in the
numerator of the Medicare fraction of the Medicare DSH percentage, as required by 42 U.S.C.§ 1395ww(d)(5)(F)(vi).</p>]]></description></item><item><title>2017D15</title><pubDate>Mon, 04 Nov 2019 02:43:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d15</guid><description><![CDATA[<p>case_name: Community Health Network Rehabilitation Hospital</p><p>case_numbers: 15-0660</p><p>decision_date: Fri, 21 Apr 2017 12:00:00 -0400</p><p>decision_number: 2017D15</p><p>fiscal_year_end: September 30, 2015</p><p>provider_number: 15-3043</p><p>summary: Whether the Provider satisfied Inpatient Rehabilitation Facility (“IRF”) Quality Reporting Program (“QRP”) requirements applicable to it during its first year of Medicare participation such that it would be entitled to the full market basket1 rate during fiscal year (“FY”) 2015.</p>]]></description></item><item><title>2017D11</title><pubDate>Mon, 04 Nov 2019 02:42:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d11</guid><description><![CDATA[<p>case_name: Hall Render Optional
and CIRP DSH Dual/SSI Eligible
Group Appeals – Medicare Fraction</p><p>case_numbers: 13-1862GC, et al.</p><p>decision_date: Mon, 27 Mar 2017 12:00:00 -0400</p><p>decision_number: 2017D11</p><p>fiscal_year_end: 2006, 2007, 2008 and 2009</p><p>provider_number: Various</p><p>summary: Whether the Medicare Disproportionate Share Hospital (“DSH”) reimbursement calculations for the Providers (“Hospitals”) were understated due to the failure of the Centers for Medicare &#x26; Medicaid Services (“CMS”) and the relevant Medicare Administrative Contractors (“Medicare
Contractors”)1 to include all supplementary security income (“SSI”) eligible patient days in the numerator of the Medicare fraction of the Medicare DSH percentage, as required by 42 U.S.C.§ 1395ww(d)(5)(F)(vi).</p>]]></description></item><item><title>2017D08</title><pubDate>Mon, 04 Nov 2019 02:42:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d08</guid><description><![CDATA[<p>case_name: Greenbrier Behavioral Health</p><p>case_numbers: 11-0124</p><p>decision_date: Fri, 24 Feb 2017 12:00:00 -0500</p><p>decision_number: 2017D08</p><p>fiscal_year_end: December 31, 2008</p><p>provider_number: 19-4069</p><p>summary: Whether the Provider is entitled to blended reimbursement for its fiscal year end (“FYE”)December 31, 2008 cost report under 42 C.F.R. § 412.426(a)(3).</p>]]></description></item><item><title>2017D10</title><pubDate>Mon, 04 Nov 2019 02:42:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d10</guid><description><![CDATA[<p>case_name: Hospice &#x26; Palliative Care of Westchester</p><p>case_numbers: 15-0839</p><p>decision_date: Tue, 07 Mar 2017 12:00:00 -0500</p><p>decision_number: 2017D10</p><p>fiscal_year_end: December 31, 2015</p><p>provider_number: 33-1520</p><p>summary: The Provider appeals the Centers for Medicare &#x26; Medicaid Services’ (“CMS”)determination that the Provider is subject to a reduced Federal Fiscal Year (“FY”) 2015
Annual Payment Update (“APU”) under the Hospice Quality Reporting Program(“HQRP”.</p>]]></description></item><item><title>2017D07</title><pubDate>Mon, 04 Nov 2019 02:42:47 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d07</guid><description><![CDATA[<p>case_name: Saint Alphonsus Regional Medical Center</p><p>case_numbers: 10-0896</p><p>decision_date: Thu, 23 Feb 2017 12:00:00 -0500</p><p>decision_number: 2017D07</p><p>fiscal_year_end: June 30, 2007</p><p>provider_number: 13-0007</p><p>summary: Whether the Medicare Contractor’s adjustments disallowing Saint Alphonsus’ claimed reimbursement for GME and IME costs in the non-hospital setting, by reducing its FTE count because Saint Alphonsus shared these costs with another hospital, was proper.</p>]]></description></item><item><title>2017D09</title><pubDate>Mon, 04 Nov 2019 02:42:47 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d09</guid><description><![CDATA[<p>case_name: North Sunflower County Hospital</p><p>case_numbers: 10-0015</p><p>decision_date: Thu, 02 Mar 2017 12:00:00 -0500</p><p>decision_number: 2017D09</p><p>fiscal_year_end: September 30, 2007</p><p>provider_number: 25-1318</p><p>summary: Whether the Intermediary’s reduction to the Provider’s fiscal year ending September 30, 2007(“FY 2007”) cost report to disallow Medicare bad debts related to the Provider’s geropsychiatric program was proper?</p>]]></description></item><item><title>2017D06</title><pubDate>Mon, 04 Nov 2019 02:42:47 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d06</guid><description><![CDATA[<p>case_name: Memorial Hermann Continuing Care Hospital</p><p>case_numbers: 06-2131; 10-0547</p><p>decision_date: Thu, 09 Feb 2017 12:00:00 -0500</p><p>decision_number: 2017D06</p><p>fiscal_year_end: 02/28/05; 02/28/07</p><p>provider_number: 45-2072</p><p>summary: Whether the Medicare Contractor?s adjustment to apply the ?must-bill? policy to bad debts related to dual eligible Medicare and Medicaid beneficiaries was proper.</p>]]></description></item><item><title>2017D05</title><pubDate>Mon, 04 Nov 2019 02:42:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d05</guid><description><![CDATA[<p>case_name: East Texas Medical Center - Athens</p><p>case_numbers: 15-0146; 16-0811</p><p>decision_date: Fri, 27 Jan 2017 12:00:00 -0500</p><p>decision_number: 2017D05</p><p>fiscal_year_end: April 30, 2015; April 30, 2016</p><p>provider_number: 45-0389</p><p>summary: Whether the Centers for Medicare and Medicaid Services (‘CMS”) have assigned the Provider to
the correct Core Based Statistical Area (“CBSA”) for the Federal Fiscal Year (“FFY”) 2015.</p>]]></description></item><item><title>2017D03</title><pubDate>Mon, 04 Nov 2019 02:42:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d03</guid><description><![CDATA[<p>case_name: Cornerstone Hospital West Monroe</p><p>case_numbers: 15-1819</p><p>decision_date: Thu, 26 Jan 2017 12:00:00 -0500</p><p>decision_number: 2017D03</p><p>fiscal_year_end: 2015</p><p>provider_number: 19-2031</p><p>summary: Whether the payment penalty imposed by the Centers for Medicare and Medicaid Services (?CMS?) to reduce Cornerstone Hospital West Monroe?s Fiscal Year (?FY?) 2015 Medicare payment by 2 percent was proper?</p>]]></description></item><item><title>2017D04</title><pubDate>Mon, 04 Nov 2019 02:42:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d04</guid><description><![CDATA[<p>case_name: Southwest Consulting UMass Memorial Health Care and Steward Health 2009 DSH CCHIP Section 1115 Waiver Days Groups</p><p>case_numbers: 14-1394GC; 14-1732GC</p><p>decision_date: Fri, 27 Jan 2017 12:00:00 -0500</p><p>decision_number: 2017D04</p><p>fiscal_year_end: 09/30/2009</p><p>provider_number: Various</p><p>summary: Whether days attributable to patients who were eligible for, and received, assistance through the Massachusetts Commonwealth Care Health Insurance Program (“CCHIP”), a
CMS-approved § 1115 waiver, should be included in the numerator of the Medicaid fraction for the Medicare Disproportionate Share Hospital (“DSH”) adjustment
calculation.</p>]]></description></item><item><title>2017D02</title><pubDate>Mon, 04 Nov 2019 02:42:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d02</guid><description><![CDATA[<p>case_name: The Park Associates, Inc.</p><p>case_numbers: 03-1599G</p><p>decision_date: Wed, 11 Jan 2017 12:00:00 -0500</p><p>decision_number: 2017D02</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 15-5443; 15-5246; 15-5280; 15-5233; 15-5202; 15-5217; 15-5304; 15-5483; 15-5409; 15-5238, 45-5947</p><p>summary: Whether the Medicare Contractor’s methodology allocating Park Associates pooled home office costs improperly denied reimbursement to the Providers?</p>]]></description></item><item><title>2017D01</title><pubDate>Mon, 04 Nov 2019 02:42:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2017d01</guid><description><![CDATA[<p>case_name: Trinity Regional Medical Center</p><p>case_numbers: 13-1012</p><p>decision_date: Thu, 15 Dec 2016 12:00:00 -0500</p><p>decision_number: 2017D01</p><p>fiscal_year_end: 12/31/2007</p><p>provider_number: 16-0016</p><p>summary: Whether Trinity Regional Medical Center (?Trinity? or ?Provider?) was entitled to a Volume Decrease Adjustment (?VDA?)?</p>]]></description></item><item><title>2016D23</title><pubDate>Mon, 04 Nov 2019 02:42:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d23</guid><description><![CDATA[<p>case_name: Valeo Home Healthcare Services, LLC</p><p>case_numbers: 15-2051</p><p>decision_date: Tue, 27 Sep 2016 12:00:00 -0400</p><p>decision_number: 2016D23</p><p>fiscal_year_end: December 31, 2015</p><p>provider_number: 46-7213</p><p>summary: Whether the Medicare Contractor properly imposed a 2 percent payment reduction upon Valeo Home Health Services, Inc. for calendar year ("CY") 2015 for failure to submit quality data as required by the Deficit Reduction Act of 2005.</p>]]></description></item><item><title>2016D24</title><pubDate>Mon, 04 Nov 2019 02:42:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d24</guid><description><![CDATA[<p>case_name: Texas Specialty Hospital of Lubbock</p><p>case_numbers: 15-1975</p><p>decision_date: Wed, 28 Sep 2016 12:00:00 -0400</p><p>decision_number: 2016D24</p><p>fiscal_year_end: December 31, 2015</p><p>provider_number: 45-2116</p><p>summary: Whether the payment penalty that the Centers for Medicare &#x26; Medicaid Services ("CMS") imposed under the Long-Term Care Hospital Quality Reporting Program to reduce the Provider's update for Fiscal Year ("FY") 2016 by 2 percent was proper.</p>]]></description></item><item><title>2016D22</title><pubDate>Mon, 04 Nov 2019 02:41:59 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d22</guid><description><![CDATA[<p>case_name: Select Specialty Medicare Dual Eligible Bad Debts CIRP Groups</p><p>case_numbers: 08-0252GC; 08-1945GC; 09-1473GC; 10-1130GC; 11-0590GC</p><p>decision_date: Tue, 27 Sep 2016 12:00:00 -0400</p><p>decision_number: 2016D22</p><p>fiscal_year_end: December 31, 2006; December 31, 2007; December 31, 2008; December 31, 2009; December 31, 2010</p><p>provider_number: Various</p><p>summary: Whether the Centers for Medicare &#x26; Medicaid Services ("CMS") must-bill policy applies to the Providers' dual eligible bad debts when the Providers did not participate in the Medicaid Program.</p>]]></description></item><item><title>2016D25</title><pubDate>Mon, 04 Nov 2019 02:41:59 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d25</guid><description><![CDATA[<p>case_name: LifeCare Hospitals</p><p>case_numbers: 10-0988; 10-0989; 09-0320; 09-0330GC; 09-2117GC; 12-0057; 11-0569GC; 14-2864; 13-2360GC; 15-2603</p><p>decision_date: Wed, 28 Sep 2016 12:00:00 -0400</p><p>decision_number: 2016D25</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Centers for Medicare &#x26; Medicaid Services' ("CMS") must-bill policy applies to the Providers' dual-eligible bad debts when the Providers did not participate in Medicaid.</p>]]></description></item><item><title>2016D17</title><pubDate>Mon, 04 Nov 2019 02:41:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d17</guid><description><![CDATA[<p>case_name: HCA DSH-Colorado State Database Group Appeals</p><p>case_numbers: 07-0637GC, 08-1019GC, 08-0258GC, 10-0249GC, 13-1238GC, 14-0003GC, 14-2395GC, 14-3725GC, 15-0196GC</p><p>decision_date: Mon, 12 Sep 2016 12:00:00 -0400</p><p>decision_number: 2016D17</p><p>fiscal_year_end: 2005 through 2012</p><p>provider_number: Various</p><p>summary: Whether patient days which the appealing Providers have identified as "inactive" in the Colorado Medicaid program should be included in the Medicaid proxy that is used in the calculation of the Medicare payment for disproportionate share hospitals ("DSH").</p>]]></description></item><item><title>2016D26</title><pubDate>Mon, 04 Nov 2019 02:41:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d26</guid><description><![CDATA[<p>case_name: Toyon 1997-2001 Intern and Resident Research FTE Group</p><p>case_numbers: 09-1541G</p><p>decision_date: Thu, 29 Sep 2016 12:00:00 -0400</p><p>decision_number: 2016D26</p><p>fiscal_year_end: December 31, 1997; December 31, 1998; December 31, 1999; December 31, 2000; December 31, 2001</p><p>provider_number: Various</p><p>summary: Did the Medicare Contractor properly reduce the Hospitals' Indirect Medical Education ("IME") Full Time Equivalent ("FTE") resident counts, for time spent by residents in research activities?</p>]]></description></item><item><title>2016D27</title><pubDate>Mon, 04 Nov 2019 02:41:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d27</guid><description><![CDATA[<p>case_name: H. Lee Moffit Cancer Center</p><p>case_numbers: 13-1119; 14-2753</p><p>decision_date: Thu, 29 Sep 2016 12:00:00 -0400</p><p>decision_number: 2016D27</p><p>fiscal_year_end: June 30, 2011; June 30, 2012</p><p>provider_number: 10-0271</p><p>summary: Did the Medicare Contractor properly calculate the cancer center's payment-to-cost ratio ("PCR") for both fiscal years ("FYs") under appeal?</p>]]></description></item><item><title>2016D19</title><pubDate>Mon, 04 Nov 2019 02:41:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d19</guid><description><![CDATA[<p>case_name: Singing River Health System</p><p>case_numbers: 09-0543</p><p>decision_date: Tue, 20 Sep 2016 12:00:00 -0400</p><p>decision_number: 2016D19</p><p>fiscal_year_end: September 30, 2006</p><p>provider_number: 25-0040</p><p>summary: Whether, in calculating the Medicaid fraction of the Medicare DSH percentage, the Medicare Contractor improperly excluded the inpatient days related to individuals eligible for either expanded Medicaid eligibility or Uncompensated Care Pool services under Hurricane Katrina Multi-State § 1115 Demonstration.</p>]]></description></item><item><title>2016D16</title><pubDate>Mon, 04 Nov 2019 02:41:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d16</guid><description><![CDATA[<p>case_name: St. Anthony Regional Hospital</p><p>case_numbers: 12-0031</p><p>decision_date: Mon, 29 Aug 2016 12:00:00 -0400</p><p>decision_number: 2016D16</p><p>fiscal_year_end: June 30, 2009</p><p>provider_number: 16-0005</p><p>summary: Whether the Medicare Administrative Contractor (Medicare Contractor) correctly determined the amount of the Sole Community Hospital ("SCH") volume decrease adjustment in accordance with the regulations and Program instructions per 42 C.F.R. § 412.92(e)(3) and the Provider Reimbursement Manual, CMS Pub 15-1 ("PRM 15-1"), § 2810.1.</p>]]></description></item><item><title>2016D21</title><pubDate>Mon, 04 Nov 2019 02:41:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d21</guid><description><![CDATA[<p>case_name: Baptist Memorial Hospital - Memphis</p><p>case_numbers: 13-3307; 14-1004; 14-1760; 15-1894</p><p>decision_date: Mon, 26 Sep 2016 12:00:00 -0400</p><p>decision_number: 2016D21</p><p>fiscal_year_end: September 30, 2007; September 30, 2008; September 30, 2009; September 30, 2010</p><p>provider_number: 44-0048</p><p>summary: Whether the Medicare Contractor's disallowance of the costs for the Hospital's Allied Health Care Management Program ("AHCMP") was correct.</p>]]></description></item><item><title>2016D18</title><pubDate>Mon, 04 Nov 2019 02:41:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d18</guid><description><![CDATA[<p>case_name: CCT&#x26;B 2005-2006 Hurricane Katrina § 1115 Waiver UCP Days Group</p><p>case_numbers: 10-1020G</p><p>decision_date: Mon, 19 Sep 2016 12:00:00 -0400</p><p>decision_number: 2016D18</p><p>fiscal_year_end: 2005-2006</p><p>provider_number: 25-0078, 25-0097</p><p>summary: Whether the Medicare Contractor properly excluded the Hospitals' patient days attributable to Mississippi's § 1115 Waiver, from the calculation of the Hospitals' disproportionate share hospital ("DSH") percentage.</p>]]></description></item><item><title>2016D20</title><pubDate>Mon, 04 Nov 2019 02:41:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d20</guid><description><![CDATA[<p>case_name: UTMD Anderson Cancer Center</p><p>case_numbers: 04-1952; 06-2367; 08-1595; 08-1951; 11-0132</p><p>decision_date: Mon, 26 Sep 2016 12:00:00 -0400</p><p>decision_number: 2016D20</p><p>fiscal_year_end: August 31, 1999; August 31, 2003; August 31, 2004; August 31, 2005; August 31, 2006</p><p>provider_number: 45-0076</p><p>summary: Issue 1 - Whether the Provider's request for adjustments to the TEFRA target amount shall be granted.
Issue 2 - Whether the Medicare Contractor's adjustment to certain Company P expenses was proper.</p>]]></description></item><item><title>2016D13</title><pubDate>Mon, 04 Nov 2019 02:41:41 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d13</guid><description><![CDATA[<p>case_name: Mercy General Hospital</p><p>case_numbers: 07-0631</p><p>decision_date: Mon, 06 Jun 2016 12:00:00 -0400</p><p>decision_number: 2016D13</p><p>fiscal_year_end: March 31, 1995</p><p>provider_number: 05-0017</p><p>summary: Whether the Medicare Contractor properly calculated the amount of the Provider's exception to the routine cost limits ("RCL") for hospital-based skilled nursing facilities ("HB-SNF") by excluding from that calculation those costs that were above the RCL but below 112 percent of the peer group mean cost?</p>]]></description></item><item><title>2016D10</title><pubDate>Mon, 04 Nov 2019 02:41:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d10</guid><description><![CDATA[<p>case_name: New Bedford Rehabilitation Hospital</p><p>case_numbers: 15-1874</p><p>decision_date: Fri, 27 May 2016 12:00:00 -0400</p><p>decision_number: 2016D10</p><p>fiscal_year_end: September 30, 2015</p><p>provider_number: 22-2043</p><p>summary: Whether the payment penalty that the Centers for Medicare &#x26; Medicaid Services ("CMS") imposed under the Long-Term Care Hospital Quality Reporting Program to reduce the Provider's payment update for Fiscal Year ("FY") 2015 by two percent was proper?</p>]]></description></item><item><title>2016D11</title><pubDate>Mon, 04 Nov 2019 02:41:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d11</guid><description><![CDATA[<p>case_name: University of Louisville Hospital</p><p>case_numbers: 06-0213, 05-2117, 06-0167, 07-0976, 08-0181, 08-1846, 08-2830</p><p>decision_date: Tue, 31 May 2016 12:00:00 -0400</p><p>decision_number: 2016D11</p><p>fiscal_year_end: December 31, 2000, December 31, 2001, December 31, 2002, December 31, 2003, December 31, 2004, December 31, 2005, December 31, 2006</p><p>provider_number: 18-0141</p><p>summary: 1. DIDACTIC TIME-Whether the Medicare Contractor's exclusion of didactic time from the FTE counts for indirect medical education ("IME") and direct graduate medical education ("DGME") for fiscal years ("FYs") 2000 to 2006 was appropriate.; 2. DENTAL FOREIGN MEDICAL GRADUATE RESIDENTS-Whether the Medicare Contractor's exclusion of foreign dental medical graduate residents for FYs 2000 to 2003 was approrpiate.; 3. RESIDENT TO BED RATIO-Whether the Medicare Contractor properly calculated the prior year interns and residents to bed ratio used to determine IME payment on the cost reports for FYs 2000 to 2003 and 2005 to 2006.</p>]]></description></item><item><title>2016D15</title><pubDate>Mon, 04 Nov 2019 02:41:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d15</guid><description><![CDATA[<p>case_name: Mid-Delta '03 Hospice Cap Group</p><p>case_numbers: 07-2449G</p><p>decision_date: Thu, 23 Jun 2016 12:00:00 -0400</p><p>decision_number: 2016D15</p><p>fiscal_year_end: October 31, 2003</p><p>provider_number: 25-1560; 25-1565</p><p>summary: Whether the Medicare Contractor used the proper date to start the running of the 3-year reopening period for the 2003 hospice cap calculation by CMS for the cap tear ending October 31, 2003 (November 1, 2002 through October 31, 2003)?</p>]]></description></item><item><title>2016D09</title><pubDate>Mon, 04 Nov 2019 02:41:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d09</guid><description><![CDATA[<p>case_name: UTMD Anderson Cancer Center</p><p>case_numbers: 04-1952, 06-2367, 08-1595, 08-1951</p><p>decision_date: Tue, 03 May 2016 12:00:00 -0400</p><p>decision_number: 2016D09 - Order to Vacate</p><p>fiscal_year_end: August 31, 1999; August 31, 2003; August 31, 2004; August 31, 2005</p><p>provider_number: 45-0076</p><p>summary: 1.Whether the Provider's request for adjustments to the TEFRA target amount shall be granted.; 2.Whether the Medicare Contractor's adjustment to certain Company P expenses was proper.</p>]]></description></item><item><title>2016D14</title><pubDate>Mon, 04 Nov 2019 02:41:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d14</guid><description><![CDATA[<p>case_name: Integris/Deaconess 2005 Non-Provider Setting IME/GME CIRP Group</p><p>case_numbers: 07-1992GC</p><p>decision_date: Tue, 07 Jun 2016 12:00:00 -0400</p><p>decision_number: 2016D14</p><p>fiscal_year_end: March 31, 2005; June 30, 2005</p><p>provider_number: 37-0032, 37-0028</p><p>summary: Was the Medicare Contractor's exclusion of all of the family practice interns and residents for each of the Hospitals from their respective full time equivalent ("FTE") counts and Medicare Contractor's denial of the associated indirect medical education ("IME") and graduate medical education ("GME") reimbursement for residents that rotated through a joint venture non-hospital family practice clinic correct?</p>]]></description></item><item><title>2016D12</title><pubDate>Mon, 04 Nov 2019 02:41:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d12</guid><description><![CDATA[<p>case_name: William Beaumont-Royal Oak</p><p>case_numbers: 10-1377, 10-1375</p><p>decision_date: Fri, 03 Jun 2016 12:00:00 -0400</p><p>decision_number: 2016D12</p><p>fiscal_year_end: December 31, 2005; December 31, 2006</p><p>provider_number: 23-0130</p><p>summary: Whether the William Beaumont Hospital, Royal Oak ("Beaumont") submitted sufficient documentation for its non-Provider-operated nurse clinical training program costs to support pass-through reimbursement for fiscal years (FYs") 2005 and 2006.</p>]]></description></item><item><title>2016D08</title><pubDate>Mon, 04 Nov 2019 02:40:41 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d08</guid><description><![CDATA[<p>decision_number: 2016D08</p><p>fiscal_year_end: September 30, 2015</p><p>provider_number: 26-2020</p><p>summary: Whether the payment penalty that the Centers for Medicare and Medicaid Services ("CMS") imposed under the Long-Term Care Hospital Quality Reporting Program to reduce the Provider's update for Fiscal Year ("FY") 2015 by two percent was proper?</p>]]></description></item><item><title>2016D07</title><pubDate>Mon, 04 Nov 2019 02:40:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d07</guid><description><![CDATA[<p>decision_number: 2016D07</p><p>fiscal_year_end: December 31, 2006</p><p>provider_number: 14-T007, 14-T217</p><p>summary: Does the Provider Reimbursement Review Board ("Board") have jurisdiction to review the Medicare Contractor's determination of the low-income patient ("LIP") adjustment for Provena St. Joseph Medical Center and Provena St. Joseph Hospital (collectively "Provena Health" or "Providers") for the fiscal year ("FY") 2006?</p>]]></description></item><item><title>2016D06</title><pubDate>Mon, 04 Nov 2019 02:40:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d06</guid><description><![CDATA[<p>decision_number: 2016D06</p><p>fiscal_year_end: 1997-1999</p><p>provider_number: Various</p><p>summary: Whether secondary MediKan days should have been included in the Provider's Medicaid fraction for the Disproportionate Share Hospital ("DSH") calculation in the disputed cost reports.</p>]]></description></item><item><title>2016D03</title><pubDate>Mon, 04 Nov 2019 02:40:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d03</guid><description><![CDATA[<p>decision_number: 2016D03</p><p>fiscal_year_end: December 31, 2008</p><p>provider_number: 16-0147</p><p>summary: Whether the Medicare Contractor properly denied the request of Grinnell Regional Medical Center ("Grinnell" or "Provider") for a volume decrease payment adjustment.</p>]]></description></item><item><title>2016D05</title><pubDate>Mon, 04 Nov 2019 02:40:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d05</guid><description><![CDATA[<p>decision_number: 2016D05</p><p>fiscal_year_end: September 30, 2015</p><p>provider_number: 10-2021</p><p>summary: Whether the payment penalty that the Centers for Medicare and Medicaid Services ("CMS") imposed under the Long-Term Care Hospital Quality Reporting Program to reduce the Provider's payment update for Fiscal Year ("FY") 2015 by two percent was proper?</p>]]></description></item><item><title>2016D04</title><pubDate>Mon, 04 Nov 2019 02:40:26 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d04</guid><description><![CDATA[<p>decision_number: 2016D04</p><p>fiscal_year_end: June 30, 2007</p><p>provider_number: 05-0006</p><p>summary: Does the Provider Reimbursement Review Board ("Board") have jurisdiction to review the Medicare Contractor's determination of the low-income patient ("LIP") adjustment pertaining to fiscal year ("FY") 2007 for St. Joseph Hospital of Eureka ("St. Joseph")?</p>]]></description></item><item><title>2016D02</title><pubDate>Mon, 04 Nov 2019 02:40:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d02</guid><description><![CDATA[<p>decision_number: 2016D02</p><p>fiscal_year_end: June 30, 2006</p><p>provider_number: 05-0009</p><p>summary: Does the Provider Reimbursement Review Board ("Board") have jurisdiction to review the Medicare Contractor's determination of the number of Medicaid eligible days included in the numerator of the low-income patient ("LIP") adjustment for Queen of the Valley Medical Center ("Queen") for fiscal year ("FY") 2006?</p>]]></description></item><item><title>2016D01</title><pubDate>Mon, 04 Nov 2019 02:40:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2016d01</guid><description><![CDATA[<p>decision_number: 2016D01</p><p>fiscal_year_end: 2000, 2002, 2003 and 2004 (through 9/30/2004)</p><p>provider_number: Various</p><p>summary: Whether inpatient days for Medicaid-eligible patients who were enrolled in a Medicare+Choice ("M+C") plan under Medicare Part C were properly excluded from the numerator of the Medicaid fraction that is used to calculate the disproportionate share hospital ("DSH") payment.</p>]]></description></item><item><title>2015D27</title><pubDate>Mon, 04 Nov 2019 02:40:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d27</guid><description><![CDATA[<p>decision_number: 2015D27</p><p>fiscal_year_end: December 31, 2005</p><p>provider_number: 05-0498</p><p>summary: Does the Provider Reimbursement Review Board ("Board") have jurisdiction to review the Medicare Contractor's determination of low-income patient ("LIP") adjustment pertaining to fiscal year ("FY") 2005 for Sutter Auburn Faith Hospital ("Auburn")?</p>]]></description></item><item><title>2015D30</title><pubDate>Mon, 04 Nov 2019 02:40:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d30</guid><description><![CDATA[<p>decision_number: 2015D30</p><p>fiscal_year_end: 9/30/2004; 9/30/2005 and 9/30/2006</p><p>provider_number: Various</p><p>summary: Does the Provider Reimbursement Review Board ("Board") have jurisdiction to review the Medicare Contractor's determination of low-income patient ("LIP") adjustment for Baptist Memorial Hospital-Germantown and Baptist Memorial Hospital North Mississippi ("Baptist") for fiscal years ("FYs") 2004, 2005, and 2006?</p>]]></description></item><item><title>2015D29</title><pubDate>Mon, 04 Nov 2019 02:40:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d29</guid><description><![CDATA[<p>decision_number: 2015D29</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Does the Provider Reimbursement Review Board ("Board") have jurisdiction to review the Medicare Contractor's determination of low-income patient ("LIP") adjustments for the 2006 and 2007 HealthSouth SSI Percentage CIRP Groups ("HealthSouth")?</p>]]></description></item><item><title>2015D24</title><pubDate>Mon, 04 Nov 2019 02:40:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d24</guid><description><![CDATA[<p>decision_number: 2015D24</p><p>fiscal_year_end: 12/31/2005 and 12/31/2006</p><p>provider_number: 45-0209</p><p>summary: Whether the current year bed count and the available bed days were properly recorded for fiscal year ("FY") 2005, and whether the current year bed count and available bed days and the available bed days used to calculate the prior year intern to resident ratio were properly calculated for FY 2006.</p>]]></description></item><item><title>2015D28</title><pubDate>Mon, 04 Nov 2019 02:40:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d28</guid><description><![CDATA[<p>decision_number: 2015D28</p><p>fiscal_year_end: December 31, 2004</p><p>provider_number: 05-0498</p><p>summary: Does the Provider Reimbursement Review Board ("Board") have jurisdiction to review the Medicare Contractor's determination of low-income patient ("LIP") adjustment pertaining to fiscal year ("FY") 2004 for Sutter Auburn Faith Hospital ("Auburn")?</p>]]></description></item><item><title>2015D18</title><pubDate>Mon, 04 Nov 2019 02:40:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d18</guid><description><![CDATA[<p>decision_number: 2015D18</p><p>fiscal_year_end: August 30, 2000</p><p>provider_number: 05-0327</p><p>summary: Whether the denial of the Provider's request for an exception to the end stage renal disease ("ESRD") composite rate by the Centers for Medicare and Medicaid Services ("CMS") was proper.</p>]]></description></item><item><title>2015D23</title><pubDate>Mon, 04 Nov 2019 02:40:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d23</guid><description><![CDATA[<p>decision_number: 2015D23</p><p>fiscal_year_end: Various - See Appendix A</p><p>provider_number: See Appendix A</p><p>summary: Whether the Providers had to bill the state Medicaid program and submit a state remittance advice to the Medicare Contractor as a precondition for the Medicare program to pay bad debts for unpaid coinsurance and deductiblees for individuals who are eligible for both Medicare and Medicaid.</p>]]></description></item><item><title>2015D22</title><pubDate>Mon, 04 Nov 2019 02:40:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d22</guid><description><![CDATA[<p>decision_number: 2015D22</p><p>fiscal_year_end: September 30, 2015</p><p>provider_number: 19-0204</p><p>summary: Whether the reduction of the Provider's market basket update for federal fiscal year ("FY") 2015 under the Hospital Inpatient Quality Reporting ("IQR)" program was proper?</p>]]></description></item><item><title>2015D25</title><pubDate>Mon, 04 Nov 2019 02:40:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d25</guid><description><![CDATA[<p>decision_number: 2015D25</p><p>fiscal_year_end: 12/31/2004; 12/31/2005</p><p>provider_number: 33-0044</p><p>summary: Whether the Medicare Contractor's adjustment to Faxton - St. Luke's Medicare bad debts was proper?</p>]]></description></item><item><title>2015D26</title><pubDate>Mon, 04 Nov 2019 02:40:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d26</guid><description><![CDATA[<p>decision_number: 2015D26</p><p>fiscal_year_end: March 31, 2009</p><p>provider_number: 10-4993</p><p>summary: 1. Whether a community mental health center ("CMHC") is a "provider of services" entitled to a hearing before the Provider Reimbursement Review Board ("the Board") under 42 U.S.C. Section 1395oo.
2. If a CMHC is a "provider of services," does this finding necessarily implicate other documentation obligations and requirements as a "provider of services"?</p>]]></description></item><item><title>2015D19</title><pubDate>Mon, 04 Nov 2019 02:40:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d19</guid><description><![CDATA[<p>decision_number: 2015D19</p><p>fiscal_year_end: August 30, 2000</p><p>provider_number: 05-2250</p><p>summary: Whether the denial of the Provider's request for an exception to the end stage renal disease ("ESRD") composite rate by the Centers for Medicare and Medicaid Services ("CMS") was proper.</p>]]></description></item><item><title>2015D20</title><pubDate>Mon, 04 Nov 2019 02:40:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d20</guid><description><![CDATA[<p>decision_number: 2015D20</p><p>fiscal_year_end: December 31, 2003</p><p>provider_number: 05-0498</p><p>summary: Does the Provider Reimbursement Review Board ("Board") have jurisdiction to review the Medicare Contractor's determination of low-income patient ("LIP") adjustment for Sutter Auburn Faith Hospital ("Auburn") for fiscal year ("FY") 2003? Specifically, Auburn filed an appeal with the Board claiming, amongst other things, that the LIP Supplemental Security Income ("SSI") ratio published by the Centers for Medicare and Medicaid Services ("CMS") and used by the Medicare contractor in the calculation of Auburn's LIP adjustment was understated.</p>]]></description></item><item><title>2015D21</title><pubDate>Mon, 04 Nov 2019 02:40:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d21</guid><description><![CDATA[<p>decision_number: 2015D21</p><p>fiscal_year_end: September 30, 2001</p><p>provider_number: 34-0168</p><p>summary: 1. Whether the Medicare Contractor's adjustment to the provider-based physician professional component was proper.;
2. Whether the Medicare Contractor's recoupment of payments related to the denial of inpatient admissions was proper.;
3. Whether the Medicare Contractor's adjustment disallowing costs related to Wilmington's partial hospitalization program was proper.</p>]]></description></item><item><title>2015D16</title><pubDate>Mon, 04 Nov 2019 02:39:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d16</guid><description><![CDATA[<p>case_name: Sutter Auburn Faith Hospital, Auburn, California</p><p>case_numbers: 08-2387</p><p>decision_date: Wed, 19 Aug 2015 12:00:00 -0400</p><p>decision_number: 2015D16</p><p>fiscal_year_end: December 31, 2006</p><p>provider_number: 05-0498</p><p>summary: Does the Provider Reimbursement Review Board (“Board”) have jurisdiction to review the Medicare Contractor’s determination of low-income patient (“LIP”) adjustment for Sutter Auburn Faith Hospital (“Auburn”) for fiscal year (“FY”) 2006? Specifically, Auburn filed an appeal with the Board claiming that:
1. the Medicare Contractor improperly excluded from the Medicaid fraction of Auburn’s LIP adjustment calculation the days of Rehab patients who were eligible for medical assistance under an approved Medicaid state plan; and
2. the LIP Supplemental Security Income (“SSI”) ratio published by Centers for Medicare and Medicaid Services (“CMS”) and used by the Medicare contractor in the calculation of Auburn’s LIP adjustment was understated.</p>]]></description></item><item><title>2015D15</title><pubDate>Mon, 04 Nov 2019 02:39:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d15</guid><description><![CDATA[<p>case_name: HCA 00, 02 DSH Medicare+Choice Plan Days;
HCA 03 DSH Medicare+Choice Plan Days;
HCA 04 DSH Medicare+Choice Plan Days</p><p>case_numbers: 05-0543GC; 05-0862GC and 06-0910GC</p><p>decision_date: Tue, 18 Aug 0015 12:00:00 -0456</p><p>decision_number: 2015D15 - Order to Vacate (Decision has been reissued as 2016D01)</p><p>fiscal_year_end: 2000, 2002, 2003, 2004 </p><p>provider_number: Various</p><p>summary: Whether inpatient days for Medicaid-eligible patients who were enrolled in a Medicare+Choice ("M+C") plan under Medicare Part C were properly excluded from the numerator of the Medicaid fraction that is used to calculate the disproportionate share hospital ("DSH") payment.</p>]]></description></item><item><title>2015D17</title><pubDate>Mon, 04 Nov 2019 02:39:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d17</guid><description><![CDATA[<p>case_name: Riverside Hospital of Louisiana</p><p>case_numbers: 15-0203</p><p>decision_date: Thu, 20 Aug 2015 12:00:00 -0400</p><p>decision_number: 2015D17</p><p>fiscal_year_end: September 30, 2015</p><p>provider_number: 19-2043</p><p>summary: Whether the payment penalty that the Centers for Medicare and Medicaid Services ("CMS") imposed under the Long-Term Care Hospital Quality Reporting Program to reduce the Provider's payment update for Fiscal Year ("FY") 2015 by two percent was proper?</p>]]></description></item><item><title>2015D13</title><pubDate>Mon, 04 Nov 2019 02:39:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d13</guid><description><![CDATA[<p>case_name: Lutheran Hospital of Indiana,
Fort Wayne, Indiana</p><p>case_numbers: 09-1754</p><p>decision_date: Tue, 04 Aug 2015 12:00:00 -0400</p><p>decision_number: 2015D13</p><p>fiscal_year_end: June 30, 2007</p><p>provider_number: 15-0017</p><p>summary: Whether the Medicare Contractor's adjustment to remove time for off-site rotations was proper?</p>]]></description></item><item><title>2015D14</title><pubDate>Mon, 04 Nov 2019 02:39:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d14</guid><description><![CDATA[<p>case_name: 08-0362</p><p>case_numbers: 08-0362</p><p>decision_date: Wed, 12 Aug 2015 12:00:00 -0400</p><p>decision_number: 2015D14</p><p>fiscal_year_end: December 31, 2005</p><p>provider_number: 31-4021</p><p>summary: Whether the Medicare Contractor improperly disallowed from the calculation of the Provider's bad debt expense, for the subject fiscal year, bad debts associated with patients whose accounts were not billed to Medicaid prior to the accounts being written off to bad debt.</p>]]></description></item><item><title>2015D11</title><pubDate>Mon, 04 Nov 2019 02:39:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d11</guid><description><![CDATA[<p>case_name: Fairbanks Memorial Hospital,
Fairbanks, Alaska</p><p>case_numbers: 09-1704</p><p>decision_date: Tue, 09 Jun 2015 12:00:00 -0400</p><p>decision_number: 2015D11</p><p>fiscal_year_end: December 31, 2005</p><p>provider_number: 02-0012</p><p>summary: Whether the Medicare Contractor's calculation of the Provider's low volume adjustment amount was determined correctly.</p>]]></description></item><item><title>2015D12</title><pubDate>Mon, 04 Nov 2019 02:39:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d12</guid><description><![CDATA[<p>case_name: Tehachapi Valley Hospital,
Tehachapi, California</p><p>case_numbers: 05-1647</p><p>decision_date: Thu, 18 Jun 0015 12:00:00 -0456</p><p>decision_number: 2015D12</p><p>fiscal_year_end: June 30, 1998</p><p>provider_number: 05-0446</p><p>summary: Whether the Medicare Contractor's denial of Tehachapi Valley Hospital's ("Tehachapi" or "Provider") request for a low volume adjustment payment under 42 C.F.R. Section 412.92(e) was proper?</p>]]></description></item><item><title>2015D09</title><pubDate>Mon, 04 Nov 2019 02:39:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d09</guid><description><![CDATA[<p>decision_number: 2015D09</p><p>fiscal_year_end: August 31, 2009</p><p>provider_number: 32-0003</p><p>summary: Whether the Medicare Contractor's denial of Alta Vista Regional Hospital's ("Alta Vista") request for a sole community hospital volume decrease adjustment payment was proper?</p>]]></description></item><item><title>2015D10</title><pubDate>Mon, 04 Nov 2019 02:39:25 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d10</guid><description><![CDATA[<p>decision_number: 2015D10</p><p>fiscal_year_end: Calendar Year 2014</p><p>provider_number: 34-7247</p><p>summary: Was it proper to impose a 2 percent reduction in the Medicare payments to Liberty Healthcare Group, LLC's home health agency located in Supply, North Carolina for calendar year ("CY") 2014?</p>]]></description></item><item><title>2015D08</title><pubDate>Mon, 04 Nov 2019 02:39:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d08</guid><description><![CDATA[<p>decision_number: 2015D08</p><p>fiscal_year_end: 9/30/1997; 9/30/1999; 09/30/2000; 9/30/2001; 9/30/2002; 9/30/2003; 9/30/2004; 9/30/2005 and 9/30/2006</p><p>provider_number: See Appendix A</p><p>summary: Whether the exclusion by the Medicare Contractor of days identified as inpatient days attributable to individuals who received medical assistance/general assistance under the Connecticut State Administered General Assistance ("SAGA") Program from the Medicaid fraction used in the calculation of the adjustment for Medicare disproportionate share hospitals was proper for the fiscal years at issue.</p>]]></description></item><item><title>2015D06</title><pubDate>Mon, 04 Nov 2019 02:39:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d06</guid><description><![CDATA[<p>decision_number: 2015D06</p><p>fiscal_year_end: Various - See Appendix I</p><p>provider_number: Various</p><p>summary: Whether the Medicare Contractor and the Centers for Medicare and Medicaid Services ("CMS") properly determined the Santa Cruz, California Metropolitan Statistical Area ("MSA") Wage Index for Federal Fiscal Year ("FFY") 2004.</p>]]></description></item><item><title>2015D07</title><pubDate>Mon, 04 Nov 2019 02:39:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d07</guid><description><![CDATA[<p>decision_number: 2015D07</p><p>fiscal_year_end: 12/31/2002; 12/31/2003; and 12/31/2004</p><p>provider_number: 10-0061</p><p>summary: Issue 1: Whether the Provider Reimbursement Review Board ("Board") has jurisdiction to review the Medicare Contractor's determination that the days of patients who were both eligible for medical assistance under an approved Medicaid state plan and enrolled in a Medicare+Choice plan under Part C of the Medicare program should be excluded from the Medicaid fraction of the low-income payment adjustment for Mercy Hospital.
Issue 2: Whether the Medicare Contractor properly determined Mercy Hospital's low-income percentage adjustment under the propsective payment system for rehabilitation facilities for fiscal years 2002, 2003, and 2004. In particular, the Medicare Contractor excluded from the Medicaid fraction of the low-income payment adjustment, the days of patients who were both eligible for medical assistance under an approved Medicaid state plan and enrolled in a Medicare+Choice plan under Part C of the Medicare program</p>]]></description></item><item><title>2015D05</title><pubDate>Mon, 04 Nov 2019 02:39:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d05</guid><description><![CDATA[<p>decision_number: 2015D05</p><p>fiscal_year_end: 2004 and 2005</p><p>provider_number: 36-0019</p><p>summary: For fiscal years ("FYs") 2004 and 2005, does the Provider Reimbursement Review Board (the "Board") have jurisdiction over the Medicaid eligible days issue in the appeals?</p>]]></description></item><item><title>2015D01</title><pubDate>Mon, 04 Nov 2019 02:39:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d01</guid><description><![CDATA[<p>provider_number: Various</p><p>summary: Whether the Intermediary's application of the Sixth Circuit Court of Appeals' holding in Clark Regional Medical Center v. United States Department of Health and Human Services, 314 F.3d. 241 (6th Cir. 2002) ("Clark") to the determination of the number of available bed days for purposes of calculating the appealing Providers' indirect medical education or disproportionate share payments, as applicable to each such provider, was proper.</p>]]></description></item><item><title>2010D39</title><pubDate>Mon, 04 Nov 2019 02:38:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d39</guid><description><![CDATA[<p>case_name: Salt Lake Regional Medical Center</p><p>case_numbers: 10-0081</p><p>decision_date: Wed, 30 Jun 2010 12:00:00 -0400</p><p>decision_number: 2010D39</p><p>fiscal_year_end: August 31, 2004</p><p>provider_number: 46-0003</p><p>summary: Should the Provider Reimbursement Review Board ("Board") grant the Providers' request for expedited judicial review ("EJR") over the validity of the provisions of the Centers for Medicare and Medicaid Services Ruling CMS-1498-R, which if valid, render moot and deny jurisdiction over the dual-eligible group appeals?</p>]]></description></item><item><title>2015D03</title><pubDate>Mon, 04 Nov 2019 02:38:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d03</guid><description><![CDATA[<p>case_name: Rural Family DGME Group Appeals</p><p>case_numbers: 01-0004GE;
04-1492GE;
06-0509GE;
09-2040G</p><p>decision_date: Fri, 06 Feb 2015 12:00:00 -0500</p><p>decision_number: 2015D03</p><p>fiscal_year_end: See Appendix I</p><p>provider_number: Various (See Appendix I)</p><p>summary: This case was remanded to the Board and the parties presented the following issues pursuant to the decision of the U.S. Court of Appeals for the Ninth Circuit ("Ninth Circuit") in Providence Yakima Medical Center v. Sebelius ("Providence Yakima"). The case involves the amount of Medicare reimbursement due a provider of medical services.
Issue 1: Was the use of CMS' sequential geography methodology ("SGM") for setting the Providers' base year per resident amounts for Medicare reimbursement of certain graduate medical education costs valid and consistent with 42 U.S.C. Section 1395ww(h)(2)(F) and 42 C.F.R. Section 413.86(e)(4)(i) (1989)?
Issue 2: If the SGM is invalid, what relief can or should the Board order?</p>]]></description></item><item><title>2015D02</title><pubDate>Mon, 04 Nov 2019 02:38:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d02</guid><description><![CDATA[<p>decision_number: 2015D02</p><p>fiscal_year_end: 2004-2008</p><p>provider_number: 15-1301</p><p>summary: Was the Intermediary's disallowance of the interest expense proper for St. Vincent Randolph for the 2004, 2005, 2006, 2007 and 2008 fiscal years?</p>]]></description></item><item><title>2010D38</title><pubDate>Mon, 04 Nov 2019 02:38:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d38</guid><description><![CDATA[<p>case_name: King &#x26; Spalding Inclusion of Medicare Advantage Days in 2007 SSI Ratios Group;
Shands HealthCare Inclusion of Medicare Advantage Days in 2007 SSI Ratios Group;
North Shore Long Island Jewish Health Services Inclusion of Medicare Advantage Days in 2007 SSI Ratios Group</p><p>case_numbers: 10-0165G;
10-0162GC; and
10-0169GC</p><p>decision_date: Tue, 29 Jun 2010 12:00:00 -0400</p><p>decision_number: 2010D38</p><p>fiscal_year_end: 2007-2008</p><p>provider_number: Various</p><p>summary: 1. Should the Provider Reimbursement Review Board ("Board") grant the Providers' request for expedited judicial review ("EJR") over the question of whether Medicare Part C days should be excluded from the numerator and denominator of the Supplemental Security Income fraction of the disproportionate share adjustment?
2. Should the Board grant the Providers' request for EJR over the validity of the regulations, 42 C.F.R. Sections 405.1853(e)(2)(i), 405.1853(e)(5)(vii) and 405.1857(a)(1)(i), which insulate the Centers for Medicare and Medicaid Services from discovery and the Board's subpoena power?
3. Should the Board grant the Providers' request for EJR over failure by the Secretary to comply with Section 951 of the Medicare Modernization Act?</p>]]></description></item><item><title>2015D04</title><pubDate>Mon, 04 Nov 2019 02:38:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2015d04</guid><description><![CDATA[<p>case_name: Breckinridge Health, Inc.;
New Horizons Health Systems, Inc.;
CAH 2009 Provider Tax Group;
CHC 2009 CAH Provider Tax CIRP Group; and
ARH CAH Provider Tax CIRP Group</p><p>case_numbers: 13-2038;
13-0452;
13-1454G;
11-0518GC; and
11-0497GC</p><p>decision_date: Tue, 10 Feb 2015 12:00:00 -0500</p><p>decision_number: 2015D04</p><p>fiscal_year_end: 2009 and 2010</p><p>provider_number: Various (See Appendix A)</p><p>summary: Did the Medicare contractor properly offset the Kentucky provider tax assessment ("KP-Tax") for each of the seven hospitals for the fiscal years at issue by the corresponding amount of the Kentucky Medicaid Disproportionate Share Hospital ("Medicaid DSH") payment that each hospital received for those fiscal years?</p>]]></description></item><item><title>2014D29</title><pubDate>Mon, 04 Nov 2019 02:38:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d29</guid><description><![CDATA[<p>case_name: Community Hospital of Anaconda
Anaconda, Montana</p><p>case_numbers: 08-0050</p><p>decision_date: Wed, 24 Sep 2014 12:00:00 -0400</p><p>decision_number: 2014D29</p><p>fiscal_year_end: December 31, 2005</p><p>provider_number: 27-1335</p><p>summary: Whether the Medicare Administrative Contractor's disallowance of the Provider's certified registered nurse anesthetist on-call costs was proper.</p>]]></description></item><item><title>2014D30</title><pubDate>Mon, 04 Nov 2019 02:38:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d30</guid><description><![CDATA[<p>case_name: HMA 2004-2006 Bad Debt Group Appeals</p><p>case_numbers: 07-2227GC; 07-2762GC and 08-1704GC</p><p>decision_date: Thu, 25 Sep 2014 12:00:00 -0400</p><p>decision_number: 2014D30</p><p>fiscal_year_end: FYEs 2004, 2005 and 2006</p><p>provider_number: Various</p><p>summary: Whether the Intermediary properly disallowed the Providers' non-indigent debts for fiscal year ends 2004, 2005, and 2006, for not meeting all applicable regulatory requirements.</p>]]></description></item><item><title>2014D28</title><pubDate>Mon, 04 Nov 2019 02:38:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d28</guid><description><![CDATA[<p>case_name: New York City Health and Hospitals Corporation Improper Application of Weighted Discharge Cap CIRP Groups</p><p>case_numbers: 08-1929GC; 09-0510GC; 11-0568GC</p><p>decision_date: Wed, 24 Sep 2014 12:00:00 -0400</p><p>decision_number: 2014D28</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary properly applied the weighted discharge cap to the Providers' ancillary costs.</p>]]></description></item><item><title>2014D26</title><pubDate>Mon, 04 Nov 2019 02:38:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d26</guid><description><![CDATA[<p>case_name: University of Pittsburgh Medical Center (UPMC) (formerly Mercy Hospital of Pittsburgh)</p><p>case_numbers: 99-1340R</p><p>decision_date: Tue, 23 Sep 2014 12:00:00 -0400</p><p>decision_number: 2014D26</p><p>fiscal_year_end: June 30, 1985</p><p>provider_number: 39-0028</p><p>summary: Whether pursuant to 42 C.F.R. Section 405.378, or otherwise, and in view of the Intermediary's ten year delay in fully implementing PRRB Decision No. 1998-D26 for PRRB Case No. 91-2673M, interest is due on the underpayments which were otherwise at issue in PRRB Case No. 99-1340.</p>]]></description></item><item><title>2014D24</title><pubDate>Mon, 04 Nov 2019 02:38:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d24</guid><description><![CDATA[<p>case_name: Southwest Ambulatory Behavioral Services, Inc.
Crowley, LA</p><p>case_numbers: 08-0496</p><p>decision_date: Wed, 10 Sep 2014 12:00:00 -0400</p><p>decision_number: 2014D24</p><p>fiscal_year_end: December 31, 2000</p><p>provider_number: 19-4650</p><p>summary: Was the Intermediary's adjustment to the allocation of the Provider's cost proper?</p>]]></description></item><item><title>2014D27</title><pubDate>Mon, 04 Nov 2019 02:38:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d27</guid><description><![CDATA[<p>case_name: Cooper Hospital/University Medical Center
Camden, New Jersey</p><p>case_numbers: 05-0553</p><p>decision_date: Tue, 23 Sep 2014 12:00:00 -0400</p><p>decision_number: 2014D27</p><p>fiscal_year_end: December 31, 2001</p><p>provider_number: 31-0014</p><p>summary: Whether days associated with patients covered under the New Jersey Charity Care Program should be included in the numerator of the Medicaid proxy of the Medicare disproportionate share hospital ("DSH") calculation pursuant to 42 U.S.C. Section 1395ww(d)(5)(F)(vi)(II).</p>]]></description></item><item><title>2014D25</title><pubDate>Mon, 04 Nov 2019 02:38:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d25</guid><description><![CDATA[<p>case_name: The Memorial Hospital of North Conway
North Conway, New Hampshire</p><p>case_numbers: 09-1897</p><p>decision_date: Thu, 11 Sep 2014 12:00:00 -0400</p><p>decision_number: 2014D25</p><p>fiscal_year_end: June 30, 2007</p><p>provider_number: 30-1307</p><p>summary: Whether the offset of "investment income" up to the amount of interest expense claimed by the Provider for the fiscal year ending June 30, 2007, was proper.</p>]]></description></item><item><title>2014D23</title><pubDate>Mon, 04 Nov 2019 02:38:11 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d23</guid><description><![CDATA[<p>case_name: Mary Greely Medical Center
Ames, IA</p><p>case_numbers: 10-0224</p><p>decision_date: Wed, 10 Sep 2014 12:00:00 -0400</p><p>decision_number: 2014D23</p><p>fiscal_year_end: June 30, 2009</p><p>provider_number: 16-0030</p><p>summary: 1. Whether the intermediary and CMS Regional Office for Region VII ("CMS Regional Office") evaluated market share for the provider for the correct geographic area when they denied the provider's request for classification as a sole community hospital on the grounds that the provider failed to meet the market share criteria under 42 C.F.R. Section 412.92(a)(1)(i).
2. Whether the Regional Office used the correct denominator in its market share calculation.</p>]]></description></item><item><title>2014D21</title><pubDate>Mon, 04 Nov 2019 02:38:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d21</guid><description><![CDATA[<p>case_name: Legacy Hospital and Palliative Care, LLC
Harrisburg, Pennsylvania</p><p>case_numbers: 14-0568</p><p>decision_date: Tue, 09 Sep 2014 12:00:00 -0400</p><p>decision_number: 2014D21</p><p>fiscal_year_end: 12/31/2014</p><p>provider_number: 39-1745</p><p>summary: Whether the imposition of a two percent reduction in Legacy Hospice and Palliative Care LLC's Medicare payments for calendar year 2014 was proper.</p>]]></description></item><item><title>2014D22</title><pubDate>Mon, 04 Nov 2019 02:38:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d22</guid><description><![CDATA[<p>case_name: Cleveland Clinic Florida Hospital
Weston, Florida</p><p>case_numbers: 06-1304; 07-0199; 08-0025; 08-0231; 08-1852</p><p>decision_date: Tue, 09 Sep 2014 12:00:00 -0400</p><p>decision_number: 2014D22</p><p>fiscal_year_end: May 31, 2002; May 31, 2003; May 31, 2004; May 31, 2005 and May 31, 2006</p><p>provider_number: 10-0289</p><p>summary: Whether the Intermediary's removal of residents who participated in Colorectal Surgery (fiscal years ("FYs") 2002-2006), Internal Medicient (FYs 2004-2006), and Neurology (FYs 2004-2006) programs (collectively, "Programs") from the Provider's Graduate Medical Education ("GME") and Indirect Medical Education ("IME") full-time equivalent ("FTE") counts on the basis that these programs did not qualify as "new programs" under 42 C.F.R. Section 413.79(1) was correct.</p>]]></description></item><item><title>2014D20</title><pubDate>Mon, 04 Nov 2019 02:38:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d20</guid><description><![CDATA[<p>case_name: Chestnut Hill Benevolent Association
The Leaves, Inc.
Arden Woods, Inc.
Broadview, Inc.</p><p>case_numbers: 07-2549R; 07-2546R; 07-2547R; 07-2548R; 07-2538R; 07-2544R; 07-2532R; 07-2533R and 08-0470R</p><p>decision_date: Thu, 28 Aug 2014 12:00:00 -0400</p><p>decision_number: 2014D20</p><p>fiscal_year_end: 12/31/2002; 12/31/2003; 12/31/2004; 12/31/2005 and 12/31/2006</p><p>provider_number: 22-1990; 45-1990; 05-1993 and 05-1991</p><p>summary: Whether the training offered by the Providers is necessary to enter the specialty of Christian Science nursing in a Religious, Non-Medical Health Care Institution and therefore, eligible for pass-through reimbursement, or whether the Providers' nurse-training program is continuing education that should be treated as normal operating costs under 42 C.F.R. 413.85(h)(3).</p>]]></description></item><item><title>2014D18</title><pubDate>Mon, 04 Nov 2019 02:38:05 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d18</guid><description><![CDATA[<p>case_name: Methodist Hospital-Southlake
Methodist Hospital-Northlake
Methodist Hospital, Inc.</p><p>case_numbers: 04-1350; 05-1139; 06-1473; 06-1477; 04-1348; 05-1185; 06-1353; 06-1303 and 07-1344</p><p>decision_date: Tue, 26 Aug 2014 12:00:00 -0400</p><p>decision_number: 2014D18</p><p>fiscal_year_end: 2000-2004</p><p>provider_number: 15-0132 and 15-0002</p><p>summary: Whether the Medicare Administrative Contractor's disallowance of Methodist Hospital's bad debt claims should be reversed.</p>]]></description></item><item><title>2014D19</title><pubDate>Mon, 04 Nov 2019 02:38:05 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d19</guid><description><![CDATA[<p>case_name: St. John Health 2004-2005 Bad Debt Moratorium CIRP Group;
Hall Render 2005-2006 Bad Debt Moratorium Group</p><p>case_numbers: 09-1065GC and 09-2172G</p><p>decision_date: Wed, 27 Aug 2014 12:00:00 -0400</p><p>decision_number: 2014D19</p><p>fiscal_year_end: 2004 and 2005</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's disallowance of the Providers' bad debts claims, because the claims had been referred to an outside collection agency, should be reversed because the Intermediary's adjustments violate the Bad Debt Moratorium.</p>]]></description></item><item><title>2014D16</title><pubDate>Mon, 04 Nov 2019 02:37:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d16</guid><description><![CDATA[<p>case_name: Lakes Regional Healthcare
Spirit Lake, Iowa</p><p>case_numbers: 10-0859</p><p>decision_date: Thu, 10 Jul 2014 12:00:00 -0400</p><p>decision_number: 2014D16</p><p>fiscal_year_end: June 30, 2006</p><p>provider_number: 16-0214</p><p>summary: Whether Wisconsin Physicians Service, the Medicare Administrative Contractor, properly calculated the Medicare dependent hospital volume decrease adjustment for Lakes Regional Healthcare, the Provider, for fiscal year 2006, by improperly excluding certain variable and semi-fixed costs?</p>]]></description></item><item><title>2014D14</title><pubDate>Mon, 04 Nov 2019 02:37:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d14</guid><description><![CDATA[<p>case_name: Swedish American Hospital</p><p>case_numbers: 05-1891; 05-1887; 04-1831; 05-0731 and 06-1938</p><p>decision_date: Wed, 09 Jul 2014 12:00:00 -0400</p><p>decision_number: 2014D14</p><p>fiscal_year_end: May 31, 1999; May 31, 2000; May 31, 2001; May 31, 2002 and May 31, 2003</p><p>provider_number: 14-0228</p><p>summary: Whether the Temporary Cap Increase Exception applies to the Provider's 1996 base year IME/GME FTE count for osteopathic and allopathic medicine interns and residents and the caps application to the May 31, 1999 through May 31, 2003 FTE counts?</p>]]></description></item><item><title>2014D17</title><pubDate>Mon, 04 Nov 2019 02:37:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d17</guid><description><![CDATA[<p>case_name: Wyatt, Tarrant &#x26; Combs FFY 07 Occupational Mix Adjustment Group</p><p>case_numbers: 07-1917G</p><p>decision_date: Fri, 25 Jul 2014 12:00:00 -0400</p><p>decision_number: 2014D17</p><p>fiscal_year_end: September 30, 2007</p><p>provider_number: 18-0038; 18-0130; 18-0138; 18-0104; 18-0103; 18-0080</p><p>summary: 1. Whether the inclusion of surgical technicians, mental health technicians, and heart center recovery technicians in the all-others category instead of the nursing aides, orderlies and attendants category in the Provider's occupational-mix survey was correct.
2. Does the fact that CMS and its Intermediaries did not classify medical technicians uniformly and that some medical technicians are classified in nursing aides, orderlies and attendants category for some other hospitals, even while the Intermediary was excluding them from that category here, require that they be reclassified here as nursing aides, orderlies and attendants, and that the Provider's occupational mix adjustments be recalculated?</p>]]></description></item><item><title>2014D15</title><pubDate>Mon, 04 Nov 2019 02:37:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d15</guid><description><![CDATA[<p>case_name: Unity Healthcare, Muscatine, IA</p><p>case_numbers: 10-0386</p><p>decision_date: Thu, 10 Jul 2014 12:00:00 -0400</p><p>decision_number: 2014D15</p><p>fiscal_year_end: June 30, 2006</p><p>provider_number: 16-0013</p><p>summary: Whether the Medicare Administrative Contractor improperly calculated the Provider's sole community hospital volume decrease adjustment by excluding certain variable and semi-fixed costs?</p>]]></description></item><item><title>2014D13</title><pubDate>Mon, 04 Nov 2019 02:37:53 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d13</guid><description><![CDATA[<p>case_name: CHS 2004-2006 Medicare Bad Debt-Passive Collection CIRP Groups</p><p>case_numbers: 08-0611GC; 08-0619GC and 08-0621GC</p><p>decision_date: Tue, 01 Jul 2014 12:00:00 -0400</p><p>decision_number: 2014D13</p><p>fiscal_year_end: 2004-2006</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's adjustments to remove the Medicare bad debts claimed by the Provider while the debts were still at the collection agency were proper?</p>]]></description></item><item><title>2014D12</title><pubDate>Mon, 04 Nov 2019 02:37:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d12</guid><description><![CDATA[<p>case_name: City of Hope National Medical Center, Duarte, CA</p><p>case_numbers: 10-1135, 10-1136 and 10-1138</p><p>decision_date: Thu, 19 Jun 2014 12:00:00 -0400</p><p>decision_number: 2014D12</p><p>fiscal_year_end: September 30, 2004, September 30, 2005 and September 30, 2006</p><p>provider_number: 05-0146</p><p>summary: Whether the Intermediary properly offset investment income against operating and capital-related interest expense for the fiscal years ending September 30, 2004, September 30, 2005, and September 30 2006?</p>]]></description></item><item><title>2014D11</title><pubDate>Mon, 04 Nov 2019 02:37:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d11</guid><description><![CDATA[<p>case_name: Cooper Hospital/University Medical Center</p><p>case_numbers: 07-0847 and 07-0306</p><p>decision_date: Wed, 18 Jun 2014 12:00:00 -0400</p><p>decision_number: 2014D11</p><p>fiscal_year_end: December 31, 2003 and December 31, 2004</p><p>provider_number: 31-0014</p><p>summary: 1. Whether a provider's collection effort on inpatient and outpatient bad debts must include personal telephone calls to patients to comprise a reasonable collection effort.
2. Whether the Intermediary incorrectly determined that the regulations affirmatively preclude a write off of bad debts prior to 120 days after the first bill is sent.
3. Whether days associated with patients covered under the New Jersey Charity Care Program should be included in the numerator of the Medicaid proxy of the Medicare disproportionate share hospital ("DSH") calculation pursuant to 42 U.S.C. § 1395ww(d)(5)(F)(vi)(II).</p>]]></description></item><item><title>2014D10</title><pubDate>Mon, 04 Nov 2019 02:37:41 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d10</guid><description><![CDATA[<p>case_name: Eastern Maine Medical Center, Bangor, Maine</p><p>case_numbers: 06-1337 and 07-1505</p><p>decision_date: Mon, 02 Jun 2014 12:00:00 -0400</p><p>decision_number: 2014D10</p><p>fiscal_year_end: September 27, 2003 and September 25, 2004</p><p>provider_number: 20-0033 </p><p>summary: Whether the Medicare Administrative Contractor (MAC) erred by excluding outside rotations from the Provider's Graduate Medical Education (GME) and Indirect Medical Education (IME) full time equivalent (FTE) count?</p>]]></description></item><item><title>2014D09</title><pubDate>Mon, 04 Nov 2019 02:37:41 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d09</guid><description><![CDATA[<p>case_name: Welch Community Hospital, Welch, West Virginia</p><p>case_numbers: 07-2350</p><p>decision_date: Thu, 29 May 2014 12:00:00 -0400</p><p>decision_number: 2014D09</p><p>fiscal_year_end: June 30, 2005</p><p>provider_number: 51-0086</p><p>summary: Was the Intermediary's adjustment to reclassify Rural Health Clinic visits associated with contracted physicians, and the associated full-time equivalents ("FTEs") from cost report Worksheet M-2, line 9 to Worksheet M-2, line 1, correct?</p>]]></description></item><item><title>2014D08</title><pubDate>Mon, 04 Nov 2019 02:37:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d08</guid><description><![CDATA[<p>case_name: Dana Farber Cancer Insitute, Boston, Massachusetts</p><p>case_numbers: 07-1797; 08-1631; 11-0211; 11-0596; 11-0609</p><p>decision_date: Wed, 28 May 2014 12:00:00 -0400</p><p>decision_number: 2014D08</p><p>fiscal_year_end: 2004-2008</p><p>provider_number: 22-0162</p><p>summary: Whether the Medicare Administrative Contractor (MAC)erred in disallowing certain of the costs associated with Dana Farber Cancer Institute (the "Provider") state provider tax expense in the Provider's Fiscal Year 2004 through Fiscal Year 2008 cost reporting periods.</p>]]></description></item><item><title>2014D06</title><pubDate>Mon, 04 Nov 2019 02:37:29 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d06</guid><description><![CDATA[<p>case_name: Accord Health 2005 Crossover Bad Debts Group</p><p>case_numbers: 07-2006GC</p><p>decision_date: Thu, 10 Apr 2014 12:00:00 -0400</p><p>decision_number: 2014D06</p><p>fiscal_year_end: June 30, 2005</p><p>provider_number: 39-5680, 39-5047 and 39-5409</p><p>summary: Whether the Intermediary's exclusion of unbilled crossover bad debts was proper.</p>]]></description></item><item><title>2014D07</title><pubDate>Mon, 04 Nov 2019 02:37:29 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d07</guid><description><![CDATA[<p>case_name: Deborah Heart and Lung Center
Brown Mills, New Jersey </p><p>case_numbers: 12-0144</p><p>decision_date: Tue, 15 Apr 2014 12:00:00 -0400</p><p>decision_number: 2014D07</p><p>fiscal_year_end: December 31, 2011</p><p>provider_number: 31-0031</p><p>summary: Whether CMS improperly denied the Provider's request to be reclassified as a rural hospital.</p>]]></description></item><item><title>2014D05</title><pubDate>Mon, 04 Nov 2019 02:37:28 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d05</guid><description><![CDATA[<p>case_name: Ashton Hall Nursing &#x26; Rehabilitation Center
Philadelphia, PA</p><p>case_numbers: 07-2069</p><p>decision_date: Wed, 09 Apr 2014 12:00:00 -0400</p><p>decision_number: 2014D05</p><p>fiscal_year_end: June 30, 2005</p><p>provider_number: 39-5110</p><p>summary: Whether the Intermediary's adjustment to disallow Medicare Bad Debts on the Medicare Cost Report was proper.</p>]]></description></item><item><title>2014D04</title><pubDate>Mon, 04 Nov 2019 02:37:27 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d04</guid><description><![CDATA[<p>case_name: Canon Health Care Hospice, LLC
Gulfport, Mississi</p><p>case_numbers: 11-0010</p><p>decision_date: Tue, 08 Apr 2014 12:00:00 -0400</p><p>decision_number: 2014D04</p><p>fiscal_year_end: October 31, 2008</p><p>provider_number: 25-1627</p><p>summary: Notice of Effect of Inpatient Day Limitation and Hospice Cap Amount </p>]]></description></item><item><title>2014D03</title><pubDate>Mon, 04 Nov 2019 02:37:11 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d03</guid><description><![CDATA[<p>case_name: Danbury Hospital</p><p>case_numbers: 08-2838</p><p>decision_date: Tue, 11 Feb 2014 12:00:00 -0500</p><p>decision_number: 2014D03</p><p>fiscal_year_end: September 30, 2005</p><p>provider_number: 07-0033</p><p>summary: Whether the Provider Reimbursement Review Board ("Board") has jurisdiction over a claim for Medicaid Eligible Days for which there was no adjustment made by the Intermediary within the Notice of Program Reimbursement.</p>]]></description></item><item><title>2014D02</title><pubDate>Mon, 04 Nov 2019 02:36:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d02</guid><description><![CDATA[<p>case_name: Hospice Complete, Inc.
Hospice Complete, Inc./Southern Care
2008 Hospice Cap CIRP Group
</p><p>case_numbers: 09-1888; 09-1889 and 10-1057GC</p><p>decision_date: Wed, 27 Nov 2013 12:00:00 -0500</p><p>decision_number: 2014D02</p><p>fiscal_year_end: October 31, 2006; October 31, 2007; October 31, 2008</p><p>provider_number: 01-1600 and 01-1662</p><p>summary: Whether the Providers' cap liability for 2006-2008 should be recalculated in light of SouthernCare Hospice's monetary settlement of the qui tam lawsuits filed against it in the United States District Court for the Northern District of Alabama at case numbers 2:05-cv-00873 and 2:07-cv-02325</p>]]></description></item><item><title>2014D01</title><pubDate>Mon, 04 Nov 2019 02:36:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2014d01</guid><description><![CDATA[<p>case_name: Owensboro Medical Health System
Owensboro, Kentucky
</p><p>case_numbers: 06-0615; 06-0651; 06-2373
</p><p>decision_date: Tue, 19 Nov 2013 12:00:00 -0500</p><p>decision_number: 2014D01</p><p>fiscal_year_end: May 31, 2003; May 31,2004 and May 31,2005</p><p>provider_number: 18-0038</p><p>summary: Whether medical assistance/general assistance days associated with patients covered under the Kentucky State Plan should be included in the numerator of the Medicaid proxy of the Medicare disproportionate share hospital ("DSH") calculation pursuant to § 1886(d)(5)(F)(vi)(II) of the Social Security Act, as amended.</p>]]></description></item><item><title>2013D42</title><pubDate>Mon, 04 Nov 2019 02:36:29 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d42</guid><description><![CDATA[<p>decision_number: 2013D42</p><p>fiscal_year_end: 09/30/2003</p><p>provider_number: 22-0001</p><p>summary: Whether the observation bed days for the Provider's fiscal year ending September 30, 2003 ("FY 2003") were properly netted from the calculation of the bed count for purposes of qualifying for a disproportionate share hospital ("DSH") payment, the DSH calculation?
</p>]]></description></item><item><title>2013D41</title><pubDate>Mon, 04 Nov 2019 02:36:29 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d41</guid><description><![CDATA[<p>decision_number: 2013D41</p><p>fiscal_year_end: June 30, 1994 through December 31, 2005</p><p>provider_number: Various</p><p>summary: Whether CMS properly omitted from the Providers' DSH calculation the patient days of individuals who were Supplemental Security Income ("SSI") recipients but who had the amount of their cash payments reduced to zero while they remained in a nursing home?</p>]]></description></item><item><title>2013D36</title><pubDate>Mon, 04 Nov 2019 02:36:27 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d36</guid><description><![CDATA[<p>case_name: St. Luke 2001-2007 DSH Inclusion of Title XIX Eligible Days CIRP Group
</p><p>case_numbers: 09-1573GC</p><p>decision_date: Mon, 09 Sep 2013 12:00:00 -0400</p><p>decision_number: 2013D36</p><p>fiscal_year_end: Various</p><p>provider_number: 18-0011; 18-0045</p><p>summary: Whether days associated with patients covered under the Kentucky Hospital Care Program should be included in the numerator of the Medicaid proxy of the Medicare disproportionate share. hospital ("DSH") calculation pursuant to §1886(d)(5)(F)(vi)(II) of the Social Security Act as amended.
</p>]]></description></item><item><title>2013D40</title><pubDate>Mon, 04 Nov 2019 02:36:26 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d40</guid><description><![CDATA[<p>case_name: Toyon DSH General Assistance Days Groups 1989-2000
</p><p>case_numbers: Various</p><p>decision_date: Tue, 17 Sep 2013 12:00:00 -0400</p><p>decision_number: 2013D40</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether State only eligible (but unpaid) patient days (commonly referred to as General Assistance or GA days), were erroneously excluded from the Medicaid proxy in the Disproportionate Share Hospital (DSH) calculations.</p>]]></description></item><item><title>2013D37</title><pubDate>Mon, 04 Nov 2019 02:36:26 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d37</guid><description><![CDATA[<p>case_name: Hall Render Pension/Post Retirement Wage
Index Appeals FFY 2007 through 2011
</p><p>case_numbers: Various</p><p>decision_date: Wed, 11 Sep 2013 12:00:00 -0400</p><p>decision_number: 2013D37</p><p>fiscal_year_end: 2007 through 2011</p><p>provider_number: Various</p><p>summary: Whether the Fiscal Intermediaries' adjustments to pension costs for the affected providers resulted in erroneous wage indices for the areas where adjustments were made.</p>]]></description></item><item><title>2013D38</title><pubDate>Mon, 04 Nov 2019 02:36:26 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d38</guid><description><![CDATA[<p>case_name: Washington General Assistance Days
Groups
</p><p>case_numbers: 00-3186G; 04-0361G; 05-0439G; 06-1812G: 08-1845G; 09-1503GC; 09-1581GC; 09-1743GC; 10-0088GC; 10-0129G; 10-0190GC</p><p>decision_date: Thu, 12 Sep 2013 12:00:00 -0400</p><p>decision_number: 2013D38</p><p>fiscal_year_end: 09/30/2003</p><p>provider_number: Various</p><p>summary: Should patient days associated with the Medically Indigent and General Assistance/Unemployable Programs in Washington State be included in the numerator of the Medicaid fraction of the Medicare Disproportionate Share Hospital ("DSH") payment
calculation formula in accordance. with 42 C.F.R. § 412.106(b)(4) and § 1886(d)(5)(F)(vi)(II)1 of
the Social Security Act?
</p>]]></description></item><item><title>2013D39</title><pubDate>Mon, 04 Nov 2019 02:36:25 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d39</guid><description><![CDATA[<p>provider_number: 15-0084</p><p>summary: Whether the Provider Reimbursement Review Board ("Board") has jurisdiction over Ambulatory Surgery Costs and Organ Acquisition Costs where the Intermediary made no audit adjustment to the cost report?</p>]]></description></item><item><title>2013D35</title><pubDate>Mon, 04 Nov 2019 02:36:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d35</guid><description><![CDATA[<p>case_name: Cleveland Clinic Hospital
Cleveland, OH </p><p>case_numbers: 06-0328</p><p>decision_date: Fri, 06 Sep 2013 12:00:00 -0400</p><p>decision_number: 2013D35</p><p>fiscal_year_end: 12/31/2002</p><p>provider_number: 36-0180</p><p>summary: Whether the contractor's decision to exclude certain physician Medicare Part A administrative costs under time study codes L and O from the Provider's fiscal year (FY) 2002 wage index data in calculating the FY 2006 wage index should be reversed? </p>]]></description></item><item><title>2013D31</title><pubDate>Mon, 04 Nov 2019 02:36:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d31</guid><description><![CDATA[<p>case_name: All Care Home Health 2012 2% Reduction CIRP Group</p><p>case_numbers: 12-0411GC</p><p>decision_date: Wed, 04 Sep 2013 12:00:00 -0400</p><p>decision_number: 2013D31</p><p>fiscal_year_end: CY2012</p><p>provider_number: Various</p><p>summary: Whether the imposition of a 2 percent reduction in All Care Home Health, All Care Home Health of San Gabriel, and Comcare Home Health, Inc. Medicare payments for calendar year 2012 was proper.</p>]]></description></item><item><title>2013D33</title><pubDate>Mon, 04 Nov 2019 02:36:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d33</guid><description><![CDATA[<p>case_name: MS Healthcare Center, Inc.
Edinburg, Texas
</p><p>case_numbers: 12-0409</p><p>decision_date: Wed, 28 Aug 2013 12:00:00 -0400</p><p>decision_number: 2013D33</p><p>fiscal_year_end: CY 2012</p><p>provider_number: 67-9201</p><p>summary: Whether the imposition of a 2 percent reduction in MS Healthcare Center, Inc.'s Medicare payments for calendar year 2012 was proper? </p>]]></description></item><item><title>2013D32</title><pubDate>Mon, 04 Nov 2019 02:36:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d32</guid><description><![CDATA[<p>case_name: Carinosa Healthcare, Inc.
McAllen, Texas
</p><p>case_numbers: 12-0408</p><p>decision_date: Wed, 28 Aug 2013 12:00:00 -0400</p><p>decision_number: 2013D32</p><p>fiscal_year_end: CY 2012</p><p>provider_number: 45-3108</p><p>summary: Whether the imposition of a 2 percent reduction in Carinosa Healthcare, Inc.'s Medicare payments for calendar year 2012 was proper? </p>]]></description></item><item><title>2013D34</title><pubDate>Mon, 04 Nov 2019 02:36:18 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d34</guid><description><![CDATA[<p>case_name: Porter Hospital
Middlebury, Vermont</p><p>case_numbers: 07-2753</p><p>decision_date: Thu, 29 Aug 2013 12:00:00 -0400</p><p>decision_number: 2013D34</p><p>fiscal_year_end: 09/30/2004</p><p>provider_number: 47-0006</p><p>summary: Whether the Provider documented that it experienced in a cost-reporting period compared to the previous cost-reporting period a decrease of more than 5 percent in its total number of patient discharges due to circumstances beyond its control in accordance with 42.U.S:C. § 1395www(d)(5)(D)(ii).
</p>]]></description></item><item><title>2013D30</title><pubDate>Mon, 04 Nov 2019 02:36:18 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d30</guid><description><![CDATA[<p>case_name: LivinRite Home Health Services
Manassas, VA
</p><p>case_numbers: 12-0410</p><p>decision_date: Tue, 27 Aug 2013 12:00:00 -0400</p><p>decision_number: 2013D30</p><p>fiscal_year_end: CY 2012</p><p>provider_number: 49-7593</p><p>summary: Whether the imposition of a 2 percent reduction in LivinRite Home Health Services' Medicare payments for calendar year 2012 was proper.</p>]]></description></item><item><title>2013D28</title><pubDate>Mon, 04 Nov 2019 02:36:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d28</guid><description><![CDATA[<p>case_name: Sun City Home Care, Inc. El Paso, TX</p><p>case_numbers: 12-0208</p><p>decision_date: Tue, 27 Aug 2013 12:00:00 -0400</p><p>decision_number: 2013D28</p><p>fiscal_year_end: CY 2012</p><p>provider_number: 67-7207</p><p>summary: Whether the imposition of a 2 percent reduction in the Medicare payments to the home health agency for calendar year 2012 was proper?</p>]]></description></item><item><title>2013D29</title><pubDate>Mon, 04 Nov 2019 02:36:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d29</guid><description><![CDATA[<p>case_name: Spectrum Home Care, Inc. Detroit, MI</p><p>case_numbers: 12-0251</p><p>decision_date: Tue, 27 Aug 2013 12:00:00 -0400</p><p>decision_number: 2013D29</p><p>fiscal_year_end: CY2012</p><p>provider_number: 23-7251</p><p>summary: Whether the imposition of a 2 percent reduction in the Medicare payments to the home health agency for calendar year 2012 was proper?</p>]]></description></item><item><title>2013D27</title><pubDate>Mon, 04 Nov 2019 02:36:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d27</guid><description><![CDATA[<p>case_name: Inteli Home Healthcare, Inc. Houston, Texas</p><p>case_numbers: 12-0180</p><p>decision_date: Thu, 22 Aug 2013 12:00:00 -0400</p><p>decision_number: 2013D27</p><p>fiscal_year_end: CY 2012</p><p>provider_number: 45-9410</p><p>summary: Whether the imposition of a 2 percent reduction in the Medicare payments to the home health agency for calendar year 2012 was proper. </p>]]></description></item><item><title>2013D26</title><pubDate>Mon, 04 Nov 2019 02:36:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d26</guid><description><![CDATA[<p>case_name: CMK Home Health Agency, Inc. Westmont, Illinois</p><p>case_numbers: 12-0407</p><p>decision_date: Thu, 22 Aug 2013 12:00:00 -0400</p><p>decision_number: 2013D26</p><p>fiscal_year_end: CY 2012</p><p>provider_number: 14-7970</p><p>summary: Whether the imposition of a 2 percentage point reduction in the annual market basket percentage update for CMK Home Health Agency, Inc.'s Medicare payments for calendar year 2012 was proper?</p>]]></description></item><item><title>2013D25</title><pubDate>Mon, 04 Nov 2019 02:36:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d25</guid><description><![CDATA[<p>case_name: Medical Professionals for Home Care, Inc.
Chicago, IL </p><p>case_numbers: 12-0250</p><p>decision_date: Wed, 21 Aug 2013 12:00:00 -0400</p><p>decision_number: 2013D25</p><p>fiscal_year_end: CY 2012</p><p>provider_number: 14-7244</p><p>summary: Whether the imposition of a 2 percent reduction in the Medicare payments to the home health agency for calendar year 2012 was proper?</p>]]></description></item><item><title>2013D24</title><pubDate>Mon, 04 Nov 2019 02:36:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d24</guid><description><![CDATA[<p>case_name: LifePoint Hospital 05-07 DSH Pymt
Inclusion Title XIX Eligible Days CIRP
Group
</p><p>case_numbers: 08-0120G</p><p>decision_date: Mon, 19 Aug 2013 12:00:00 -0400</p><p>decision_number: 2013D24</p><p>fiscal_year_end: 2005-2007</p><p>provider_number: 18-0116; 18-0132</p><p>summary: Whether days associated with patients covered under the Kentucky Hospital Care Program ("KHCP") should be included in the numerator of the Medicaid proxy of the Medicare disproportionate share hospital ("DSH") calculation pursuant to§ 1886(d)(5)(F)(vi)(II) of the Social Security Act as amended. </p>]]></description></item><item><title>2013D22</title><pubDate>Mon, 04 Nov 2019 02:35:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d22</guid><description><![CDATA[<p>case_name: Holy Redeemer Hospital and Medical Center
Philadelphia, PA
</p><p>case_numbers: 02-1305</p><p>decision_date: Wed, 31 Jul 2013 12:00:00 -0400</p><p>decision_number: 2013D22</p><p>fiscal_year_end: 06/30/2000</p><p>provider_number: 39-0097</p><p>summary: Whether the Intermediary's adjustment disallowing therapy services claims pursuant to a comprehensive medical review was proper?</p>]]></description></item><item><title>2013D21</title><pubDate>Mon, 04 Nov 2019 02:35:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d21</guid><description><![CDATA[<p>case_name: QRS UMHC 1991-1996 DSH/Michigan
General Assistance Days Group
</p><p>case_numbers: 07-2446G</p><p>decision_date: Thu, 25 Jul 2013 12:00:00 -0400</p><p>decision_number: 2013D21</p><p>fiscal_year_end: 1991-1996 &#x26; 2003-2006</p><p>provider_number: 23-0046</p><p>summary: Whether days associated with patients covered under the Michigan Indigent/Charity Care Program should be included in the numerator of the Medicaid proxy of the Medicare disproportionate share hospital ("DSH") calculation pursuant to§ 1886(d)(5)(F)(vi)(II) of the Social Security Act, as amended. </p>]]></description></item><item><title>2013D23</title><pubDate>Mon, 04 Nov 2019 02:35:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d23</guid><description><![CDATA[<p>case_name: QRS DSH Florida/General Assistance Days Groups
</p><p>case_numbers: 07-2057G; 07-2058G; 07-2059G; 07-2060G; 07-2061G;
07-2308G and 09-1563G
</p><p>decision_date: Wed, 31 Jul 2013 12:00:00 -0400</p><p>decision_number: 2013D23</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary properly excluded Medicaid eligible Florida Charity Care and Low­ Income days from the disproportionate share hospital ("DSH") calculation.</p>]]></description></item><item><title>2013D20</title><pubDate>Mon, 04 Nov 2019 02:35:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d20</guid><description><![CDATA[<p>case_name: Mountain View Regional Medical Center</p><p>case_numbers: 07-0401</p><p>decision_date: Tue, 02 Jul 2013 12:00:00 -0400</p><p>decision_number: 2013D20</p><p>fiscal_year_end: 03/31/2003</p><p>provider_number: 32-0085</p><p>summary: Whether the Intermediary's determination that the Provider should be reimbursed under the federal rate of the inpatient prospective payment system for capital costs for the fiscal year end
2003 was proper.</p>]]></description></item><item><title>2013D19</title><pubDate>Mon, 04 Nov 2019 02:35:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d19</guid><description><![CDATA[<p>case_name: River Region Medical Center
Vicksburg, MS</p><p>case_numbers: 03-1339</p><p>decision_date: Wed, 05 Jun 2013 12:00:00 -0400</p><p>decision_number: 2013D19</p><p>fiscal_year_end: 06/30/1999</p><p>provider_number: 25-0031</p><p>summary: Did the Intermediary correctly determine the Provider's disproportionate share hospital ("DSH")payment for the fiscal period November 1, 1998 to June 30, 1999?</p>]]></description></item><item><title>2013D15</title><pubDate>Mon, 04 Nov 2019 02:35:26 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d15</guid><description><![CDATA[<p>case_name: St. Francis Medical Center
Cape Girardeau, Missouri
</p><p>case_numbers: 07-0235</p><p>decision_date: Wed, 08 May 2013 12:00:00 -0400</p><p>decision_number: 2013D15</p><p>fiscal_year_end: 06/30/2004</p><p>provider_number: 26-0183</p><p>summary: Whether the Intermediary used the correct number of days when computing the disproportionate share percentage when the cost-reporting periods overlapped April1, 2004.</p>]]></description></item><item><title>2013D16</title><pubDate>Mon, 04 Nov 2019 02:35:26 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d16</guid><description><![CDATA[<p>case_name: BB&#x26;L 95-03 IME Research FTE Group
Seattle, Washington
</p><p>case_numbers: 05-1479G</p><p>decision_date: Thu, 09 May 2013 12:00:00 -0400</p><p>decision_number: 2013D16</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether time spent in research when the residents were assigned to the inpatient prospective payment system portion and/or the outpatient department of the Providers should be included in the full-time equivalent counts ("FTE") for indirect medical education ("IME") payment in the Providers' IME FTE Count Cost Reports pursuant to 42 C.F.R.§ 412.105 (1999).
</p>]]></description></item><item><title>2013D17</title><pubDate>Mon, 04 Nov 2019 02:35:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d17</guid><description><![CDATA[<p>case_name: Alpena Dialysis Services
Alpena, Michigan
</p><p>case_numbers: 09-0234</p><p>decision_date: Tue, 14 May 2013 12:00:00 -0400</p><p>decision_number: 2013D17</p><p>fiscal_year_end: 03/01/2000</p><p>provider_number: 23-2553</p><p>summary: Whether CMS' denial of the Provider's request for an exception to the ESRD composite rate was proper?</p>]]></description></item><item><title>2013D18</title><pubDate>Mon, 04 Nov 2019 02:35:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d18</guid><description><![CDATA[<p>case_name: Blumberg Ribner 91-99 SNF 112% Peer
Mean Group
</p><p>case_numbers: 00-0655G</p><p>decision_date: Thu, 16 May 2013 12:00:00 -0400</p><p>decision_number: 2013D18</p><p>fiscal_year_end: 6/30/1991 to 6/30/1999</p><p>provider_number: Various</p><p>summary: Whether the methodology of the Centers for Medicare and Medicaid Services for determining the Providers' exception to the hospital-based skilled nursing facility ("HB-SNF") routine cost limit was proper.</p>]]></description></item><item><title>2013D14</title><pubDate>Mon, 04 Nov 2019 02:35:18 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d14</guid><description><![CDATA[<p>case_name: St. Francis Hospital, Inc.
Greenville, SC</p><p>case_numbers: 08-2778</p><p>decision_date: Thu, 02 May 2013 12:00:00 -0400</p><p>decision_number: 2013D14</p><p>fiscal_year_end: 08/31/2003</p><p>provider_number: 42-0023</p><p>summary: Whether the Intermediary's determination not to increase certain Medicare cost outlier payments was proper, where the outliers were underpaid because of an erroneous overpayment of DSH, which was a factor in the outlier amount calculation and which the MAC subsequently recouped without recalculating the affected outliers.</p>]]></description></item><item><title>2013D11</title><pubDate>Mon, 04 Nov 2019 02:34:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d11</guid><description><![CDATA[<p>provider_number: 15-0011</p><p>summary: Whether the Medicare Administrative Contractor's (MAC) denial of Marion General Hospital's Sole Community Hospital Low Volume Adjustment was proper based on procedural and timing requirements.</p>]]></description></item><item><title>2013D10</title><pubDate>Mon, 04 Nov 2019 02:34:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d10</guid><description><![CDATA[<p>case_name: QRS 1995, 2001-2002, 2004-2005 Missouri DSH/General Assistance Days Group
</p><p>case_numbers: 07-2274G</p><p>decision_date: Tue, 23 Apr 2013 12:00:00 -0400</p><p>decision_number: 2013D10</p><p>fiscal_year_end: 1995,2001-2002,2004-2005</p><p>provider_number: Various</p><p>summary: Whether days associated with patients covered under the Missouri State Plan should be included in the numerator of the Medicaid proxy of the Medicare disproportionate share hospital (DSH) calculation pursuant to the Social Security Act, as amended (Act). </p>]]></description></item><item><title>2013D12</title><pubDate>Mon, 04 Nov 2019 02:34:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d12</guid><description><![CDATA[<p>provider_number: 23-0217; 23-0075</p><p>summary: Whether the Intermediary appropriately included wage data from Trillium Hospital for purposes of calculating the Federal Fiscal Year 2006 hospital wage index ("FFY 2006 Wage Index") for the Battle Creek, Michigan Metropolitan Statistical Area.</p>]]></description></item><item><title>2013D13</title><pubDate>Mon, 04 Nov 2019 02:34:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d13</guid><description><![CDATA[<p>case_name: UMDNJ - University Hospital
Newark, New Jersey
</p><p>case_numbers: 03-0262,04-1461,05-0450, 06-1449, and 09-0710
</p><p>decision_date: Thu, 25 Apr 2013 12:00:00 -0400</p><p>decision_number: 2013D13</p><p>fiscal_year_end: June 30, 2000 - June 30, 2004</p><p>provider_number: 31-0119</p><p>summary: Whether the Medicare administrative contractor properly determined that the Provider was not entitled to reimbursement for medical education pass-through costs related to the university's nursing education and allied health program because the Provider did not meet the requirement of operating the program.</p>]]></description></item><item><title>2013D09</title><pubDate>Mon, 04 Nov 2019 02:34:35 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d09</guid><description><![CDATA[<p>case_name: Maine Type 6 Medicaid Dual Eligible Days
DSH Groups
</p><p>case_numbers: 09-0480G, 09-0383G, 09-0491G, 09-0487G, 07-2217G, 07-2291G
</p><p>decision_date: Fri, 29 Mar 2013 12:00:00 -0400</p><p>decision_number: 2013D09</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's reopening adjustment to exclude Type 6 Medicaid dual eligible days from the Providers' Medicaid fraction used in the calculation of the disproportionate share hospital adjustment was proper.</p>]]></description></item><item><title>2013D07</title><pubDate>Mon, 04 Nov 2019 02:33:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d07</guid><description><![CDATA[<p>case_name: HLB Wage Index Pension and Post
Retirement Cost Groups-
FFY 2007 and 2008
</p><p>case_numbers: Various</p><p>decision_date: Tue, 12 Mar 2013 12:00:00 -0400</p><p>decision_number: 2013D07</p><p>fiscal_year_end: FFY 2007 &#x26; 2008</p><p>provider_number: Various</p><p>summary: Whether the Intermediary improperly eliminated or reduced the pension and postretirement benefit ("PRB") costs of the University of California medical centers ("UC Providers"), and the pension costs of the Catholic Healthcare West medical centers ("CHW Providers") for the purposes of computing their prospective payment system ("PPS") wage indexes for federal fiscal years ("FFYs") 2007 and 2008.</p>]]></description></item><item><title>2013D04</title><pubDate>Mon, 04 Nov 2019 02:33:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d04</guid><description><![CDATA[<p>case_name: The Phoenix Clinic, North Miami FL</p><p>case_numbers: 11-0160</p><p>decision_date: Thu, 31 Jan 2013 12:00:00 -0500</p><p>decision_number: 2013D04</p><p>fiscal_year_end: 03/31/2009</p><p>provider_number: 10-4993</p><p>summary: Whether the Intermediary properly removed total costs and total payments.</p>]]></description></item><item><title>2013D06</title><pubDate>Mon, 04 Nov 2019 02:33:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d06</guid><description><![CDATA[<p>case_name: Mountain States Health Alliance 05 Bad
Debt- Passive Collection CIRP Group
</p><p>case_numbers: 08-0105GC</p><p>decision_date: Mon, 04 Mar 2013 12:00:00 -0500</p><p>decision_number: 2013D06</p><p>fiscal_year_end: 06/30/2004; 06/30/2005</p><p>provider_number: 44-0176; 44-0063</p><p>summary: Whether the Intermediary's adjustments to remove Medicare bad debts from the Providers' cost reports were proper?</p>]]></description></item><item><title>2013D08</title><pubDate>Mon, 04 Nov 2019 02:33:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d08</guid><description><![CDATA[<p>case_name: Lima Memorial Hospital
Lima, OH
</p><p>case_numbers: 04-0376; 05-01805</p><p>decision_date: Wed, 13 Mar 2013 12:00:00 -0400</p><p>decision_number: 2013D08</p><p>fiscal_year_end: 12/31/2000; 12/31/2001</p><p>provider_number: 36-0009</p><p>summary: Whether the Intermediary improperly calculated reimbursement for the Provider's skilled nursing facility unit during the skilled nursing facility PPS (prospective payment system) transition period.</p>]]></description></item><item><title>2013D05</title><pubDate>Mon, 04 Nov 2019 02:33:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d05</guid><description><![CDATA[<p>case_name: Maine Coast Memorial Hospital, Ellsworth ME</p><p>case_numbers: 11-0570</p><p>decision_date: Thu, 21 Feb 2013 12:00:00 -0500</p><p>decision_number: 2013D05</p><p>fiscal_year_end: 06/30/2009</p><p>provider_number: 20-0050</p><p>summary: Was Maine Coast Memorial Hospital's request to be designated as a Sole Community Hospital properly denied?</p>]]></description></item><item><title>2013D02</title><pubDate>Mon, 04 Nov 2019 02:32:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d02</guid><description><![CDATA[<p>case_name: QRS 93-07 DSH/Iowa Indigent
Patient/Charity Care (GA) Group
</p><p>case_numbers: 06-1735G</p><p>decision_date: Wed, 21 Nov 2012 12:00:00 -0500</p><p>decision_number: 2013D02</p><p>fiscal_year_end: 06/30/1996 to 06/30/2007</p><p>provider_number: 16-0067; 28-0013</p><p>summary: Whether days associated with patients covered under the Iowa State Plan should be included in the numerator of the Medicaid proxy of the Medicare disproportionate share hospital (DSH) calculation pursuant to § 1886(d)(5)(F)(vi)(II) of the Social Security Act, as amended (Act).</p>]]></description></item><item><title>2013D01</title><pubDate>Mon, 04 Nov 2019 02:32:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d01</guid><description><![CDATA[<p>case_name: QRS 1995, 1996, 1998-2007
DSH/Pennsylvania General Assistance
Days Group
</p><p>case_numbers: 07-2447G</p><p>decision_date: Tue, 20 Nov 2012 12:00:00 -0500</p><p>decision_number: 2013D01</p><p>fiscal_year_end: 06/30/1995 to 06/30/2007</p><p>provider_number: 39-0009; 39-0147</p><p>summary: Whether medical assistance/general assistance days associated with patients covered under the Pennsylvania State Plan should be included in the numerator of the Medicaid proxy of the Medicare disproportionate share hospital (DSH) calculation pursuant to §1886(d)(S)(F)(vi)(II) of the Social Security Act, as amended (Act).</p>]]></description></item><item><title>2013D03</title><pubDate>Mon, 04 Nov 2019 02:32:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2013d03</guid><description><![CDATA[<p>case_name: Maine Medical Center
Portland, Maine
</p><p>case_numbers: 06-1318; 07-1386</p><p>decision_date: Thu, 29 Nov 2012 12:00:00 -0500</p><p>decision_number: 2013D03</p><p>fiscal_year_end: 09/30/2002; 09/30/2003</p><p>provider_number: 20-0009</p><p>summary: Whether the Intermediary's exclusion of the crossover bad debts for cost reporting periods ended
September 30, 2002 and September 30, 2003 due to a lack of documentation was proper.
</p>]]></description></item><item><title>2012D23</title><pubDate>Mon, 04 Nov 2019 02:32:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d23</guid><description><![CDATA[<p>case_name: QRS 1991-2006 Colorado DSH/General Assistance Days Group</p><p>case_numbers: 07-2273G</p><p>decision_date: Thu, 06 Sep 2012 12:00:00 -0400</p><p>decision_number: 2012D23</p><p>fiscal_year_end: 1991-2006</p><p>provider_number: Various</p><p>summary: Whether days associated with patients covered under the Colorado Indigent Care Program (CICP) should be included in the numerator of the Medicaid proxy of the Medicare disproportionate share hospital (DSH) calculation pursuant to § 1886(d)(5)(F)(vi)(Il) of the Social Security Act, as amended (Act).</p>]]></description></item><item><title>2012D24</title><pubDate>Mon, 04 Nov 2019 02:32:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d24</guid><description><![CDATA[<p>case_name: Swedish American Hospital, Rockford, IL</p><p>case_numbers: 07-0624; 08-0441; 08-2005; 09-0768</p><p>decision_date: Thu, 06 Sep 2012 12:00:00 -0400</p><p>decision_number: 2012D24</p><p>fiscal_year_end: 05/31/2004 to 05/31/2007</p><p>provider_number: 14-0228</p><p>summary: Whether the Intermediary's adjustments reducing the 1996 base year IME/GME FTE  count for osteopathic and allopathic medicine interns and residents and their effect on the May 31, 2004 through May 31, 2007 FTE counts are correct.</p>]]></description></item><item><title>2012D25</title><pubDate>Mon, 04 Nov 2019 02:32:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d25</guid><description><![CDATA[<p>case_name: Bergen Regional Medical Center, Paramus, NJ</p><p>case_numbers: 10-1237; 10-1236; 10-1235; 12-0034; 12-0033</p><p>decision_date: Tue, 25 Sep 2012 12:00:00 -0400</p><p>decision_number: 2012D25</p><p>fiscal_year_end: 12/31/2005 to 12/31/2009</p><p>provider_number: 31-0058</p><p>summary: Whether the Provider Reimbursement Review Board ("Board") has jurisdiction over the
calculation of the Provider's 1996 Indirect Medical Education ("IME") Cap Reduction for the redistribution of unused residency slots.</p>]]></description></item><item><title>2012D22</title><pubDate>Mon, 04 Nov 2019 02:32:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d22</guid><description><![CDATA[<p>case_name: Lemuel Shattuck Hospital, Jamaica Plain, MA</p><p>case_numbers: 08-1580; 10-0178; 10-0179</p><p>decision_date: Fri, 10 Aug 2012 12:00:00 -0400</p><p>decision_number: 2012D22</p><p>fiscal_year_end: 6/30/2003; 6/30/2004; 6/30/2005</p><p>provider_number: 22-2006</p><p>summary: Whether the allocation of the physician costs between Part A and Part B was proper.</p>]]></description></item><item><title>2012D21</title><pubDate>Mon, 04 Nov 2019 02:32:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d21</guid><description><![CDATA[<p>case_name: San Joaquin Community Hospital -SNF Bakersfield, CA</p><p>case_numbers: 97-2425R</p><p>decision_date: Wed, 08 Aug 2012 12:00:00 -0400</p><p>decision_number: 2012D21</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 05-0455</p><p>summary: Whether the Secretary's failure to reclassify costs in the peer group construction was arbitrary, capricious or plainly erroneous?</p>]]></description></item><item><title>2012D20</title><pubDate>Mon, 04 Nov 2019 02:32:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d20</guid><description><![CDATA[<p>case_name: John H. Stroger, Jr. Hospital of Cook County, Chicago IL</p><p>case_numbers: 08-1417</p><p>decision_date: Wed, 01 Aug 2012 12:00:00 -0400</p><p>decision_number: 2012D20</p><p>fiscal_year_end: 11/30/2004</p><p>provider_number: 14-0124</p><p>summary: Whether the Intermediary's exclusion of the physician malpractice expense from Worksheets A-8-2 and D-9 of the cost report was proper.</p>]]></description></item><item><title>2012D18</title><pubDate>Mon, 04 Nov 2019 02:31:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d18</guid><description><![CDATA[<p>case_name: Doctors Hospital, Columbus OH</p><p>case_numbers: 08-1404</p><p>decision_date: Wed, 18 Jul 2012 12:00:00 -0400</p><p>decision_number: 2012D18</p><p>fiscal_year_end: 06/30/2004</p><p>provider_number: 36-0152</p><p>summary: Did the Intermediary properly disallow Medicare bad debt expense- specifically, did the Intermediary correctly disallow those claims from the sample review where the Provider was unable to produce all of the documentation from the patient file used to substantiate the
indigency determination.</p>]]></description></item><item><title>2012D19</title><pubDate>Mon, 04 Nov 2019 02:31:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d19</guid><description><![CDATA[<p>case_name: HCR Manor Care 1999 Laundry and Central Supply Statistics Group</p><p>case_numbers: 02-0387GC</p><p>decision_date: Thu, 19 Jul 2012 12:00:00 -0400</p><p>decision_number: 2012D19</p><p>fiscal_year_end: 05/31/1999</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's adjustments to the Laundry and Linen and the Central Service and Supply statistics were proper.</p>]]></description></item><item><title>2012D17</title><pubDate>Mon, 04 Nov 2019 02:31:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d17</guid><description><![CDATA[<p>case_name: Ober Kaler DSH Charity Care Groups</p><p>case_numbers: 04-2249G; 10-0431GC; 10-432GC; 10-433GC; 10-434GC; 10-435GC; 10-0436GC; 04-2265G; 10-1206GC; 10-1211GC; 10-1212GC; 10-1213GC; 10-1214GC; 10-1215GC; 10-1216GC; 10-1217GC; 05-1862G; 10-1218GC; 10-1219GC; 10-1220GC; 10-1221GC; 10-1222GC; 10-1223GC; 10-1224GC; 06-1816G; 10-1225GC; 10-1226GC; 10-1227GC; 10-1228GC; 10-1229GC; 10-1230GC; 10-1231GC; 12-1232GC; 07-1466G; 09-2301G; 09-0811GC; 11-0082GC; 10-1090GC; 11-0081GC; 10-0183GC; 11-0079GC; 11-0080GC; 10-1095GC</p><p>decision_date: Wed, 20 Jun 2012 12:00:00 -0400</p><p>decision_number: 2012D17</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether days associated with patients covered under the New Jersey Charity Care Program should be included in the numerator of the Medicaid proxy of the Medicare disproportionate share hospital (DSH) calculation pursuant to § 1886(d)(5)(F)(vi)(II) of the Social Security Act, as amended.</p>]]></description></item><item><title>2012D16</title><pubDate>Mon, 04 Nov 2019 02:31:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d16</guid><description><![CDATA[<p>case_name: Alegent Health - Immanuel Medical Center, Omaha NE</p><p>case_numbers: 07-0552; 07-2253</p><p>decision_date: Fri, 15 Jun 2012 12:00:00 -0400</p><p>decision_number: 2012D16</p><p>fiscal_year_end: 06/30/2004; 06/30/2005</p><p>provider_number: 28-0081</p><p>summary: Were the Intermediary's adjustments to disallow the Provider's indirect medical education (IME) and direct graduate medical education (DGME) reimbursement for its graduate medical education activities correct?</p>]]></description></item><item><title>2012D13</title><pubDate>Mon, 04 Nov 2019 02:31:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d13</guid><description><![CDATA[<p>case_name: Fort Wayne (Indiana) FFY 2002 MSA Wage Index Group</p><p>case_numbers: 02-0529G</p><p>decision_date: Fri, 16 Mar 2012 12:00:00 -0400</p><p>decision_number: 2012D13</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Fiscal Intermediary and the Centers for Medicare and Medicaid Services (CMS) appropriately included certain paid hours not actually worked by Parkview Health System (Parkview) employees for purposes of calculating the federal fiscal year 2002 wage index for the Fort Wayne, Indiana, Metropolitan Statistical Area (MSA).</p>]]></description></item><item><title>2012D14</title><pubDate>Mon, 04 Nov 2019 02:31:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d14</guid><description><![CDATA[<p>case_name: Norwalk Hospital, Norwalk CT</p><p>case_numbers: 09-0704</p><p>decision_date: Mon, 19 Mar 2012 12:00:00 -0400</p><p>decision_number: 2012D14</p><p>fiscal_year_end: 09/30/2005</p><p>provider_number: 07-0034</p><p>summary: Whether the Provider Reimbursement Review Board has jurisdiction over Medicaid eligible days for which there was no adjustment made by the Intermediary within the Notice of Program Reimbursement.</p>]]></description></item><item><title>2012D09</title><pubDate>Mon, 04 Nov 2019 02:31:47 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d09</guid><description><![CDATA[<p>case_name: Rush University Medical Center, Chicago IL</p><p>case_numbers: 00-2351</p><p>decision_date: Wed, 08 Feb 2012 12:00:00 -0500</p><p>decision_number: 2012D09</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 14-0119</p><p>summary: 5-A. Were the Intermediary's adjustments to the Provider's bed count as used for purposes of the indirect medical education (IME) calculation proper?;
5-B. In calculating the Provider's bed count as used for purposes of IME calculation, should there have been a reduction for beds used for observation purposes?;
5-C. For purposes of the Provider's intern and resident count for IME, was the Intermediary correct in disallowing research rotations for residents participating in an approved medical residency program at the Provider?</p>]]></description></item><item><title>2011D07</title><pubDate>Mon, 04 Nov 2019 02:31:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d07</guid><description><![CDATA[<p>case_name: Marian Medical Center, Santa Maria CA</p><p>case_numbers: 00-1489</p><p>decision_date: Wed, 03 Nov 2010 12:00:00 -0400</p><p>decision_number: 2011D07</p><p>fiscal_year_end: 04/23/1997</p><p>provider_number: 05-0107</p><p>summary: Whether a loss on disposal of assets is required to be recognized by Medicare as a result of the April 24, 1997 statutory merger of the Provider.</p>]]></description></item><item><title>2012D07</title><pubDate>Mon, 04 Nov 2019 02:31:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d07</guid><description><![CDATA[<p>case_name: Alegent Health - Immanuel Medical Center</p><p>case_numbers: 06-1709; 05-0627; 06-0192; 06-1710</p><p>decision_date: Fri, 20 Jan 2012 12:00:00 -0500</p><p>decision_number: 2012D07</p><p>fiscal_year_end: 06/30/2000; 06/30/2001; 06/30/2002; 06/30/2003</p><p>provider_number: 28-0081</p><p>summary: Were the Intermediary's adjustments to disallow the Provider's indirect medical education (IME) and direct graduate medical education (DGME) reimbursement for its graduate medical education activities correct?</p>]]></description></item><item><title>2012D10</title><pubDate>Mon, 04 Nov 2019 02:31:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d10</guid><description><![CDATA[<p>case_name: Alameda Hospital- SNF</p><p>case_numbers: 98-0460</p><p>decision_date: Fri, 10 Feb 2012 12:00:00 -0500</p><p>decision_number: 2012D10</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 05-0211</p><p>summary: Whether the District of Columbia District Court's memorandum decision issued in this case finding the Secretary's methodology was improper under the precedent established in. Alaska Professional Hunters Association, Inc. vs. FAA, 177 F.3d 1030 (D.C. Cir.
1999) ("Alaska Hunters"), also applies to the Secretary's low occupancy adjustment.</p>]]></description></item><item><title>2012D15</title><pubDate>Mon, 04 Nov 2019 02:31:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d15</guid><description><![CDATA[<p>case_name: Canon Health Care Hospice, LLC, New Orleans LA</p><p>case_numbers: 09-0008</p><p>decision_date: Fri, 13 Apr 2012 12:00:00 -0400</p><p>decision_number: 2012D15</p><p>fiscal_year_end: 10/30/2006</p><p>provider_number: 19-1555</p><p>summary: Whether a full or partial waiver is permissible for the Provider's hospice inpatient day limitation overpayment for the cap year November 1, 2005, through October 31, 2006.</p>]]></description></item><item><title>2012D11</title><pubDate>Mon, 04 Nov 2019 02:31:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d11</guid><description><![CDATA[<p>case_name: Doctors Medical Center of Modesto, Modesto CA</p><p>case_numbers: 07-0900; 06-1259; 07-0824; 09-0905; 09-0908; 09-0903; 09-0904</p><p>decision_date: Fri, 24 Feb 2012 12:00:00 -0500</p><p>decision_number: 2012D11</p><p>fiscal_year_end: 05/31/2001 to 5/31/2007</p><p>provider_number: 05-0464</p><p>summary: Whether the Intermediary improperly eliminated all direct medical education and indirect medical education reimbursement for the Provider's family practice residency program for fiscal years ended May 31, 2001 through May 31, 2007.</p>]]></description></item><item><title>2012D04</title><pubDate>Mon, 04 Nov 2019 02:31:41 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d04</guid><description><![CDATA[<p>case_name: Oakwood Annapolis Hospital, Wayne, MI</p><p>case_numbers: 09-0894; 08-1351; 09-0892</p><p>decision_date: Fri, 30 Dec 2011 12:00:00 -0500</p><p>decision_number: 2012D04</p><p>fiscal_year_end: 12/31/2004; 12/31/2005; 12/31/2006</p><p>provider_number: 23-0142</p><p>summary: Did the Oakwood Annapolis Family Practice Residency Program, which received "provisional accreditation" from the Accreditation Council for Graduate Medical Education (ACGME) meet the definition of a "new" program in 2004.</p>]]></description></item><item><title>2012D06</title><pubDate>Mon, 04 Nov 2019 02:31:41 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d06</guid><description><![CDATA[<p>case_name: Lifespan SWC 2003 DSH Medicare Choice Days Group</p><p>case_numbers: 10-1386GC</p><p>decision_date: Wed, 18 Jan 2012 12:00:00 -0500</p><p>decision_number: 2012D06</p><p>fiscal_year_end: 09/30/2003</p><p>provider_number: Various</p><p>summary: Whether inpatient days for Medicaid-eligible patients who were enrolled in a Medicare Choice (M C) plan under Part C of the Medicare statute were properly excluded from the numerator of the Medicaid fraction that is used to calculate the disproportionate share hospital (DSH) payment.</p>]]></description></item><item><title>2012D12</title><pubDate>Mon, 04 Nov 2019 02:31:41 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d12</guid><description><![CDATA[<p>case_name: Research Medical Center, Kansas City MO</p><p>case_numbers: 06-0269</p><p>decision_date: Fri, 09 Mar 2012 12:00:00 -0500</p><p>decision_number: 2012D12</p><p>fiscal_year_end: 12/31/2001</p><p>provider_number: 26-0027</p><p>summary: Whether the Intermediary's determination of additional amounts paid to the Provider for nursing and allied health (N&#x26;AH) education costs associated with Medicare+ Choice (M+C) enrollees was proper.</p>]]></description></item><item><title>2012D05</title><pubDate>Mon, 04 Nov 2019 02:31:41 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d05</guid><description><![CDATA[<p>case_name: Youngstown-Warren 02 MSA Wage Index Group01/06/2012</p><p>case_numbers: 02-0531G</p><p>decision_date: Fri, 06 Jan 2012 12:00:00 -0500</p><p>decision_number: 2012D05</p><p>fiscal_year_end: FYE 2002</p><p>provider_number: Various</p><p>summary: 1. Did the Intermediary err in refusing to exclude Provider's "bonus" or "call back" hours paid from its Federal Fiscal Year (FFY) 2002 wage index calculations?; 2. Did the Intermediary err in refusing to include salary costs for Provider's Senior Vice President of Medical and Academic Affairs (Medical Director) from its FFY 2002 wage index calculations?; 3. Did the Intermediary err in refusing to include Provider's costs for contracted pathology services in its FFY 2002 wage index calculations?; 4. Did the Intermediary err in refusing to include Provider's costs for contracted perfusionist services in its FFY 2002 wage index calculations?; 5. Did the Intermediary err in refusing to include Provider's costs related to its self-insured workers' compensation fund in its FFY 2002 wage index calculations?; 6. Did the Intermediary err in refusing to include Provider's costs associated with an on-site day care center in its FFY 2002 wage index calculations?</p>]]></description></item><item><title>2012D08</title><pubDate>Mon, 04 Nov 2019 02:31:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d08</guid><description><![CDATA[<p>case_name: Rush University Medical Center, Chicago IL</p><p>case_numbers: 96-0819; 97-1814</p><p>decision_date: Wed, 08 Feb 2012 12:00:00 -0500</p><p>decision_number: 2012D08</p><p>fiscal_year_end: 06/30/1993; 06/30/1994</p><p>provider_number: 14-0119</p><p>summary: 1. Did the Intermediary properly calculate the number of interns and residents for FY 1993 for purposes of the Provider's graduate medical education?; 2-A. Were the Intermediary's adjustments to the Provider's bed count as used for purposes of the indirect medical education (IME) calculation proper?; 2-B. In calculating the Provider's bed count as used for purposes of the IME calculation, should there have been a reduction for beds used for observation purposes?; 2-C. For purposes of the Provider's intern and resident count for IME, was the Intermediary correct in disallowing research rotations for residents participating in an approved medical residency program at the Provider?</p>]]></description></item><item><title>2008D34</title><pubDate>Mon, 04 Nov 2019 02:24:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d34</guid><description><![CDATA[<p>case_name: Henry Ford Hospital. Detroit MI</p><p>case_numbers: 02-1010; 02-0892; 02-1663; 02-2148; 30-0597; 03-1011; 04-0021; 04-0022</p><p>decision_date: Fri, 12 Sep 2008 12:00:00 -0400</p><p>decision_number: 2008D34</p><p>fiscal_year_end: 12/31/1991-12/31/1999</p><p>provider_number: 23-0053</p><p>summary: 1. Whether the Intermediary properly excluded FTEs attributable to rotations by residents in certain unaccredited training programs.; 2. Whether the Intermediary properly excluded IME FTEs attributable to time spent by residents in research that was required by the residents' approved medical residency programs.(On the Record); 3. Whether the Intermediary properly excluded FTEs attributable to resident leave time when it is taken during rotations in which the resident is conducting reserarch.; 4. Whether the Intermediary properly excluded from the FTE cap, FTes attributable to time spent by residents in new programs.</p>]]></description></item><item><title>2007D65</title><pubDate>Mon, 04 Nov 2019 02:24:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d65</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d65</guid><description><![CDATA[<p>case_name: Baptist Memorial Hospital, Memphis TN</p><p>case_numbers: 03-0132</p><p>decision_date: Thu, 30 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D65</p><p>fiscal_year_end: 09/30/1995</p><p>provider_number: 44-0048</p><p>summary: 1. Whether the Centers for Medicare and Medicaid Services (CMS) properly disallowed the Provider's request for an exception to its Skilled Nursing Facility (SNF) Routine Service Cost Limit(RCL).; 2. Whether the Provider is entitled under CMS Program Memorandum (PM) A-99-62 to include the Social Security Act, Section 1115 waiver days for the expanded Medicaid populations (a/k/a Tenn Care) days in the Medicaid component of the disproportionate share hospital (DSH) adjustment calculation.</p>]]></description></item><item><title>2007D63</title><pubDate>Mon, 04 Nov 2019 02:24:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d63</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d63</guid><description><![CDATA[<p>case_name: Saint Mary's Mercy Medical Center, Grand Rapids MI</p><p>case_numbers: 03-0721; 04-0473</p><p>decision_date: Fri, 24 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D63</p><p>fiscal_year_end: 06/30/2000; 06/30/2001</p><p>provider_number: 23-0059</p><p>summary: Did the Intermediary properly calculate the Provider's disproportionate share payment adjustment in accordance with Medicare regulations as set forth in 42 C.F.R. Section 412.106?</p>]]></description></item><item><title>2010D52</title><pubDate>Mon, 04 Nov 2019 02:24:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d52</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d52</guid><description><![CDATA[<p>case_name: Southwest Consulting DSH Medicare Choice Days Groups</p><p>case_numbers: Various</p><p>decision_date: Thu, 30 Sep 2010 12:00:00 -0400</p><p>decision_number: 2010D52</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether Medicare Choice (M C) days should be included in the Medicaid fraction used to calculate the disproportionate share hospital (DSH) adjustment.</p>]]></description></item><item><title>2010D50</title><pubDate>Mon, 04 Nov 2019 02:24:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d50</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d50</guid><description><![CDATA[<p>case_name: Walter O. Boswell Memorial hospital, Sun City AZ</p><p>case_numbers: 06-1889; 06-1886; 06-1890; 02-1517; 06-1888; 06-1887; 06-0755; 06-0524; 06-1142</p><p>decision_date: Tue, 28 Sep 2010 12:00:00 -0400</p><p>decision_number: 2010D50</p><p>fiscal_year_end: 12/31/1995 - 12/31/2003</p><p>provider_number: 03-0061</p><p>summary: 1. Whether the Provider's nursing education program qualified as provider-operated.; 2. Whether, assuming the Provider's nursing education program did not qualify as provider-operated, the Provider is entitled to receive an additional payment to account for services provided to Medicare managed care patients (fiscal years 2000-2003 only).</p>]]></description></item><item><title>2009D28</title><pubDate>Mon, 04 Nov 2019 02:24:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d28</guid><description><![CDATA[<p>case_name: Lunch Hour Dispute Wage Index Group</p><p>case_numbers: 04-0597G; 05-0663G; 06-0682G; 03-0282G; 04-0598G</p><p>decision_date: Fri, 26 Jun 2009 12:00:00 -0400</p><p>decision_number: 2009D28</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether paid lunch period time should be added to hours used to calculate the Providers' hourly wage rates.</p>]]></description></item><item><title>2008D39</title><pubDate>Mon, 04 Nov 2019 02:24:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d39</guid><description><![CDATA[<p>case_name: Harrisburg Hospital/ Seidle Memorial Hospital, Harrisburg PA</p><p>case_numbers: 00-1456</p><p>decision_date: Fri, 26 Sep 2008 12:00:00 -0400</p><p>decision_number: 2008D39</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 39-0098</p><p>summary: Whether the Intermediary's adjustments disallowing the loss on disposal of depreciable assets through consolidation were proper.</p>]]></description></item><item><title>2008D38</title><pubDate>Mon, 04 Nov 2019 02:24:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d38</guid><description><![CDATA[<p>case_name: Polyclinic Medical Center, Harrisburg PA</p><p>case_numbers: 00-1454</p><p>decision_date: Fri, 26 Sep 2008 12:00:00 -0400</p><p>decision_number: 2008D38</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 39-0067</p><p>summary: Whether the Intermediary's adjustments disallowing the loss on disposal of depreciable assets through consolidation were proper.</p>]]></description></item><item><title>2011D43</title><pubDate>Mon, 04 Nov 2019 02:24:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d43</guid><description><![CDATA[<p>case_name: Kingsbrook Jewish Medical Center, Brooklyn NY</p><p>case_numbers: 05-0023</p><p>decision_date: Wed, 14 Sep 2011 12:00:00 -0400</p><p>decision_number: 2011D43</p><p>fiscal_year_end: 12/31/1999</p><p>provider_number: 33-0201</p><p>summary: Whether the Provider's cost reimbursement should be computed taking into account the charges included in the Provider's log of late charges which have not been billed to Medicare.</p>]]></description></item><item><title>2011D45</title><pubDate>Mon, 04 Nov 2019 02:24:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d45</guid><description><![CDATA[<p>case_name: Good Shepherd Rehabilitation Hospital, Bethlehem PA</p><p>case_numbers: 05-1802</p><p>decision_date: Thu, 15 Sep 2011 12:00:00 -0400</p><p>decision_number: 2011D45</p><p>fiscal_year_end: 06/30/2003</p><p>provider_number: 39-3050</p><p>summary: Whether the Intermediary properly reimbursed the Provider based on the blended rate for inpatient rehabilitation facilities (IRF) versus the 100 percent federal prospective payment system (PPS) rate for IRFs.</p>]]></description></item><item><title>2011D35</title><pubDate>Mon, 04 Nov 2019 02:24:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d35</guid><description><![CDATA[<p>case_name: Saint Mary and Elizabeth Medical Center- Claremont Campus, Chicago IL</p><p>case_numbers: 09-1970</p><p>decision_date: Thu, 16 Jun 2011 12:00:00 -0400</p><p>decision_number: 2011D35</p><p>fiscal_year_end: 12/31/2009</p><p>provider_number: 14-0094</p><p>summary: Whether CMS properly reduced the Provider's Outpatient Prospective Payment System (OPPS) Calendar Year (CY) 2009 market basket update by two (2.0) percentage points.</p>]]></description></item><item><title>2011D37</title><pubDate>Mon, 04 Nov 2019 02:24:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d37</guid><description><![CDATA[<p>case_name: Partners2002-2004 DSH Medicare+Choice Groups</p><p>case_numbers: 06-0867GC; 08-2122GC; 08-1592GC</p><p>decision_date: Thu, 30 Jun 2011 12:00:00 -0400</p><p>decision_number: 2011D37</p><p>fiscal_year_end: 09/30/2002-09/30/2004</p><p>provider_number: Various</p><p>summary: Should patient days attributable to Medicare beneficiaries who elected to enroll in a Medicare+Choice (M+C) plan be included in the numerator of the Medicaid fraction that was used to calculate each of the Providers' Disproportionate Share Hospital (DSH) payments under Section 1886(d)(5)(F) of the Social Security Act (42 U.S.C. Section 1395ww(d)(5)(F)), and 42 C.F.R. Section 412.106 for the cost reporting periods at issue?</p>]]></description></item><item><title>2008D12</title><pubDate>Mon, 04 Nov 2019 02:24:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d12</guid><description><![CDATA[<p>case_name: Baptist Regional Medical Center, Corbin, KT</p><p>case_numbers: 04-1491; 04-1495; 04-1496</p><p>decision_date: Mon, 10 Dec 2007 12:00:00 -0500</p><p>decision_number: 2008D12</p><p>fiscal_year_end: 08/31/1999-08/31/2001</p><p>provider_number: 18-0080</p><p>summary: Whether the Intermediary properly adjusted Medicare bad debts accounts considered indigent by the Provider.</p>]]></description></item><item><title>2010D23</title><pubDate>Mon, 04 Nov 2019 02:24:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d23</guid><description><![CDATA[<p>case_name: Life Care Center of Scottsdale</p><p>case_numbers: 07- 0459; 07-2370</p><p>decision_date: Wed, 31 Mar 2010 12:00:00 -0400</p><p>decision_number: 2010D23</p><p>fiscal_year_end: 12/31/2004; 12/31/2005</p><p>provider_number: 03-5143</p><p>summary: Whether the CMS must-bill policy applies to the Provider's dual-eligible bad debts when the Provider did not participate in the Medicaid program.</p>]]></description></item><item><title>2010D25</title><pubDate>Mon, 04 Nov 2019 02:24:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d25</guid><description><![CDATA[<p>case_name: Select Specialty '05 Medicare Dual Eligible Bad Debts Group</p><p>case_numbers: 08-0251G</p><p>decision_date: Tue, 13 Apr 2010 12:00:00 -0400</p><p>decision_number: 2010D25</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the CMS must-bill policy applies to the Providers' dual-eligible bad debts when the Providers did not participate in the Medicaid program.</p>]]></description></item><item><title>2000D85</title><pubDate>Mon, 04 Nov 2019 02:24:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d85</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d85</guid><description><![CDATA[<p>case_name: Sonoma Valley Hospital District, Sonoma CA</p><p>case_numbers: 96-2085</p><p>decision_date: Wed, 20 Sep 2000 12:00:00 -0400</p><p>decision_number: 2000D85</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 05-0090</p><p>summary: Was the Intermediary's calculation of the Skilled Nursing Facility (SNF) Routine Cost Limits (RCL) proper?</p>]]></description></item><item><title>2000D87</title><pubDate>Mon, 04 Nov 2019 02:24:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d87</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d87</guid><description><![CDATA[<p>case_name: Mercy General Hospital- SNF, Sacramento CA</p><p>case_numbers: 95-0634</p><p>decision_date: Fri, 22 Sep 2000 12:00:00 -0400</p><p>decision_number: 2000D87</p><p>fiscal_year_end: 03/31/1989</p><p>provider_number: 05-0017</p><p>summary: Was HCFA's denial of the Provider's routine cost limit (RCL) exception request proper?</p>]]></description></item><item><title>2009D30</title><pubDate>Mon, 04 Nov 2019 02:24:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d30</guid><description><![CDATA[<p>case_name: SRI 1998 DSH Medicare Part C Days Group</p><p>case_numbers: 04-2128G</p><p>decision_date: Thu, 09 Jul 2009 12:00:00 -0400</p><p>decision_number: 2009D30</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the exclusion of patient days attributable to Medicare Choice (M C) enrollees from the Medicaid fraction in calculating the Providers' disproportionate patient percentages contravenes the statute and regulations.</p>]]></description></item><item><title>2011D23</title><pubDate>Mon, 04 Nov 2019 02:24:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d23</guid><description><![CDATA[<p>case_name: Memorial Hermann Hospital, Houston TX</p><p>case_numbers: 05-0476</p><p>decision_date: Thu, 24 Mar 2011 12:00:00 -0400</p><p>decision_number: 2011D23</p><p>fiscal_year_end: 11/03/1997</p><p>provider_number: 45-0068</p><p>summary: Whether the Intermediary properly disallowed the loss claimed by Hermann Hospital representing a complete write-off of the book value of its depreciable assets as a result of the merger with the Memorial Hospital System.</p>]]></description></item><item><title>2000D64</title><pubDate>Mon, 04 Nov 2019 02:24:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d64</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d64</guid><description><![CDATA[<p>case_name: Regions Hospital, St. Paul MN</p><p>case_numbers: 96-0847</p><p>decision_date: Thu, 22 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D64</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 24-0106</p><p>summary: Was the Intermediary's adjustment offsetting the Provider-paid surcharge (tax) to the Minnesota Medicaid Program proper?</p>]]></description></item><item><title>2011D21</title><pubDate>Mon, 04 Nov 2019 02:24:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d21</guid><description><![CDATA[<p>case_name: McCamey Hospital and Convalescent Center, McCamey, TX</p><p>case_numbers: 04-0327; 04-0328</p><p>decision_date: Thu, 17 Mar 2011 12:00:00 -0400</p><p>decision_number: 2011D21</p><p>fiscal_year_end: 09/30/1998; 09/30/1999</p><p>provider_number: 45-0728</p><p>summary: Whether the Provider is entitled to payment of "fair compensation" pursuant to 42 C.F.R.Section 413.13.</p>]]></description></item><item><title>2000D54</title><pubDate>Mon, 04 Nov 2019 02:24:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d54</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d54</guid><description><![CDATA[<p>case_name: Daniel Freeman Marina Hospital, Marina Del Ray CA</p><p>case_numbers: 96-2623</p><p>decision_date: Mon, 15 May 2000 12:00:00 -0400</p><p>decision_number: 2000D54</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 05-0559</p><p>summary: Did the Intermediary properly include the Provider's inpatient Part B charges with outpatient Part B charges, subjecting the inpatient Part B charges to the 5.8% outpatient cost reduction?</p>]]></description></item><item><title>2000D55</title><pubDate>Mon, 04 Nov 2019 02:24:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d55</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d55</guid><description><![CDATA[<p>case_name: Maxicare, Incorporated, Deerfield Beach FL</p><p>case_numbers: 97-1810</p><p>decision_date: Tue, 30 May 2000 12:00:00 -0400</p><p>decision_number: 2000D55</p><p>fiscal_year_end: 05/31/1995</p><p>provider_number: 10-7123</p><p>summary: Was the Intermediary's adjustment to the Provider's visit statistic proper?</p>]]></description></item><item><title>2000D61</title><pubDate>Mon, 04 Nov 2019 02:24:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d61</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d61</guid><description><![CDATA[<p>case_name: Hurley Medical Center, Flint MI</p><p>case_numbers: 96-2534</p><p>decision_date: Tue, 06 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D61</p><p>fiscal_year_end: 06/30/1988</p><p>provider_number: 23-0132</p><p>summary: Was the denial of the TEFRA exception request proper?</p>]]></description></item><item><title>1998D104</title><pubDate>Mon, 04 Nov 2019 02:24:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d104</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d104</guid><description><![CDATA[<p>case_name: Los Angeles County NICU/IME Beds Group</p><p>case_numbers: 94-0284G</p><p>decision_date: Thu, 24 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D104</p><p>fiscal_year_end: 06/30/1991</p><p>provider_number: Various</p><p>summary: Was the Intermediary's inclusion of neonatal intensive care unit ("NICU") beds in the indirect medical education ("IME") calculation proper?</p>]]></description></item><item><title>2010D43</title><pubDate>Mon, 04 Nov 2019 02:24:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d43</guid><description><![CDATA[<p>case_name: Palmetto General Hospital - Skilled Nursing Facility</p><p>case_numbers: 02-0162</p><p>decision_date: Mon, 13 Sep 2010 12:00:00 -0400</p><p>decision_number: 2010D43</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 10-5990</p><p>summary: In light of the August 29, 2007 Remand Order from the Administrator of the Centers for Medicare and Medicaid Services ("CMS"), what is the proper regulation and manual provision to apply to the facts of this case and what is the relevance of the Provider's cost reporting period and skilled nursing facility's ("SNF") Medicare certification date with respect to the reimbursement scheme that should govern payments?</p>]]></description></item><item><title>2010D45</title><pubDate>Mon, 04 Nov 2019 02:24:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d45</guid><description><![CDATA[<p>case_name: University Medical Center, Tucson AZ</p><p>case_numbers: 04-0380; 05-1209; 06-0688</p><p>decision_date: Thu, 16 Sep 2010 12:00:00 -0400</p><p>decision_number: 2010D45</p><p>fiscal_year_end: 06/30/2000 - 06/30/2010</p><p>provider_number: 03-0064</p><p>summary: 1. Whether the Intermediary properly excluded resident rotations for research and other scholarly activities when calculating the resident full time equivalent (FTE) count for indirect medical education (IME) adjustment purposes.; 2. Whether the Intermediary's calculation of the new program add-on to the Provider FTE cap was improper by virtue of the fact that it omitted time spent by residents in research and scholarly activities.</p>]]></description></item><item><title>2000D45</title><pubDate>Mon, 04 Nov 2019 02:24:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d45</guid><description><![CDATA[<p>case_name: Edgewater Medical Center, Chicago IL</p><p>case_numbers: 94-0614</p><p>decision_date: Sun, 07 May 2000 12:00:00 -0400</p><p>decision_number: 2000D45</p><p>fiscal_year_end: 12/31/1991</p><p>provider_number: 14-0087</p><p>summary: Was the Intermediary's calculation of the Provider's disproportionate share ("DSH") adjustment proper?</p>]]></description></item><item><title>2000D43</title><pubDate>Mon, 04 Nov 2019 02:24:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d43</guid><description><![CDATA[<p>case_name: Lloyd Noland Hospital, Fairfield AL</p><p>case_numbers: 96-0527</p><p>decision_date: Fri, 05 May 2000 12:00:00 -0400</p><p>decision_number: 2000D43</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 01-0068</p><p>summary: Was the Intermediary's adjustment disallowing portions of compensation paid to physicians based on the application of the 1984 reasonable compensation equivalents ("RCE") proper?</p>]]></description></item><item><title>1998D075</title><pubDate>Mon, 04 Nov 2019 02:24:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d075</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d075</guid><description><![CDATA[<p>case_name: Miami Heart Institute, Dade Co. FL</p><p>case_numbers: 88-1339</p><p>decision_date: Mon, 27 Jul 1998 12:00:00 -0400</p><p>decision_number: 1998D075</p><p>fiscal_year_end: 12/31/1985- 12/31/1988</p><p>provider_number: 10-0060</p><p>summary: Did the Intermediary correctly apply the lower of cost or charge limit?</p>]]></description></item><item><title>2007D27</title><pubDate>Mon, 04 Nov 2019 02:24:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d27</guid><description><![CDATA[<p>case_name: North Memorial Health Care, Minneapolis MN</p><p>case_numbers: 04-0552</p><p>decision_date: Fri, 20 Apr 2007 12:00:00 -0400</p><p>decision_number: 2007D27</p><p>fiscal_year_end: 12/31/2000</p><p>provider_number: 24-0001</p><p>summary: Whether the FY 2000 ambulance cost trip limits were improperly low because the Intermediary improperly applied the 5.8% outpatient operating cost reduction and the 10% outpatient capital cost reduction to base year costs utilized to calculate those limits.</p>]]></description></item><item><title>2010D37</title><pubDate>Mon, 04 Nov 2019 02:24:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d37</guid><description><![CDATA[<p>case_name: Carney Hospital Transitional Care Unit</p><p>case_numbers: 02-0816</p><p>decision_date: Tue, 29 Jun 2010 12:00:00 -0400</p><p>decision_number: 2010D37</p><p>fiscal_year_end: 09/30/1996 - 09/30/1998</p><p>provider_number: 22-5681</p><p>summary: Was the Intermediary's denial of the Provider's request for a new provider exemption from Medicare routine service cost limits proper in light of the standards set forth in St. Elizabeth's Medical Center of Boston, Inc. v. Thompson, 396 Fed. 3rd 1228 (D.C. Cir. 2005)?</p>]]></description></item><item><title>1998D086</title><pubDate>Mon, 04 Nov 2019 02:24:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d086</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d086</guid><description><![CDATA[<p>case_name: Catskill Dialysis and Renal Disease Center, Monticello NY</p><p>case_numbers: 94-3045</p><p>decision_date: Tue, 01 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D086</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 33-2546</p><p>summary: Was the Intermediary's denial of the Provider's request for an exception to its End-Stage Renal Disease ("ESRD") composite rate proper?</p>]]></description></item><item><title>1998D106</title><pubDate>Mon, 04 Nov 2019 02:24:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d106</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d106</guid><description><![CDATA[<p>case_name: Village Concepts 93 Speech/Occupational Therapy Group</p><p>case_numbers: 96-0175G</p><p>decision_date: Wed, 30 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D106</p><p>fiscal_year_end: 1993</p><p>provider_number: Various</p><p>summary: Were the Intermediary's audit adjustments reducing charges for occupational and speech therapy services based upon the prudent buyer concept proper?</p>]]></description></item><item><title>2010D32</title><pubDate>Mon, 04 Nov 2019 02:24:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d32</guid><description><![CDATA[<p>case_name: Clinton Memorial Hospital, Wilmington OH</p><p>case_numbers: 05-1693; 05-1694</p><p>decision_date: Wed, 26 May 2010 12:00:00 -0400</p><p>decision_number: 2010D32</p><p>fiscal_year_end: 12/31/2001; 12/31/2002</p><p>provider_number: 36-0175</p><p>summary: Was the Intermediary's adjustment to include outpatient observation bed days in the bed count for purposes of calculating the Provider's indirect medical education (IME) reimbursement proper?</p>]]></description></item><item><title>2010D34</title><pubDate>Mon, 04 Nov 2019 02:24:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d34</guid><description><![CDATA[<p>case_name: Canon Healthcare Hospice, LLC, New Orleans LA</p><p>case_numbers: 08-0382; 08-0383</p><p>decision_date: Fri, 04 Jun 2010 12:00:00 -0400</p><p>decision_number: 2010D34</p><p>fiscal_year_end: 10/31/2003; 10/31/2004</p><p>provider_number: 19-1555</p><p>summary: Whether the Intermediary followed the proper reopening procedures prior to the issuance of the Intermediary's letter dated June 11, 2007 (Notice of Effect of Inpatient Day Limitation and Hospice Cap Amount) recalculating the hospice cap for years ending October 31, 2003 and October 31, 2004, respectively.</p>]]></description></item><item><title>1998D068</title><pubDate>Mon, 04 Nov 2019 02:24:29 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d068</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d068</guid><description><![CDATA[<p>case_name: Dyna Care Home Health, Inc., Alsip IL</p><p>case_numbers: 92-1805; 93-0196; 94-0366; 95-0672; 96-0750; 97-0104</p><p>decision_date: Thu, 25 Jun 1998 12:00:00 -0400</p><p>decision_number: 1998D068</p><p>fiscal_year_end: 12/31/1989-12/31/1994</p><p>provider_number: 14-7407</p><p>summary: 1. Was the Intermediary's adjustments offsetting key employees' compensation proper?; 2. Was the Intermediary's adjustments to disallow Christmas gifts made to employees and third parties proper?; 3. Was the Intermediary's adjustments to offset charitable contributions proper?; 4. Was the Intermediary's adjustments to the Board of Directors' fee proper?; 5. Was the Intermediary's adjustments to coinsurance amounts proper?; 6. Was the Intermediary's adjustments to Medicare program visits proper?; 7. Was the Intermediary's adjustments to medical supply charges proper?; 8. Was the Intermediary's adjustments offsetting legal service fees proper?; 9. Was the Intermediary's adjustments offsetting auto expense proper?; 10. Was the Intermediary's adjustments applying sequestration factors proper?</p>]]></description></item><item><title>2008D19</title><pubDate>Mon, 04 Nov 2019 02:24:29 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d19</guid><description><![CDATA[<p>case_name: North Dakota 99-01 Adjustment of FTE GME/IME Group</p><p>case_numbers: 04-1995G</p><p>decision_date: Tue, 26 Feb 2008 12:00:00 -0500</p><p>decision_number: 2008D19</p><p>fiscal_year_end: 12/31/1999-12/31/2001</p><p>provider_number: 35-0002; 35-0015</p><p>summary: Whether the Intermediary properly disallowed reimbursement for direct graduate medical education (DGME) and indirect medical education (IME) costs in the non-hospital setting by reducing the Provider's full-time equivalent (FTE) resident counts.</p>]]></description></item><item><title>2008D14</title><pubDate>Mon, 04 Nov 2019 02:24:29 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d14</guid><description><![CDATA[<p>case_name: Riverside Center for Jewish Seniors, Pittsburgh PA</p><p>case_numbers: 01-0215</p><p>decision_date: Wed, 23 Jan 2008 12:00:00 -0500</p><p>decision_number: 2008D14</p><p>fiscal_year_end: 06/30/1998</p><p>provider_number: 39-5526</p><p>summary: Whether the Intermediary's adjustment to remove Nursing Administration, Medical Records, and Social Services allocation statistics from the Provider's ancillary cost centers on the Medicare cost report were proper?</p>]]></description></item><item><title>1998D066</title><pubDate>Mon, 04 Nov 2019 02:24:29 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d066</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d066</guid><description><![CDATA[<p>case_name: Holzer Medical Center, Gallipolis OH</p><p>case_numbers: 94-0070</p><p>decision_date: Thu, 18 Jun 1998 12:00:00 -0400</p><p>decision_number: 1998D066</p><p>fiscal_year_end: 06/30/1991</p><p>provider_number: 36-0054</p><p>summary: Does the Provider meet the criteria for receiving disproportionate share payments based on application of undisputed facts?</p>]]></description></item><item><title>2007D28</title><pubDate>Mon, 04 Nov 2019 02:24:27 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d28</guid><description><![CDATA[<p>case_name: Decatur County General Hospital, Parsons TN</p><p>case_numbers: 03-0513; 04-0456</p><p>decision_date: Fri, 20 Apr 2007 12:00:00 -0400</p><p>decision_number: 2007D28</p><p>fiscal_year_end: 06/30/2000; 06/30/2001</p><p>provider_number: 44-0070</p><p>summary: Whether the FYEs 6/30/00 and 6/30/01 ambulance cost per trip limits were improperly low because the Intermediary improperly applied the 5.8% outpatient operating cost reduction and the 10% outpatient capital cost reduction to base year costs utilized to calculate those limits.</p>]]></description></item><item><title>2007D23</title><pubDate>Mon, 04 Nov 2019 02:24:27 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d23</guid><description><![CDATA[<p>case_name: Jordan Hospital, Plymouth, MA</p><p>case_numbers: 01-2214</p><p>decision_date: Wed, 28 Feb 2007 12:00:00 -0500</p><p>decision_number: 2007D23</p><p>fiscal_year_end: 09/30/1998</p><p>provider_number: 22-0060</p><p>summary: Whether the Intermediary's denial of the application of Jordan Hospital for a new provider exemption from the routine cost limits for its provider-based skilled nursing facility was justified.</p>]]></description></item><item><title>2007D21</title><pubDate>Mon, 04 Nov 2019 02:24:27 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d21</guid><description><![CDATA[<p>case_name: El Centro Regional Medical Center, El Centro, CA</p><p>case_numbers: 03-0268; 03-0269</p><p>decision_date: Fri, 23 Feb 2007 12:00:00 -0500</p><p>decision_number: 2007D21</p><p>fiscal_year_end: 06/30/1999; 06/30/2000</p><p>provider_number: 05-0045</p><p>summary: Whether the Intermediary's adjustments disallowing the Provider's regular Medicare bad debts were proper.</p>]]></description></item><item><title>1998D037</title><pubDate>Mon, 04 Nov 2019 02:24:27 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d037</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d037</guid><description><![CDATA[<p>case_name: Howard Young Medical Center, Woodruff WI</p><p>case_numbers: 93-0145</p><p>decision_date: Thu, 26 Mar 1998 12:00:00 -0500</p><p>decision_number: 1998D037</p><p>fiscal_year_end: 03/31/1991</p><p>provider_number: 52-0091</p><p>summary: Was the Intermediary's denial of sole community status under 42 C.F.R. Section 412.92 proper?</p>]]></description></item><item><title>1998D039</title><pubDate>Mon, 04 Nov 2019 02:24:27 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d039</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d039</guid><description><![CDATA[<p>case_name: Regency Health/ Gran Care Occupational and Speech Therapy Group</p><p>case_numbers: 97-0111G; 97-0112G</p><p>decision_date: Tue, 14 Apr 1998 12:00:00 -0400</p><p>decision_number: 1998D039</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Were the Intermediary's adjustments to occupational therapy and speech therapy costs proper?</p>]]></description></item><item><title>1998D053</title><pubDate>Mon, 04 Nov 2019 02:24:27 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d053</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d053</guid><description><![CDATA[<p>case_name: Barton Creek Health Care, Inc., Austin TX</p><p>case_numbers: 96-0229</p><p>decision_date: Thu, 21 May 1998 12:00:00 -0400</p><p>decision_number: 1998D053</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 45-7663</p><p>summary: 1.Was the Intermediary's adjustment disallowing a portion of interest cost incurred proper?; 2. Was the Intermediary's proposed adjustment disallowing all interest cost related to accounts receivable financing proper?</p>]]></description></item><item><title>1998D051</title><pubDate>Mon, 04 Nov 2019 02:24:27 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d051</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d051</guid><description><![CDATA[<p>case_name: In Home Health, Inc., 92-93 Salary Equivalent Guidelines Group</p><p>case_numbers: 95-2407G</p><p>decision_date: Wed, 20 May 1998 12:00:00 -0400</p><p>decision_number: 1998D051</p><p>fiscal_year_end: 09/30/1992; 09/30/1993</p><p>provider_number: Various</p><p>summary: Whether the physical therapy salary equivalent guidelines as issued and applied to the Providers are arbitrary, capricious and/or not in accordence with 42 C.F.R. Section 413.106 or other law?</p>]]></description></item><item><title>2006D42</title><pubDate>Mon, 04 Nov 2019 02:24:25 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d42</guid><description><![CDATA[<p>case_name: Logos Healthcare Rehabilitation, Inc., Boone NC</p><p>case_numbers: 00-3347</p><p>decision_date: Fri, 04 Aug 2006 12:00:00 -0400</p><p>decision_number: 2006D42</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 34-6538</p><p>summary: 1. Was the Intermediary's adjustment to disallow costs due to missing records proper?; 2. Did the Intermediary improperly reopen the cost report?; 3. Was the Intermediary's adjustment to physical therapy salaries proper?; 4. Was the Intermediary's adjustment to the accrued 401(K) plan proper?; 5. Was the Intermediary's adjustment to the accrued payroll taxes proper?; 6, Was the Intermediary's adjustment to accrued profit sharing plan proper?; 7. Was the Intermediary's adjustments to accrued FICA and Federal withholding proper?; 8. Was the Intermediary's adjustment to health insurance cost paid on behalf of physical therapists proper?; 9. Was the Intermediary's adjustment to contract physical therapy and Quality Assurance consultant expenses proper?; 10. Was the Intermediary's adjustment to contracted occupational therapy proper?; 11. Was the Intermediary's adjustment to contracted speech therapy proper?; 12. Was the Intermediary's adjustment to auto expense proper?; 13. Was the Intermediary's adjustment to auto lease expense proper?; 14. Was the Intermediary's adjustment to administrative recruiting proper?; 15. Was the Intermediary's adjustment to telephone expenses proper?; 16. Was the Intermediary's adjustment to accounting expense proper?; 17. Was the Intermediary's adjustment to occupational therapy dues proper?; 18. Was the Intermediary's adjustment to administrative dues proper?; 19. Was the Intermediary's adjustment to nursing home rent expense proper?; 20. Was the Intermediary's adjustment to rent expense proper?; 21. Was the Intermediary's adjustment to office lease expense proper?; 22. Was the Intermediary's adjustment to other charges- occupational, physical and speech therapy proper?; 23. Were the Provider's requests for additional costs for depreciation, contracted occupational therapy services, recruiting- physical therapy, recruiting- administrative and accounting expenses proper?</p>]]></description></item><item><title>2006D44</title><pubDate>Mon, 04 Nov 2019 02:24:25 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d44</guid><description><![CDATA[<p>case_name: DCH Regional Medical Center, Tuscaloosa AL</p><p>case_numbers: 04-0643</p><p>decision_date: Tue, 29 Aug 2006 12:00:00 -0400</p><p>decision_number: 2006D44</p><p>fiscal_year_end: 09/30/2004</p><p>provider_number: 01-0092</p><p>summary: Whether the Fiscal Intermediary/Centers for Medicare and Medicaid Services' (FI/CMS) denial of the request to include additional pension costs as wage-related costs for purposes of the Provider's FY 2004 wage index was proper.</p>]]></description></item><item><title>2007D01</title><pubDate>Mon, 04 Nov 2019 02:24:25 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d01</guid><description><![CDATA[<p>case_name: Iowa Lutheran Hospital, Des Moines IA</p><p>case_numbers: 97-0174</p><p>decision_date: Fri, 06 Oct 2006 12:00:00 -0400</p><p>decision_number: 2007D01</p><p>fiscal_year_end: 11/21/1993</p><p>provider_number: 16-0024</p><p>summary: Was the Intermediary's disallowance of the loss on disposal of assets resulting from a merger proper?</p>]]></description></item><item><title>2007D03</title><pubDate>Mon, 04 Nov 2019 02:24:25 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d03</guid><description><![CDATA[<p>case_name: Allegany County Department of Health, Belmont NY</p><p>case_numbers: 04-0372</p><p>decision_date: Tue, 07 Nov 2006 12:00:00 -0500</p><p>decision_number: 2007D03</p><p>fiscal_year_end: 12/31/2000</p><p>provider_number: 33-7089</p><p>summary: Whether the Intermediary's adjustment to reconcile the fiscal year ended (FYE) 12/31/00 home health agency aide charges to the Provider Statistical &#x26; Reimbursement Report (PS and R) was proper.</p>]]></description></item><item><title>2011D10</title><pubDate>Mon, 04 Nov 2019 02:24:25 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d10</guid><description><![CDATA[<p>case_name: Indiana DSH-HCI Days Group I -V</p><p>case_numbers: 00-3532G; 04-1657G; 06-0468G; 07-2031G; 08-2585G</p><p>decision_date: Fri, 19 Nov 2010 12:00:00 -0500</p><p>decision_number: 2011D10</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's non-inclusion of the Indiana Hospital Care for the Indigent (HCI) program patient days as Medicaid eligible days, whether paid or unpaid, in the calculation of the Medicaid proxy for Medicare Disproportionate Share Hospital (DSH) eligibility and payment determinations, including any impact such would have on capital DSH, was proper.</p>]]></description></item><item><title>2009D35</title><pubDate>Mon, 04 Nov 2019 02:24:25 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d35</guid><description><![CDATA[<p>case_name: Allina Health System 1995-2003 DSH Dual Eligible Days Group</p><p>case_numbers: 04-2261G</p><p>decision_date: Thu, 30 Jul 2009 12:00:00 -0400</p><p>decision_number: 2009D35</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's calculation of the Provider's Medicare disproportionate share hospital (DSH) payments improperly omitted days attributable to patients who were dually eligible for Medicare Part A and Medicaid, but for which Medicare Part A did not make payment, from the numerator of the "Medicaid fraction" described in 42 U.S.C. Section 1395ww(d)(5)(F)(vi)(II) and 42 C.F.R. Section 412.106(b).</p>]]></description></item><item><title>2011D03</title><pubDate>Mon, 04 Nov 2019 02:24:25 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d03</guid><description><![CDATA[<p>case_name: Diversicare 05-06 Medicare Bad Debts Group</p><p>case_numbers: 08-0298G</p><p>decision_date: Fri, 22 Oct 2010 12:00:00 -0400</p><p>decision_number: 2011D03</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's adjustments to the Providers' Medicare bad debts were proper.</p>]]></description></item><item><title>2004D34</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d34</guid><description><![CDATA[<p>case_name: Berks Visiting Nurse Association, Wyomissing, PA</p><p>case_numbers: 99-3196; 00-0018</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D34</p><p>fiscal_year_end: 12/31/95; 12/31/96</p><p>provider_number: 39-7001</p><p>summary: Were the Intermediary's adjustments applying Medicare's Physical Therapy Compensation Guidelines to the Provider's employee physical therapists proper?</p>]]></description></item><item><title>2004D45</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d45</guid><description><![CDATA[<p>case_name: Florida Convalescent Centers 97 Therapy Mgmt. Fee Group</p><p>case_numbers: 00-2151G</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D45</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: Various</p><p>summary: 1. Whether the Intermediary's disallowance of the Provider's therapy management fees was Proper?; 2. If the Providers are found to be entitled to a reversal of the Intermediary's disallowance, does the Board have subject matter jurisdiction to determine what entity is entitled to payment?</p>]]></description></item><item><title>2004D12</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d12</guid><description><![CDATA[<p>case_name: Saginaw General Hospital, Saginaw, MI</p><p>case_numbers: 97-1685</p><p>decision_date: Thu, 05 Feb 2004 12:00:00 -0500</p><p>decision_number: 2004D12</p><p>fiscal_year_end: 09/30/1994</p><p>provider_number: 23-0122</p><p>summary: For purposes of allocation of Administrative and General costs, should the Part B physicians' compensation and related fringe benefits be included in total expenses of the private physician practices?</p>]]></description></item><item><title>2011D01</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d01</guid><description><![CDATA[<p>case_name: Kaiser Foundation Hospitals- Southern CA Region 1999-2003 GME FTE CAP Groups</p><p>case_numbers: 06-0419G; 06-1433G; 06-1482G; 06-1451G; 07-0020G</p><p>decision_date: Fri, 01 Oct 2010 12:00:00 -0400</p><p>decision_number: 2011D01</p><p>fiscal_year_end: 12/31/99 - 12/31/2003</p><p>provider_number: Various</p><p>summary: Whether the Intermediary has improperly adjusted the Providers' direct graduate medical education (GME) intern and resident full-time equivalent (FTE) counts for their respective fiscal years ended (FYE) 12/31/1999 through 12/31/2003 by disallowing various FTEs associated with rotations to the Providers' outpatient medical office clinics in FYE 12/31/1996, the GME FTE cap base year.</p>]]></description></item><item><title>2008D09</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d09</guid><description><![CDATA[<p>case_name: Medical Park Hospital, Hope, AR</p><p>case_numbers: 03-0811</p><p>decision_date: Thu, 29 Nov 2007 12:00:00 -0500</p><p>decision_number: 2008D09</p><p>fiscal_year_end: 06/30/2000</p><p>provider_number: 04-0091</p><p>summary: Whether the Provider's Disproportionate Share Hospital (DSH) adjustment was correctly calculated.</p>]]></description></item><item><title>2007D52</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d52</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d52</guid><description><![CDATA[<p>case_name: Allentown-Bethlehem MSA Wage Index Group</p><p>case_numbers: 02-0530G</p><p>decision_date: Wed, 25 Jul 2007 12:00:00 -0400</p><p>decision_number: 2007D52</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether St. Luke's Hospital's letter of March 8, 2001 requesting corrections to its hospital wage data for its fiscal year ended 6/30/1999 (including documentation contained in Exhibit 1-7) satisfied the requirements established by CMS (then HCFA) set forth in 66 Fed. Reg. 39828 -39871 (Aug 1, 2001) for a timely request to the hospital's intermediary to correct any incorrectly reported wage data on its cost report for purposes of the wage data correction process.</p>]]></description></item><item><title>2001D18</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d18</guid><description><![CDATA[<p>case_name: Interim Healthcare of Kansas City, Kansas City KS</p><p>case_numbers: 99-2430; 00-0769</p><p>decision_date: Tue, 17 Apr 2001 12:00:00 -0400</p><p>decision_number: 2001D18</p><p>fiscal_year_end: 12/31/1996; 12/31/1997</p><p>provider_number: 17-7087</p><p>summary: 1. Was the Intermediary's adjustment to owner's compensation proper?; 2. Was the Intermediary's adjustment to community liason salary and benefits proper?; 3. Was the Intermediary's adjustment to franchise fees proper?</p>]]></description></item><item><title>2008D04</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d04</guid><description><![CDATA[<p>case_name: Hallmark Health System, Inc., Everett, MA et al</p><p>case_numbers: 04-1796</p><p>decision_date: Tue, 16 Oct 2007 12:00:00 -0400</p><p>decision_number: 2008D04</p><p>fiscal_year_end: 09/30/2001</p><p>provider_number: 22-0070</p><p>summary: Whether the Intermediary's determination of the Provider's dental intern and resident count for purposes of calculating its direct and indirect medical education adjustment was accurate.</p>]]></description></item><item><title>2001D21</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d21</guid><description><![CDATA[<p>case_name: Southwest Medical Center-Moore, Inc., Moore, OK</p><p>case_numbers: 97-1287</p><p>decision_date: Thu, 26 Apr 2001 12:00:00 -0400</p><p>decision_number: 2001D21</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 37-0161</p><p>summary: Were the Intermediary's adjustments reducing the loss on asset disposal proper?</p>]]></description></item><item><title>2009D04</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d04</guid><description><![CDATA[<p>case_name: Flagstaff Medical Center, Flagstaff AZ</p><p>case_numbers: 04-1915</p><p>decision_date: Thu, 18 Dec 2008 12:00:00 -0500</p><p>decision_number: 2009D04</p><p>fiscal_year_end: 06/30/1997-06/30/2001</p><p>provider_number: 03-0023</p><p>summary: Whether the Intermediary properly calculated and applied the Provider's ambulance cost per trip limit.</p>]]></description></item><item><title>2007D66</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d66</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d66</guid><description><![CDATA[<p>case_name: Memorial Healthcare Center, Owosso MI</p><p>case_numbers: 01-3169; 03-1194</p><p>decision_date: Thu, 30 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D66</p><p>fiscal_year_end: 12/31/1994; 12/31/1997</p><p>provider_number: 23-5472; 23-0121</p><p>summary: Whether the Intermediary improperly limited the Provider's hospital-based Skilled Nursing Facility's (SNF's) routine cost limit exception amount to costs in excess of 112 percent of its peer group costs rather than costs in excess of the routine cost limit.</p>]]></description></item><item><title>2007D61</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d61</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d61</guid><description><![CDATA[<p>case_name: Montefiore Medical Center, New York NY</p><p>case_numbers: 96-1582</p><p>decision_date: Tue, 14 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D61</p><p>fiscal_year_end: 12/31/1990</p><p>provider_number: 33-0059</p><p>summary: Whether the Intermediary improperly limited the Provider's hospital-based Skilled Nursing Facility's (SNF's) routine cost limit exception amount to costs in excess of 112 percent of its peer group costs rather than costs in excess of the routine cost limit.</p>]]></description></item><item><title>2011D05</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d05</guid><description><![CDATA[<p>case_name: Unique Care Home Health, Hammond LA</p><p>case_numbers: 05-2270</p><p>decision_date: Mon, 25 Oct 2010 12:00:00 -0400</p><p>decision_number: 2011D05</p><p>fiscal_year_end: 05/31/1998; 03/17/1999</p><p>provider_number: 19-7717</p><p>summary: Whether the Provider Statistical and Reimbursement Reports (PS&#x26;Rs) used to settle the Provider's cost reports for the fiscal years ended May 31, 1998 and March 17, 1999 are accurate.</p>]]></description></item><item><title>2010D47</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d47</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d47</guid><description><![CDATA[<p>case_name: Illinois Masonic Medical Center</p><p>case_numbers: 08-2017</p><p>decision_date: Fri, 17 Sep 2010 12:00:00 -0400</p><p>decision_number: 2010D47</p><p>fiscal_year_end: 06/30/1997</p><p>provider_number: 14-0132</p><p>summary: Whether the Provider Reimbursement Review Board has jurisdiction over Medicaid eligible days that were not specifically considered within the implementation of a revised Notice of Program Reimbursement (NPR).</p>]]></description></item><item><title>2007D60</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d60</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d60</guid><description><![CDATA[<p>case_name: Guam Memorial Hospital Authority</p><p>case_numbers: 04-1341; 04-1369</p><p>decision_date: Thu, 09 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D60</p><p>fiscal_year_end: 09/30/2000; 09/30/1998</p><p>provider_number: 65-0001</p><p>summary: Whether the Intermediary's adjustment disallowing the Provider's claimed withholding tax expense was proper.</p>]]></description></item><item><title>2007D54</title><pubDate>Mon, 04 Nov 2019 02:24:23 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d54</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d54</guid><description><![CDATA[<p>case_name: UPMC- Braddock Hospital, Braddock PA</p><p>case_numbers: 00-1411</p><p>decision_date: Tue, 31 Jul 2007 12:00:00 -0400</p><p>decision_number: 2007D54</p><p>fiscal_year_end: 11/30/1996</p><p>provider_number: 39-0128</p><p>summary: Whether the Intermediary properly disallowed the Provider's loss on disposal of depreciable assets as a result of the merger with UPMC Braddock, a subsidiary of the University of Pittsburgh Medical Center (UPMC).</p>]]></description></item><item><title>2009D02</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d02</guid><description><![CDATA[<p>case_name: Rochester 2004 MSA Wage Index Group</p><p>case_numbers: 04-0596G</p><p>decision_date: Mon, 10 Nov 2008 12:00:00 -0500</p><p>decision_number: 2009D02</p><p>fiscal_year_end: 13/31/2003; 12/31/2004</p><p>provider_number: Various</p><p>summary: Whether the intermediary properly determined the Rochester New York Metropolitan Statistical Area (MSA) wage index for fiscal year 2004 in a manner that reflected the relative hospital wage level in that geographic area as compared to the national average.</p>]]></description></item><item><title>2009D09</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d09</guid><description><![CDATA[<p>case_name: St. Luke Community Healthcare, Ronan MT</p><p>case_numbers: 07-1153</p><p>decision_date: Wed, 25 Feb 2009 12:00:00 -0500</p><p>decision_number: 2009D09</p><p>fiscal_year_end: 12/31/2004</p><p>provider_number: 27-1325</p><p>summary: Whether the Intermediary's disallowance of the Provider's certified registered nurse anesthetist (CRNA) on-call costs was proper.</p>]]></description></item><item><title>2012D01</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d01</guid><description><![CDATA[<p>case_name: Hall Render Wage Index Group Appeals</p><p>case_numbers: Various</p><p>decision_date: Thu, 06 Oct 2011 12:00:00 -0400</p><p>decision_number: 2012D01</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: 1. Whether the Fiscal Intermediary and CMS properly determined the Wage Indexes for St. Elizabeth Medical Center (18-0035); St. Luke Hospital East (18-0001); St. Luke Hospital West (18-0045); Mercy Hospital Anderson (36-0001); University Hospital, Inc. (36-0003); Jewish Hospital (36-0016); Mercy Hospital Fairfield (36-0056); Mercy Franciscan Hospital Western Hills (36-0113); Fort Hamilton Hospital (36-0132); Christ Hospital (36-0163); Mercy Franciscan Hospital - Mt. Airy (36-0234); and Mercy Hospital Clermont (36-0236) and the Cincinnati-Middletown, OH-KY-IN Core Based Statistical Area (CBSA) for Federal Fiscal Year 2009.; 2. Whether the fiscal intermediary and the Centers for Medicare and Medicaid properly determined the Wage Indexes for St. Elizabeth Medical Center (18-0035) and the Cincinnati-Middleton, Ohio-Kentucky-Indiana Core Based Statistical Area (CBSA).</p>]]></description></item><item><title>2011D32</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d32</guid><description><![CDATA[<p>case_name: Exempla Lutheran Medical Center</p><p>case_numbers: 06-2319</p><p>decision_date: Fri, 03 Jun 2011 12:00:00 -0400</p><p>decision_number: 2011D32</p><p>fiscal_year_end: 12/31/2004</p><p>provider_number: 06-0009</p><p>summary: Whether the Intermediary properly disallowed the Provider's entire Medicare disproportionate share hospital (DSH) payment.</p>]]></description></item><item><title>2007D56</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d56</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d56</guid><description><![CDATA[<p>case_name: Innovis Health, Fargo ND</p><p>case_numbers: 04-0823</p><p>decision_date: Thu, 02 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D56</p><p>fiscal_year_end: 12/31/2000</p><p>provider_number: 35-0070</p><p>summary: Whether the Provider is entitled to Transitional Outpatient Payments (TOPs).</p>]]></description></item><item><title>2010D48</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d48</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d48</guid><description><![CDATA[<p>case_name: Southwest Consulting DSH SSI Group Appeals - Consolidated Pilot Project</p><p>case_numbers: Various</p><p>decision_date: Fri, 24 Sep 2010 12:00:00 -0400</p><p>decision_number: 2010D48</p><p>fiscal_year_end: 1998-2006</p><p>provider_number: Various</p><p>summary: Should the ProviderReimbursement Review Board grant the Provider's request for expedited judicial review (EJR) over the validity of the provisions of the Centers for Medicare &#x26; Medicaid Services Ruling CMS-1498-R, which if valid, render moot and deny jurisdiction over these appeals of the disproportionate share adjustment (DSH) supplemental security income (SSI) issue?</p>]]></description></item><item><title>2007D76</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d76</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d76</guid><description><![CDATA[<p>case_name: Logos Healthcare Rehabilitation of South Carolina, Inc., West Columbia, SC</p><p>case_numbers: 00-3355</p><p>decision_date: Wed, 26 Sep 2007 12:00:00 -0400</p><p>decision_number: 2007D76</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: 42-6548</p><p>summary: 1. Was the Intermediary's adjustment to salaries proper?; 2. Was the Intermediary's adjustment to contract labor proper?; 3. Was the Intermediary's adjustment to advertising expense proper?; 4. Was the Intermediary's adjustment to utilities expense proper?; 5. Was the Intermediary's adjustment to travel expense proper?; 6. Was the Intermediary's adjustment to rent expense proper?; 7. Was the Intermediary's adjustment to professional fees proper?; 8. Was the Intermediary's adjustment to office expense proper?; 9. Was the Intermediary's adjustment to dues and subscriptions proper?; 10. Was the Intermediary's adjustment to physical therapy - total charges proper?; 11. Was the Intermediary's adjustment to home office costs proper? (Provider Issue 12); 12. Was the Provider's request for costs incurred in settling the cost reports after termination from the Medicare program proper? (Provider Issue 11)</p>]]></description></item><item><title>2009D08</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d08</guid><description><![CDATA[<p>case_name: Quality 89-92 Hospital Based SNF Group</p><p>case_numbers: 98-3176G</p><p>decision_date: Mon, 26 Jan 2009 12:00:00 -0500</p><p>decision_number: 2009D08</p><p>fiscal_year_end: Various</p><p>provider_number: 05-0008; 05-0058; 05-0132; 05-0152; 05-0655</p><p>summary: Whether the Centers for Medicare and Medicaid Services' (CMS) methodology for determining the Providers' exception to the hospital-based skilled nursing facility cost limits was proper.</p>]]></description></item><item><title>2010D46</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d46</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d46</guid><description><![CDATA[<p>case_name: Davies Medical Center, San Francisco CA</p><p>case_numbers: 97-0206</p><p>decision_date: Fri, 17 Sep 2010 12:00:00 -0400</p><p>decision_number: 2010D46</p><p>fiscal_year_end: 12/31/1983</p><p>provider_number: 05-0008</p><p>summary: Whether the Intermediary properly denied the Provider's Tax Equity and Fiscal Responsibility Act (TEFRA) exception request because of the timeliness of the request.</p>]]></description></item><item><title>2009D07</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d07</guid><description><![CDATA[<p>case_name: Pleasant Care Corp. Utilization Review Cost Group</p><p>case_numbers: 05-1420G</p><p>decision_date: Fri, 23 Jan 2009 12:00:00 -0500</p><p>decision_number: 2009D07</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's adjustment to utilization review costs was proper.</p>]]></description></item><item><title>2009D05</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d05</guid><description><![CDATA[<p>case_name: Mayo Clinic Hospital, Phoenix AZ</p><p>case_numbers: 06-1300; 06-1301; 06-1307</p><p>decision_date: Mon, 22 Dec 2008 12:00:00 -0500</p><p>decision_number: 2009D05</p><p>fiscal_year_end: 12/31/2000- 12/31/2002</p><p>provider_number: 03-0103</p><p>summary: Whether the Intermediary used proper cost to charge ratios in calculating the Provider's outlier payments.</p>]]></description></item><item><title>2008D44</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d44</guid><description><![CDATA[<p>case_name: Cancer Treatment Center of Tulsa, Tulsa OK</p><p>case_numbers: 03-1643</p><p>decision_date: Tue, 30 Sep 2008 12:00:00 -0400</p><p>decision_number: 2008D44</p><p>fiscal_year_end: 12/31/2000</p><p>provider_number: 37-0190</p><p>summary: Whether the Intermediary properly treated the Provider as an acute care prospective payment system (PPS) facility instead of an excluded cancer hospital.</p>]]></description></item><item><title>2011D46</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d46</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d46</guid><description><![CDATA[<p>case_name: Borgess Medical Center &#x26; Bronson Methodist Hospital, Kalamazoo MI</p><p>case_numbers: 08-1452; 08-1800; 08-2699; 08-2533; 08-2534; 08-1156; 08-2532; 09-0914</p><p>decision_date: Tue, 27 Sep 2011 12:00:00 -0400</p><p>decision_number: 2011D46</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: 1. Whether the Intermediary's adjustment to the direct graduate medical education and indirect medical education counts for residents training at the Kalamazoo Center for Medical Studies/Michigan State University nonhospital site clinics was proper.; 2. Whether the Intermediary's calculation of Borgess Medical Center's Supplemental Security Income percentage, the proportion of the patients eligible for Medicare Part A or Part C who are also eligible for supplemental security income, for cost reporting period ending June 30, 2003 was proper.</p>]]></description></item><item><title>2008D42</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d42</guid><description><![CDATA[<p>case_name: Oakwood Healthcare System 1992-2001 Capital Prosp. Rate Sys. Hosp. Spec. Rate Determination Grp</p><p>case_numbers: 04-0393G</p><p>decision_date: Mon, 29 Sep 2008 12:00:00 -0400</p><p>decision_number: 2008D42</p><p>fiscal_year_end: 12/31/1992-12/31/2001</p><p>provider_number: 23-0412; 23-0270; 23-0176</p><p>summary: Whether as a result of underpayment of Medicare reimbursement during the ten-year transition period of the Capital Prospective Payment System (CPPS), the Providers are entitled to a payment of interest under the Medicare statute, 42 U.S.C. Section 1395g(d), the applicable Medicare regulation, 42 C.F.R. Section 405.378, and the Medicare Intermediary Manual (CMS Pub. 13-2) Section 2219.</p>]]></description></item><item><title>2011D34</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d34</guid><description><![CDATA[<p>case_name: Sutter 98-99 Managed Care (CIRP) Group</p><p>case_numbers: 05-1740G</p><p>decision_date: Thu, 16 Jun 2011 12:00:00 -0400</p><p>decision_number: 2011D34</p><p>fiscal_year_end: 12/31/1998; 12/31/1999</p><p>provider_number: Various</p><p>summary: Whether the Intermediary improperly disallowed direct graduate medical education (DGME) and indirect medical education (IME) payments related to managed care days, discharges, and simulated payments solely on the grounds the provider failed to submit UB 92 claim forms for Medicare managed care.</p>]]></description></item><item><title>2010D49</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d49</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d49</guid><description><![CDATA[<p>case_name: Interim Health Care of Oklahoma City, Oklahoma City OK</p><p>case_numbers: 10-0056</p><p>decision_date: Fri, 24 Sep 2010 12:00:00 -0400</p><p>decision_number: 2010D49</p><p>fiscal_year_end: 10/31/2007</p><p>provider_number: 37-1635</p><p>summary: Whether the amount in controversy requirement under 42 C.F.R. Section 405.1835 is satisfied.</p>]]></description></item><item><title>2009D06</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d06</guid><description><![CDATA[<p>case_name: Banner Health System 2000 DSH Calculation Group</p><p>case_numbers: 04-1790G</p><p>decision_date: Tue, 23 Dec 2008 12:00:00 -0500</p><p>decision_number: 2009D06</p><p>fiscal_year_end: 12/31/2000</p><p>provider_number: 03-0002; 03-0065; 03-0018</p><p>summary: Whether the Intermediary improperly omitted certain inpatient hospital days from the numerator of the Medicaid low-income proxy used to calculate the Providers' disproportionate share hospital (DSH) adjustment.</p>]]></description></item><item><title>2009D03</title><pubDate>Mon, 04 Nov 2019 02:24:22 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d03</guid><description><![CDATA[<p>case_name: QRS 1994 DSH Medicare Managed Care and Mediciad Eligible Days Group</p><p>case_numbers: 04-2130G</p><p>decision_date: Wed, 17 Dec 2008 12:00:00 -0500</p><p>decision_number: 2009D03</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 50-0024</p><p>summary: Whether the Intermediary should include dual-eligible, managed care days in the Medicaid proxy in determining Medicare reimbursement for disproportionate share hospital (DSH) payments in accordance with the Medicare statute at 42 U.S.C. Section 1395ww(d)(5)(F)(vi)(II).</p>]]></description></item><item><title>2005D33</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d33</guid><description><![CDATA[<p>case_name: California Nurses Home Health Services, Los Angeles CA</p><p>case_numbers: 03-0055</p><p>decision_date: Mon, 11 Apr 2005 12:00:00 -0400</p><p>decision_number: 2005D33</p><p>fiscal_year_end: 06/30/2000</p><p>provider_number: 05-8034</p><p>summary: Was the Intermediary's adjustment to start-up costs proper?</p>]]></description></item><item><title>2007D62</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d62</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d62</guid><description><![CDATA[<p>case_name: Hi-Desert Medical Center, Joshua Tree CA</p><p>case_numbers: 96-2468</p><p>decision_date: Wed, 15 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D62</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 05-0279</p><p>summary: Whether the Intermediary's determination of non-allowable physician office and vacant space costs was proper.</p>]]></description></item><item><title>2011D02</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d02</guid><description><![CDATA[<p>case_name: Penrose/ St. Francis Health Services, Colorado Springs CO</p><p>case_numbers: 06-1009; 07-0237</p><p>decision_date: Thu, 07 Oct 2010 12:00:00 -0400</p><p>decision_number: 2011D02</p><p>fiscal_year_end: 06/30/2003; 06/30/2004</p><p>provider_number: 06-0031</p><p>summary: Whether the Intermediary improperly recouped alleged overpayments resulting from an incorrect cost-to-charge ratio (CCR) calculated and applied by the Intermediary to determine outlier payments made to the Provider for inpatient rehabilitation services furnished during the cost reporting periods at issue.</p>]]></description></item><item><title>2008D29</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d29</guid><description><![CDATA[<p>case_name: UPHS 99/ 2000 Medicare Choice Beneficiaries Group</p><p>case_numbers: 05-0133G; 05-243G</p><p>decision_date: Tue, 03 Jun 2008 12:00:00 -0400</p><p>decision_number: 2008D29</p><p>fiscal_year_end: 06/30/1999; 06/30/2000</p><p>provider_number: Various</p><p>summary: Was the Provider's reimbursement for indirect medical education (IME) and direct graduate medical education (DGME) for Medicare managed care patients properly disallowed for fiscal year 1999 and fiscal year 2000 for failure to file UB92s in accordance with CMS instruction.</p>]]></description></item><item><title>2007D58</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d58</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d58</guid><description><![CDATA[<p>case_name: MetroWest Medical Center, Framingham MA</p><p>case_numbers: 03/0759</p><p>decision_date: Wed, 08 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D58</p><p>fiscal_year_end: 04/30/1996</p><p>provider_number: 22-0089</p><p>summary: Whether the Provider's Notice of Program Reimbursement (NPR) dated September 24, 2002 was an original or a revised NPR.</p>]]></description></item><item><title>2007D77</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d77</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d77</guid><description><![CDATA[<p>case_name: Logos Healthcare Rehabilitation of Tennessee, Inc., Franklin, TN</p><p>case_numbers: 00-3356</p><p>decision_date: Thu, 27 Sep 2007 12:00:00 -0400</p><p>decision_number: 2007D77</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 44-6530</p><p>summary: 1. Did the Intermediary improperly reopen the cost report?; 2. Was the Intermediary adjustment to contract services - administrative proper?; 3-4. Were the Intermediary's adjustment to contract services - speech and occupational therapy proper?; 5. Was the Intermediary's adjustment to travel - speech therapy proper?; 6-8. Were the Intermediary's adjustments to travel - physical therapy, occupational therapy and administrative proper?; 9. Was the Intermediary's adjustment to accounting expense proper?; 10. Was the Intermediary's adjustment to telephone expense proper?; 11. Was the Intermediary's adjustment to office supplies proper?; 12. Was the Intermediary's adjustment to recruiting costs proper?; 13. Was the Intermediary's adjustment to rent expense proper?; 14. Was the Intermediary's adjustment to total expense proper?; 15. Was the Intermediary's adjustment to interim payments proper? (Provider Issue 16); 16. Was the Intermediary's adjustment to home office costs proper? (Provider Issue 17); 17. Was the Provider's request for costs incurred in the settling of cost reports after termination from the Medicare program proper? (Provider Issue 15)</p>]]></description></item><item><title>2011D04</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d04</guid><description><![CDATA[<p>case_name: Sonoma Valley Health Care District, Sonoma CA</p><p>case_numbers: 06-0828</p><p>decision_date: Fri, 22 Oct 2010 12:00:00 -0400</p><p>decision_number: 2011D04</p><p>fiscal_year_end: 06/30/2000</p><p>provider_number: 05-0090</p><p>summary: Whether the Intermediary's reclassification of clinic meals statistics on Worksheet B-1 from the reimbursable "clinic" cost center (clinic) to a non-reimbursable cost center was proper.</p>]]></description></item><item><title>2009D01</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d01</guid><description><![CDATA[<p>case_name: Roanoke 93 DSH Medicaid Percentage Group</p><p>case_numbers: 96-1627G</p><p>decision_date: Tue, 21 Oct 2008 12:00:00 -0400</p><p>decision_number: 2009D01</p><p>fiscal_year_end: 03/30/1990; 06/30/1991</p><p>provider_number: 39-0001</p><p>summary: Whether the Medicaid percentage component of the Provider's disproportionate share hospital (DSH) adjustment has been properly computed to contain all Medicaid patient days including Medicaid eligible days.</p>]]></description></item><item><title>2010D53</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d53</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d53</guid><description><![CDATA[<p>case_name: Henry Ford Health System, Detroit MI</p><p>case_numbers: 05-1261</p><p>decision_date: Thu, 30 Sep 2010 12:00:00 -0400</p><p>decision_number: 2010D53</p><p>fiscal_year_end: 12/31/2000</p><p>provider_number: 23-0053</p><p>summary: 1. Whether the Intermediary properly determined the Provider's full time equivalents (FTEs) counts used for purposes of calculating payment for direct graduate medical education (DGME) and indirect medical education (IME), based on its exclusion of residents in other approved programs, including unaccredited programs.; 2. Whether the Intermediary properly determined the Provider's FTE counts used for purposes of calculating payment for IME based on its exclusion of residents' time for research.</p>]]></description></item><item><title>2010D51</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d51</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d51</guid><description><![CDATA[<p>case_name: University of Louisville Hospital</p><p>case_numbers: 04-2159</p><p>decision_date: Wed, 29 Sep 2010 12:00:00 -0400</p><p>decision_number: 2010D51</p><p>fiscal_year_end: 12/31/1999</p><p>provider_number: 18-0141</p><p>summary: Whether the Intermediary improperly reduced the Provider's numbers of resident full-time equivalents ("FTEs") used for purposes of Medicare direct graduate medical education ("GME") and indirect graduate medical education ("IME") based on its contention that the Provider did not meet the written agreement requirement for counting resident time spent in non-provider settings in 42 C.F.R. Sections 412.105 and 413.86.</p>]]></description></item><item><title>2011D30</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d30</guid><description><![CDATA[<p>case_name: Univeral Health Services, Inc. 2004/2005 Medicare Bad Debts Still at Agency Group Appeal</p><p>case_numbers: 07-0084GC</p><p>decision_date: Fri, 27 May 2011 12:00:00 -0400</p><p>decision_number: 2011D30</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Fiscal Intermediary improperly disallowed the Provider's claimed Medicare bad debts solely on the ground that accounts related to such bad debts were still pending at outside collection agencies.</p>]]></description></item><item><title>2011D29</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d29</guid><description><![CDATA[<p>case_name: Memorial Hospital of Salem County, Salem NJ</p><p>case_numbers: 05-0148</p><p>decision_date: Thu, 26 May 2011 12:00:00 -0400</p><p>decision_number: 2011D29</p><p>fiscal_year_end: 12/31/2001</p><p>provider_number: 31-0091</p><p>summary: Whether the Intermediary properly included all appropriate Medicaid eligible days in calculating the Provider's disproportionate patient percentage for purposes of the Medicare disproportionate share hospital (DSH) adjustment under the Prospective Payment System (PPS) for inpatient operating and capital costs for the fiscal year ended (FYE) December 31, 2001.</p>]]></description></item><item><title>2007D55</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d55</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d55</guid><description><![CDATA[<p>case_name: Covenant Health Care, Saginaw MI</p><p>case_numbers: 02-1565; 03-0517; 04-0338</p><p>decision_date: Thu, 02 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D55</p><p>fiscal_year_end: 06/30/1999-06/30/2001</p><p>provider_number: 23-0070</p><p>summary: 1. Whether the Intermediary properly determined the full-time equivalent (FTE) intern and resident count for purposes of computing the Provider's indirect medical education (IME) adjustment and the direct graduate medical education (DGME) payment for FYEs 6/30/99, 6/30/00 &#x26; 6/30/01.; 2. Whether bank fees claimed by the Provider are allowable interest related costs. (FY 6/30/99); 3. Whether the hospital-based physician compensation should be reimbursed under Medicare Part A or Part B. (FY 6/30/99); 4. Whether the proper statistic to allocate housekeeping costs is hours worked or square footage. (FY 6/30/00); 5. Whether the Intermediary properly adjusted the hospital's cafeteria costs by removing all non-administrative Home Health Agency (HHA) FTEs from the Worksheet B-1 statistical base. (FY 6/30/00); 6. Whether the Intermediary properly disallowed the allocation of nursing administration costs to the HHA. (FY 6/30/00); 7. Whether the Intermediary properly weighted Worksheet B-1 statistics to account for the psychiatric unit being closed during the year. (FY 6/30/00); 8. Whether the Intermediary properly adjusted the rehabilitation unit hospital-based physician compensation from Medicare Part A to Part B. (FY 6/30/00).</p>]]></description></item><item><title>2007D64</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d64</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d64</guid><description><![CDATA[<p>case_name: Harbor Healthcare and Rehabilitation Center, Lewes DE</p><p>case_numbers: 04-0831; 04-0833</p><p>decision_date: Fri, 24 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D64</p><p>fiscal_year_end: 12/31/1996; 12/31/1997</p><p>provider_number: 08-5034</p><p>summary: 1. Whether the Intermediary's notification of the opening of the Provider's 1996 and 1997 final settled cost reports was timely pursuant to regulatory standards.; 2. Whether the sampling methodology used by the Intermediary to disallow charges for the Provider's rehabilitation services was proper.</p>]]></description></item><item><title>2001D15</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d15</guid><description><![CDATA[<p>case_name: Methodist Hospital, St. Louis Park, MN</p><p>case_numbers: 94-0463</p><p>decision_date: Thu, 05 Apr 2001 12:00:00 -0400</p><p>decision_number: 2001D15</p><p>fiscal_year_end: 01/17/2001</p><p>provider_number: 24-0053</p><p>summary: Were the Intermediary's adjustments to SNF routine cost limits proper?</p>]]></description></item><item><title>2011D33</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d33</guid><description><![CDATA[<p>case_name: Winn Parish Medical Center, Winnfield LA</p><p>case_numbers: 08-1168; 08-1169; 08-1170; 08-1171; 09-0911; 09-0130; 09-1195</p><p>decision_date: Wed, 15 Jun 2011 12:00:00 -0400</p><p>decision_number: 2011D33</p><p>fiscal_year_end: Various</p><p>provider_number: 19-0090</p><p>summary: Whether the Provider is eligible to be classified and reimbursed as a Medicare Dependent Hospital (MDH) for the fiscal years ended (FYEs) 2/31/01, 12/31/02, 12/31/03, 12/31/04, 12/31/05, 03/31/07, and 03/31/08.</p>]]></description></item><item><title>2012D03</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d03</guid><description><![CDATA[<p>case_name: Lakeland Regional Medical Center, St. Joseph MI</p><p>case_numbers: 09-0957</p><p>decision_date: Wed, 14 Dec 2011 12:00:00 -0500</p><p>decision_number: 2012D03</p><p>fiscal_year_end: 09/30/2005</p><p>provider_number: 23-0021</p><p>summary: Whether the Intermediary's disallowance of Medicare bad debts that had been referred to an outside collection agency was proper.</p>]]></description></item><item><title>2007D57</title><pubDate>Mon, 04 Nov 2019 02:24:21 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d57</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d57</guid><description><![CDATA[<p>case_name: University of Chicago Hospitals and Clinic, Chicago Il</p><p>case_numbers: 00-2326</p><p>decision_date: Wed, 08 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D57</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 14-0088</p><p>summary: Whether the time spent by residents conducting research in the Provider's facility as part of an approved residency program should be in the Indirect Medical Education FTE calculation.</p>]]></description></item><item><title>2007D53</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d53</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d53</guid><description><![CDATA[<p>case_name: St. Francis Hospital, Wilmington DE</p><p>case_numbers: 00-1081</p><p>decision_date: Thu, 26 Jul 2007 12:00:00 -0400</p><p>decision_number: 2007D53</p><p>fiscal_year_end: 06/30/1997</p><p>provider_number: 08-0003</p><p>summary: Whether the Intermediary's application of the reasonable compensation equivalent (RCE) limits was proper.</p>]]></description></item><item><title>2008D11</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d11</guid><description><![CDATA[<p>case_name: Hackensack University Medical Center, Hackensack, NJ</p><p>case_numbers: 03-1549</p><p>decision_date: Mon, 03 Dec 2007 12:00:00 -0500</p><p>decision_number: 2008D11</p><p>fiscal_year_end: 12/31/2002</p><p>provider_number: 31-0001</p><p>summary: Whether the Medicare fiscal intermediary erred by not including all of the Provider's inpatient days relating to patients who were not entitled to Medicare, but who qualified for medical assistance under the New Jersey Charity Care Program in the calculation of the disproportionate share hospital (DSH) payment for fiscal year 2002.</p>]]></description></item><item><title>2008D05</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d05</guid><description><![CDATA[<p>case_name: Summer Hill Nursing Home, Old Bridge, NJ</p><p>case_numbers: 06-1478</p><p>decision_date: Thu, 01 Nov 2007 12:00:00 -0400</p><p>decision_number: 2008D05</p><p>fiscal_year_end: 12/31/2004</p><p>provider_number: 31-5381</p><p>summary: Whether the Intermediary properly adjusted Medicare bad debts.</p>]]></description></item><item><title>2008D36</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d36</guid><description><![CDATA[<p>case_name: Cedars-Sinai Medical Center, Los Angeles CA</p><p>case_numbers: 99-3519M</p><p>decision_date: Fri, 19 Sep 2008 12:00:00 -0400</p><p>decision_number: 2008D36</p><p>fiscal_year_end: 03/31/1987-03/31/1989</p><p>provider_number: 05-0625</p><p>summary: Whether the Intermediary may refuse to apply a revised graduate medical education base year average per resident amount to the subsequent cost years that fall outside the three-year reopening period set forth in 42 C.F.R. Section 405.1885.</p>]]></description></item><item><title>2012D02</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2012d02</guid><description><![CDATA[<p>case_name: L.O. Crosby Memorial Hospital, Picayune MS</p><p>case_numbers: 08-2202; 08-2203</p><p>decision_date: Fri, 09 Dec 2011 12:00:00 -0500</p><p>decision_number: 2012D02</p><p>fiscal_year_end: 12/31/1997; 12/31/1998</p><p>provider_number: 25-0117</p><p>summary: 1. Whether CMS is precluded from recovering the alleged overpayments from the Provider's fiscal year end 12/31/97 and 10/31/98 cost reports due to the Intermediary's issuance of the Notice of Program Reimbursement over ten years after the cost report year ends.; 2. Whether the Intermediary improperly disallowed bad debts claimed and costs related to the hospital's unduplicated census for fiscal year ends 12/31/97 and 10/31/98.</p>]]></description></item><item><title>2009D32</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d32</guid><description><![CDATA[<p>case_name: Sharp Coronado Hospital and HealthCare Center, Coronado CA</p><p>case_numbers: 05-1133; 06-0127</p><p>decision_date: Wed, 15 Jul 2009 12:00:00 -0400</p><p>decision_number: 2009D32</p><p>fiscal_year_end: 09/30/2000; 09/30/2001</p><p>provider_number: 05-0234</p><p>summary: 1. Whether the Intermediary's calculation of the Provider's disproportionate share hospital (DSH) payments, as it pertains to subacute unit days was proper.; 2. Whether the Intermediary's calculation of the Provider's disproportionate share hospital (DSH) payments, as it pertains to Medicare Part A exhausted days for dual eligible patients was proper.</p>]]></description></item><item><title>2008D06</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d06</guid><description><![CDATA[<p>case_name: Queen of the Valley Hospital, West Covina, CA</p><p>case_numbers: 99-3140</p><p>decision_date: Fri, 02 Nov 2007 12:00:00 -0400</p><p>decision_number: 2008D06</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 05-0369</p><p>summary: Whether the Intermediary improperly allowed 0.54 intern and resident full time equivalent (FTE) for indirect medical education (IME) purposes on the Provider's fiscal year ended December 31. 1996 cost report.</p>]]></description></item><item><title>2008D10</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d10</guid><description><![CDATA[<p>case_name: Hackensack University Medical Center, Hackensack, NJ</p><p>case_numbers: 02-0363</p><p>decision_date: Mon, 03 Dec 2007 12:00:00 -0500</p><p>decision_number: 2008D10</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 31-0001</p><p>summary: Whether the Intermediary's adjustments to the Provider's direct graduate medical education and indirect medical education full-time equivalent counts were proper.</p>]]></description></item><item><title>2011D38</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d38</guid><description><![CDATA[<p>case_name: Prosser Memorial Hospital, Prosser WA</p><p>case_numbers: 07-0522</p><p>decision_date: Wed, 13 Jul 2011 12:00:00 -0400</p><p>decision_number: 2011D38</p><p>fiscal_year_end: 12/31/2004</p><p>provider_number: 50-1312</p><p>summary: Whether the Intermediary's adjustment to the Provider's ambulance service rates was proper.</p>]]></description></item><item><title>2011D31</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d31</guid><description><![CDATA[<p>case_name: George Washington University Hospital, Washington DC</p><p>case_numbers: 04-0848</p><p>decision_date: Fri, 27 May 2011 12:00:00 -0400</p><p>decision_number: 2011D31</p><p>fiscal_year_end: 12/31/1999</p><p>provider_number: 09-0001</p><p>summary: Whether the Intermediary's adjustments of the Provider's bad debts, because they were written off while they remained at an outside collection agency, were appropriate.</p>]]></description></item><item><title>2008D01</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d01</guid><description><![CDATA[<p>case_name: Marion General Hospital</p><p>case_numbers: 05-0686</p><p>decision_date: Wed, 10 Oct 2007 12:00:00 -0400</p><p>decision_number: 2008D01</p><p>fiscal_year_end: 06/30/2005</p><p>provider_number: 15-0011</p><p>summary: Whether the recission of the hospital's approved request for Sole Community Hospital (SCH) status was proper.</p>]]></description></item><item><title>2008D02</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d02</guid><description><![CDATA[<p>case_name: LAC 98 DSH/Non-Federal Low-Income</p><p>case_numbers: 01-1674G</p><p>decision_date: Thu, 11 Oct 2007 12:00:00 -0400</p><p>decision_number: 2008D02</p><p>fiscal_year_end: 06/30/1998</p><p>provider_number: Various</p><p>summary: 1. Whether the Providers entitled to have general relief (GR) days included in the calculation of their disproportionate share percentage to the hold harmless provisions of Program Memorandum A-99-62.; 2. Whether the failure to allow the Providers to include GR days in the calculation of their disproportionate share percentage was arbitrary and capricious and in violation of law.</p>]]></description></item><item><title>2008D41</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d41</guid><description><![CDATA[<p>case_name: Munson Medical Center, Traverse City MI</p><p>case_numbers: 06-0614</p><p>decision_date: Mon, 29 Sep 2008 12:00:00 -0400</p><p>decision_number: 2008D41</p><p>fiscal_year_end: 06/30/2002</p><p>provider_number: 23-0097</p><p>summary: Whether the Intermediary correctly limited the Provider's ambulance reimbursement to its charges.</p>]]></description></item><item><title>2007D48</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d48</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d48</guid><description><![CDATA[<p>case_name: Spectrum Health-Kent Community Campus, Grand Rapids MI</p><p>case_numbers: 05-0310</p><p>decision_date: Mon, 16 Jul 2007 12:00:00 -0400</p><p>decision_number: 2007D48</p><p>fiscal_year_end: 12/31/2001</p><p>provider_number: 23-2029</p><p>summary: Whether the Intermediary and CMS erred in denying the Provider's rate adjustment request made under the Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA).</p>]]></description></item><item><title>2008D03</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d03</guid><description><![CDATA[<p>case_name: Bayfront Medical Center, St. Petersburg, FL</p><p>case_numbers: 01-2270; 02-1573; 03-1015</p><p>decision_date: Fri, 12 Oct 2007 12:00:00 -0400</p><p>decision_number: 2008D03</p><p>fiscal_year_end: 06/30/1998-12/31/1999</p><p>provider_number: 10-0032</p><p>summary: Whether the Intermediary improperly disallowed direct graduate medical education (DGME) and indirect medical education (IME) payments with respect to discharges of Medicare beneficiaries who were enrolled in the Medicare + Choice or other Medicare risk plans in fiscal years ending June 30, 1998, June 30, 1999, and December 31, 1999.</p>]]></description></item><item><title>2007D59</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d59</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d59</guid><description><![CDATA[<p>case_name: Mountains Community Hospital, Lake Arrowhead, CA</p><p>case_numbers: 05-1792</p><p>decision_date: Thu, 09 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D59</p><p>fiscal_year_end: 06/30/2001</p><p>provider_number: 05-0260</p><p>summary: Whether the Intermediary properly required the use of a full year's Medicaid days in the Disproportionate Share Hospital (DSH) calculation based on its interpretation of the Benefit Improvements and Protection Act (BIPA) of 2000.</p>]]></description></item><item><title>2007D51</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d51</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d51</guid><description><![CDATA[<p>case_name: The Aroostock Medical Center, Presque Isle ME</p><p>case_numbers: 01-0883</p><p>decision_date: Wed, 25 Jul 2007 12:00:00 -0400</p><p>decision_number: 2007D51</p><p>fiscal_year_end: 08/30/2000</p><p>provider_number: 20-0018</p><p>summary: Was CMS' denial of the end stage renal disease (ESRD) composite rate exception correct based on applicable Medicare law? (Case 2004D26 was remanded by the US District Court)</p>]]></description></item><item><title>2008D35</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d35</guid><description><![CDATA[<p>case_name: St. Vincent Mercy Medical Center, Toledo OH</p><p>case_numbers: 05-2054</p><p>decision_date: Mon, 15 Sep 2008 12:00:00 -0400</p><p>decision_number: 2008D35</p><p>fiscal_year_end: 12/31/2001</p><p>provider_number: 36-0112</p><p>summary: 1. Whether the Intermediary's adjustment to include outpatient observation bed days in the bed count for purposes of calculating the Provider's indirect medical education (IME) reimbursment was proper.; 2. Whether the Intermediary's adjustment to include Medicaid outpatient observation days when determining disproportionate share hospital (DSH) eligibility and payment was proper.</p>]]></description></item><item><title>2011D47</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d47</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d47</guid><description><![CDATA[<p>case_name: DMC Hospitals FFY 201 Wage Index Pension Group</p><p>case_numbers: 09-2261CG</p><p>decision_date: Wed, 28 Sep 2011 12:00:00 -0400</p><p>decision_number: 2011D47</p><p>fiscal_year_end: 12/31/2006</p><p>provider_number: 23-0024; 23-0104; 23-0273; 23-0277</p><p>summary: Whether the Intermediary properly disallowed the Providers' pension costs for the fiscal year ended December 31, 2006 in determining the Medicare geographical wage index for federal fiscal year (FFY) 2010.</p>]]></description></item><item><title>2000D89</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d89</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d89</guid><description><![CDATA[<p>case_name: Hess Memorial Hospital, Mauston WI</p><p>case_numbers: 97-2390</p><p>decision_date: Wed, 27 Sep 2000 12:00:00 -0400</p><p>decision_number: 2000D89</p><p>fiscal_year_end: 09/30/1995</p><p>provider_number: 52-0109</p><p>summary: Were the Intermediary's adjustments offsetting investment income related to the sale of HMO stock proper?</p>]]></description></item><item><title>2011D28</title><pubDate>Mon, 04 Nov 2019 02:24:20 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d28</guid><description><![CDATA[<p>case_name: Valley Presbyterian Hospital, Van Nuys, CA</p><p>case_numbers: 08-2579</p><p>decision_date: Fri, 13 May 2011 12:00:00 -0400</p><p>decision_number: 2011D28</p><p>fiscal_year_end: 9/30/2008</p><p>provider_number: 05-0126</p><p>summary: Did CMS properly reduce the Provider's federal fiscal year (FFY) 2008 inpatient prospective payments system market basket adjust by two (2.0) percentage points?</p>]]></description></item><item><title>2008D28</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d28</guid><description><![CDATA[<p>case_name: Quality Lifestyles of Mesa, Mesa AZ</p><p>case_numbers: 02-0463</p><p>decision_date: Tue, 20 May 2008 12:00:00 -0400</p><p>decision_number: 2008D28</p><p>fiscal_year_end: 12/31/2008</p><p>provider_number: 03-7205</p><p>summary: Whether the Intermediary properly reclassified professional fees from the Administrative and General (A and G) -reimbursable cost center to the A and G-Shared cost center for the cost reporting period ending December 31, 1999.</p>]]></description></item><item><title>2007D50</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d50</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d50</guid><description><![CDATA[<p>case_name: Methodist Hospitals of Memphis, Memphis TN</p><p>case_numbers: 00-1757; 00-1859; 01-0958; 03-0180; 04-0110</p><p>decision_date: Thu, 19 Jul 2007 12:00:00 -0400</p><p>decision_number: 2007D50</p><p>fiscal_year_end: 12/31/1995- 12/31/1999</p><p>provider_number: 44-0049</p><p>summary: Whether the Intermediary's adjustment to the Provider's per resident amount (PRA) was proper.</p>]]></description></item><item><title>2011D44</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d44</guid><description><![CDATA[<p>case_name: Kingsbrook Jewish Medical Center, Brooklyn NY</p><p>case_numbers: 05-1144</p><p>decision_date: Wed, 14 Sep 2011 12:00:00 -0400</p><p>decision_number: 2011D44</p><p>fiscal_year_end: 12/31/2000</p><p>provider_number: 33-0201</p><p>summary: Whether the Provider's cost reimbursement should be computed taking into account the charges included in the Provider's log of late charges which have not been billed to Medicare.</p>]]></description></item><item><title>2008D40</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d40</guid><description><![CDATA[<p>case_name: Marias Medical Center, Shelby MT</p><p>case_numbers: 06-0987</p><p>decision_date: Mon, 29 Sep 2008 12:00:00 -0400</p><p>decision_number: 2008D40</p><p>fiscal_year_end: 06/30/2004</p><p>provider_number: 27-1328</p><p>summary: Whether the Intermediary's adjustment to Certified Registered Nurse Anesthetist (CRNA) cost was proper.</p>]]></description></item><item><title>2008D32</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d32</guid><description><![CDATA[<p>case_name: Port Huron Hospital, Port Huron MI</p><p>case_numbers: 03-0778; 04-0914</p><p>decision_date: Mon, 11 Aug 2008 12:00:00 -0400</p><p>decision_number: 2008D32</p><p>fiscal_year_end: 06/30/2000; 06/30/2001</p><p>provider_number: 23-0216</p><p>summary: 1. Whether the Provider was required to submit a claim to the Michigan Medicaid program and to obtain a Medicaid remittance advice in order to receive Medicare reimbursement for Part B bad debts relating to services furnished to patients dually eligible for Medicare and Medicaid.; 2. Whether the sampling methodology used by the Intermediary for determining the Provider's entitlement to bad debt payment for the fiscal year ended 6/30/2000 was proper. (CN: 03-0778 only)</p>]]></description></item><item><title>2007D70</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d70</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d70</guid><description><![CDATA[<p>case_name: Logos Healthcare Rehabilitation, Inc., Boone, NC</p><p>case_numbers: 00-3349</p><p>decision_date: Tue, 18 Sep 2007 12:00:00 -0400</p><p>decision_number: 2007D70</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 34-6538</p><p>summary: 1. Did the Intermediary improperly reopen the cost report? (Provider Issue 1); 2. Was the Intermediary's adjustment to bad debts proper? (Provider Issue 2); 3. Was the Intermediary's adjustment to salaries proper? (Provider Issue 3); 4. Was the Intermediary's adjustment to travel expense - speech therapy proper? (Provider Issue 4); 5. Was the Intermediary's adjustment to travel expense - physical therapy proper? (Provider Issue 5); 6. Was the Intermediary's adjustment to travel expense - occupational therapy proper? (Provider Issue 6); 7. Were the Intermediary's adjustments to travel expense - administrative and general proper? (Provider Issue 7); 8. Was the Intermediary's adjustment to auto expense proper? (Provider Issue 8); 9. Was the Intermediary's adjustment to contracted services - occupational therapy services proper? (Provider Issue 9); 10. Was the Intermediary's adjustment to contracted services - speech therapy proper? (Provider Issue 10); 11. Was the Intermediary's adjustment to contracted services - administrative and general proper? (Provider Issue 11); 12. Was the Intermediary's adjustment to consulting expenses proper? (Provider Issue 12); 13. Was the Intermediary's adjustment to accounting expense proper? (Provider Issue 13); 14. Was the Intermediary's adjustment to legal fees proper? (Provider Issue 14); 15. Was the Intermediary's adjustment to supply expense proper? (Provider Issue 15); 16. Was the Intermediary's adjustment to seminar expense proper? (Provider Issue 16); 17. Was the Intermediary's adjustment to telephone expense proper? (Provider Issue 17); 18. Was the Intermediary's adjustment to administrative dues and subscription expense proper? (Provider Issue 18); 19. Was the Intermediary's adjustment to office supply expense proper? (Provider Issue 19); 20. Was the Intermediary's adjustment to rent expense - building and equipment proper? (Provider Issue 20); 21. Was the Intermediary's adjustment to maintenance agreement expense proper? (Provider Issue 21); 22. Was the Intermediary's adjustment to depreciation expense proper? (Provider Issue 22); 23. Was the Intermediary's adjustment to recruiting costs - Rehab Resources proper? (Provider Issue 23); 24. Was the Intermediary's adjustment to total charges - physical therapy proper? (Provider Issue 24); 25. Was the Intermediary's adjustment to total charges - occupational therapy proper? (Provider Issue 24); 26. Was the Intermediary' adjustment to total charges -speech therapy proper? (Provider Issue 24); 27. Was the Intermediary's adjustment to other charges - physical therapy proper? (Provider Issue 24); 28. Was the Intermediary's adjustment to other charges - occupational therapy proper? (Provider Issue 24); 29. Was the Intermediary's adjustment to other charges - speech therapy proper? (Provider Issue 24); 30. Were the Provider's requests for additional costs for depreciation and contracted services - physical therapy proper? (Provider Issues 25 and 26)</p>]]></description></item><item><title>2000D82</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d82</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d82</guid><description><![CDATA[<p>case_name: Cameo Care Center, Inc., Milwaukee WI</p><p>case_numbers: 96-2052</p><p>decision_date: Thu, 07 Sep 2000 12:00:00 -0400</p><p>decision_number: 2000D82</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 52-5504</p><p>summary: Was the Intermediary's recalculation of the Provider's gross-up method proper?</p>]]></description></item><item><title>2007D49</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d49</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d49</guid><description><![CDATA[<p>case_name: Sacred Heart Medical Center- Psychiatric, Eugene OR</p><p>case_numbers: 01-1010</p><p>decision_date: Wed, 18 Jul 2007 12:00:00 -0400</p><p>decision_number: 2007D49</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 38-0033</p><p>summary: 1. Whether the exception review process engaged in by the Health Care Financing Administration (HCFA) and the Fiscal Intermediary violated due process and fundamental fairness, including violations of the time limits established by federal regulation and the Provider Reimbursement Manual so as to cause the exception request to be deemed approved in full.; 2. Whether HCFA and the Fiscal Intermediary improperly denied the Tax Equity and Fiscal Responsibility Act (TEFRA) adjustment in its entirety, when at a minimum Oregon Medical Professional Review Organizations (OMPRO's) independent medical review supported a reduced exception amount.; 3. Whether HCFA and the Fiscal Intermediary erred in denying the Provider's revised TEFRA exception request without correcting the Intermediary's use of an incorrect TEFRA target rate.</p>]]></description></item><item><title>2011D36</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d36</guid><description><![CDATA[<p>case_name: Southern Christian Medical Center (Formerly Bella Vista del Suroeste)</p><p>case_numbers: 06-1431; 06-2384</p><p>decision_date: Wed, 22 Jun 2011 12:00:00 -0400</p><p>decision_number: 2011D36</p><p>fiscal_year_end: 12/16/2002; 12/31/2000</p><p>provider_number: 40-0110</p><p>summary: Whether the Intermediary improperly excluded certain days attributable to Puerto Rico Medicaid enrollees who were classified by the Administration De Seguros De Salute De Puerto Rico as category six, for which Puerto Rico receives no Federal matching funds in computing the fraction reflecting the percentage of inpatients who were entitled to medical assistance under an approved state plan (the Medicaid fraction) for purposes of the Medicare disproportionate share hospital calculation.</p>]]></description></item><item><title>2008D30</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d30</guid><description><![CDATA[<p>case_name: Forest Hospital, Des Plaines IL</p><p>case_numbers: 02-0050; 02-0615</p><p>decision_date: Thu, 05 Jun 2008 12:00:00 -0400</p><p>decision_number: 2008D30</p><p>fiscal_year_end: 10/31/1998; 10/31/1999</p><p>provider_number: 14-4036</p><p>summary: 1. Whether the Intermediary properly adjusted Medicare bad debts.; 2. Whether the Intermediary properly adjusted the Provider's treatment of asset relifing.; 3. Whether the Intermediary properly adjusted public relations and marketing expenses.; 4. Whether the Intermediary properly adjusted officers' life insurance and wind down expenses. (Fiscal year ended (FYE) 10/31/99 only)</p>]]></description></item><item><title>2008D33</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d33</guid><description><![CDATA[<p>case_name: Oak Knoll Health Care Center, Framingham MA</p><p>case_numbers: 98-0019; 02-0785</p><p>decision_date: Tue, 12 Aug 2008 12:00:00 -0400</p><p>decision_number: 2008D33</p><p>fiscal_year_end: 12/31/1995; 12/31/1999</p><p>provider_number: 22-5682</p><p>summary: 1. Whether the Provider is entitled to a new provider exemption from the skilled nursing facility (SNF) routine service cost limits under 42 C.F.R. section 1413.30(e) for the cost reporting year ended December 31, 1995.; 2. Whether the Intermediary's denial of the Provider's request to be reimbursed the Transitional Period Rate for SNFs under 42 C.F.R. section 413.340(e) for the cost reporting year ended December 31, 1999 was proper.</p>]]></description></item><item><title>2007D47</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d47</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d47</guid><description><![CDATA[<p>case_name: Texas Senior Care, Dallas TX</p><p>case_numbers: 05-0658</p><p>decision_date: Thu, 12 Jul 2007 12:00:00 -0400</p><p>decision_number: 2007D47</p><p>fiscal_year_end: 07/31/1999</p><p>provider_number: 45-7789</p><p>summary: 1. Whether the Intermediary properly allocated home office cost from the finalized home office cost statement to the Provider.; 2. Whether the Intermediary's adjustment to the salaries, benefits and mileage of the program managers was proper.; 3. Whether the Intermediary's adjustment to Dara Stewarts's salary and benefits was proper.; 4. Whether the Intermediary's reopening was proper.</p>]]></description></item><item><title>2007D45</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d45</guid><description><![CDATA[<p>case_name: Palmetto General Hospital- SNF, Hialeah FL</p><p>case_numbers: 02-0162</p><p>decision_date: Mon, 02 Jul 2007 12:00:00 -0400</p><p>decision_number: 2007D45</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 10-5990</p><p>summary: Whether the Centers for Medicare and Medicaid Services (CMS) properly denied the request(s) of the Provider for an exemption from the Routine Service Cost Limits (RCLs) for the fiscal year ended December 31, 1998.</p>]]></description></item><item><title>2008D37</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d37</guid><description><![CDATA[<p>case_name: Beverly Hospital, Beverly MA</p><p>case_numbers: 04-1083; 04-1091; 04-1093; 04-1950</p><p>decision_date: Tue, 23 Sep 2008 12:00:00 -0400</p><p>decision_number: 2008D37</p><p>fiscal_year_end: 9/30/1999-9/30/2002</p><p>provider_number: 22-0033</p><p>summary: 1. Whether the Intermediary improperly computed the numerator of the Medicaid fractions that were used to calculate the Provider's disproportionate share hospital (DSH) payments for fiscal years (FYs) 1999, 2000, 2001, and 2002 by excluding inpatient days attributable to individuals who were both eligible for medical assistance under an approved Medicaid State plan and enrolled in a Medicare +Choice (M+C) plan for such days.; 2. Whether the Intermediary improperly computed the numerators of the Medicaid fractions that were used to calculate the Provider's DSH payments for FYs 1999, 2000, 2001 and 2002 by excluding inpatient days attributable to individuals who allegedly received assistance under the Massachusetts Uncompensated Care Pool for such days.; 3. Whether the Intermediary improperly computed the Medicaid fraction that was used to calculate the Provider's DSH payment for fiscal year 2002 by i) excluding from the numerator inpatient days attributable to individuals who were in a labor and delivery room at the census-taking hour and who had not previously occupied a routine bed and ii) including such days in the denominator.; 4.Whether the Medicare/Supplemental Security Income (SSI) fraction that was used to calculate the Provider's DSH payment for FY 1999 should be recalculated, or, in the alternative, whether the Medicare SSI fraction should be revised.</p>]]></description></item><item><title>2008D43</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d43</guid><description><![CDATA[<p>case_name: Tulsa Regional Medical Center, Tulsa OK</p><p>case_numbers: 04-1792; 05-2073; 05-2074; 05-2154; 06-0010; 06-0300</p><p>decision_date: Tue, 30 Sep 2008 12:00:00 -0400</p><p>decision_number: 2008D43</p><p>fiscal_year_end: 12/31/1999-1231/2003</p><p>provider_number: 37-0078</p><p>summary: Whether the Intermediary properly adjusted the Provider's indirect medical education full-time equivalent (FTE) cap?</p>]]></description></item><item><title>2007D78</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d78</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d78</guid><description><![CDATA[<p>case_name: Santa Barbara Cottage Hospital, Santa Barbara, CA</p><p>case_numbers: 02-0328; 03-0383; 04-0283; 05-1327</p><p>decision_date: Fri, 28 Sep 2007 12:00:00 -0400</p><p>decision_number: 2007D78</p><p>fiscal_year_end: 12/31/1998- 12/31/2001</p><p>provider_number: 05-0396</p><p>summary: 1. Whether the Intermediary improperly disallowed direct graduate medical education (DGME) and indirect medical education (IME) payments with respect to discharge of Medicare beneficiaries who were enrolled in the Medicare + Choice or other Medicare risk plans in fiscal years ending December 31, 1998, 1999, 2000 and 2001.; 2. Whether the Intermediary improperly disallowed residents' time spent in non-provider settings within the scope of the Provider's approved medical residency training programs from the Provider's full-time equivalent resident counts for DGME and IME purposes.</p>]]></description></item><item><title>2008D07</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d07</guid><description><![CDATA[<p>case_name: St. Mary's Hospital- Milwaukee, Milwaukee, WI</p><p>case_numbers: 03-1056</p><p>decision_date: Fri, 16 Nov 2007 12:00:00 -0500</p><p>decision_number: 2008D07</p><p>fiscal_year_end: 06/30/2000</p><p>provider_number: 52-0051</p><p>summary: 1. Whether the CMS improperly calculated St. Mary's Hospital's Medicare disproportionate share hospital (DSH) adjustment by excluding fifty two (52) patient days from the Supplemental Security Income (SSI) fraction.; 2. Whether the Intermediary improperly calculated St. Mary's Medicare DSH adjustment by excluding 366 Long Term Respiratory Unit (LTRU) patient days from the Medicaid proxy of the DSH calculation.</p>]]></description></item><item><title>2008D31</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d31</guid><description><![CDATA[<p>case_name: Medical Center of North Hollywood, North Hollywood CA</p><p>case_numbers: 02-0705</p><p>decision_date: Mon, 16 Jun 2008 12:00:00 -0400</p><p>decision_number: 2008D31</p><p>fiscal_year_end: 12/31/1987</p><p>provider_number: 05-0241</p><p>summary: Whether the Intermediary may recoup an overpayment relative to the Provider's 1987 cost reporting period through a revised Notice of Program Reimbursement (NPR) issued in January 2002.</p>]]></description></item><item><title>2008D45</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d45</guid><description><![CDATA[<p>case_name: Swedish American Hospital, Rockford IL</p><p>case_numbers: 05-1891; 05-1887; 04-1831; 05-0731; 06-1938</p><p>decision_date: Tue, 30 Sep 2008 12:00:00 -0400</p><p>decision_number: 2008D45</p><p>fiscal_year_end: 05/31/1999-05/31/2003</p><p>provider_number: 14-0228</p><p>summary: Whether the Intermediary's adjustments reducing the 1996 base year IME/GME FTE count for osteopathic and allopathic medicine interns and residents and their effect on the May 31, 1999 through May 31, 2003 FTE counts are correct.</p>]]></description></item><item><title>2008D26</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d26</guid><description><![CDATA[<p>case_name: Loma Linda University Medical Center, Loma Linda, CA</p><p>case_numbers: 02-0326; 03-0730; 04-1130</p><p>decision_date: Fri, 09 May 2008 12:00:00 -0400</p><p>decision_number: 2008D26</p><p>fiscal_year_end: 12/31/1998 - 12/31/2000</p><p>provider_number: 05-0327</p><p>summary: Whether the payment for indirect medical education (IME) and direct graduate medical education (DGME) was understand because not all managed care days and discharges for inpatient services for Medicare beneficiaries were included in the calculation.</p>]]></description></item><item><title>2007D46</title><pubDate>Mon, 04 Nov 2019 02:24:19 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d46</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d46</guid><description><![CDATA[<p>case_name: Franklin Square Hospital Transitional Care Unit/ Good Samaritan Hospital Comprehensive Care Unit</p><p>case_numbers: 97-1239; 97-1240</p><p>decision_date: Thu, 12 Jul 2007 12:00:00 -0400</p><p>decision_number: 2007D46</p><p>fiscal_year_end: 06/30/96-06/30/98</p><p>provider_number: 21-5279; 21-5280</p><p>summary: Whether the Intermediary properly denied requests by Franklin Square and Good Samaritan for New Provider Exemptions from the routine cost limits for fiscal years ending 6/30/97 and 6/30/98.</p>]]></description></item><item><title>2009D26</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d26</guid><description><![CDATA[<p>case_name: National DSH Dual Eligible Group Appeal</p><p>case_numbers: Various</p><p>decision_date: Tue, 23 Jun 2009 12:00:00 -0400</p><p>decision_number: 2009D26</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary properly excluded dual eligible patient days from the Medicaid eligible days in determining the Medicaid percentages that were used for the disproportionate share hospital (DSH) adjustment payments.</p>]]></description></item><item><title>2008D27</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d27</guid><description><![CDATA[<p>case_name: Oswego Medical Center, Oswego KS</p><p>case_numbers: 05-1219</p><p>decision_date: Thu, 15 May 2008 12:00:00 -0400</p><p>decision_number: 2008D27</p><p>fiscal_year_end: 12/31/2002</p><p>provider_number: 17-1302</p><p>summary: Was the Intermediary's adjustment to the provider's claimed owner's compensation proper?</p>]]></description></item><item><title>2009D24</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d24</guid><description><![CDATA[<p>case_name: New England Deaconess Hospital, Boston MA</p><p>case_numbers: 99-2786</p><p>decision_date: Fri, 29 May 2009 12:00:00 -0400</p><p>decision_number: 2009D24</p><p>fiscal_year_end: 09/30/1996</p><p>provider_number: 22-0118</p><p>summary: Whether the Intermediary's disallowance of the Provider's claim for a loss in connection with its October 1, 1996 statutory merger was proper.</p>]]></description></item><item><title>2000D83</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d83</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d83</guid><description><![CDATA[<p>case_name: Brae Loch Manor Health Care Facility et al, Rochester NY</p><p>case_numbers: Various</p><p>decision_date: Tue, 19 Sep 2000 12:00:00 -0400</p><p>decision_number: 2000D83</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Was the Intermediary's inclusion of maintenance treatments in the Provider's cost aportionment statistics for Medicare reimbursement proper?</p>]]></description></item><item><title>1999D52</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d52</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d52</guid><description><![CDATA[<p>case_name: Lutheran Community Hospital, Norfolk NE</p><p>case_numbers: 94-2925</p><p>decision_date: Thu, 17 Jun 1999 12:00:00 -0400</p><p>decision_number: 1999D52</p><p>fiscal_year_end: 02/28/1995</p><p>provider_number: 28-0034</p><p>summary: Was the Intermediary's disallowance of the Provider's excess dialysis costs, based upon the Health Care Financing Administration ("HCFA's") denial of the Provider's exception request, correct?</p>]]></description></item><item><title>2010D15</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d15</guid><description><![CDATA[<p>case_name: Affinity Medical Center</p><p>case_numbers: 08-1816</p><p>decision_date: Thu, 11 Mar 2010 12:00:00 -0500</p><p>decision_number: 2010D15</p><p>fiscal_year_end: 06/30/2006</p><p>provider_number: 36-0151</p><p>summary: Does the Board have jurisdiction over the resident-to-bed ratio where an alleged error in the filed cost report was discovered by the Provider after the final determination was issued?</p>]]></description></item><item><title>1999D67</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d67</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d67</guid><description><![CDATA[<p>case_name: Riverside Medical Center SNF, Gonzales LA</p><p>case_numbers: 96-0869</p><p>decision_date: Thu, 02 Sep 1999 12:00:00 -0400</p><p>decision_number: 1999D67</p><p>fiscal_year_end: 08/31/1993</p><p>provider_number: 19-0207</p><p>summary: Was HCFA's measurement of an exception to the cost limits for hosiptal-based SNFs from 112% of the mean hospital-based inpatient routine service costs, instead of from the hospital-based SNF routine cost limit, proper?</p>]]></description></item><item><title>1999D69</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d69</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d69</guid><description><![CDATA[<p>case_name: MAryland General Hospital Transitional Care Center, Baltimore MD</p><p>case_numbers: 97-0503</p><p>decision_date: Mon, 20 Sep 1999 12:00:00 -0400</p><p>decision_number: 1999D69</p><p>fiscal_year_end: 06/30/1996-06/30/1999</p><p>provider_number: 21-5282</p><p>summary: Was the Health Care Financing Administration's ("HCFA") denial of the Provider's request for an exemption to the routine cost limits as a new provider under 42 C.F.R. Section 413.30(e) proper?</p>]]></description></item><item><title>1998D018</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d018</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d018</guid><description><![CDATA[<p>case_name: California Speicial Care Center, La Mesa CA</p><p>case_numbers: 93-1769</p><p>decision_date: Wed, 14 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D018</p><p>fiscal_year_end: 12/31/1991</p><p>provider_number: 05-5632</p><p>summary: Was the Intermediary's classification of the salaries of restorative nursing aides from the physical therapy cost center to the routine cost area proper?</p>]]></description></item><item><title>1999D50</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d50</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d50</guid><description><![CDATA[<p>case_name: Barry Healthcare Services, Inc., Milwaukee WI</p><p>case_numbers: 95-0523; 96-0510</p><p>decision_date: Wed, 09 Jun 1999 12:00:00 -0400</p><p>decision_number: 1999D50</p><p>fiscal_year_end: 12/31/1992; 12/31/1993</p><p>provider_number: 52-7143</p><p>summary: Were the Intermediary's adjustments to reclassify certain costs and visits from skilled nursing to either other visits or private duty visits proper?</p>]]></description></item><item><title>2010D12</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d12</guid><description><![CDATA[<p>case_name: Ober Kaler 2005 &#x26; 2006 Illinois Provider Tax Groups</p><p>case_numbers: 06-2136G; 07-2590G;08-2765GC;082961GC;08-2963GC; 08-2964GC</p><p>decision_date: Fri, 29 Jan 2010 12:00:00 -0500</p><p>decision_number: 2010D12</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's disallowance of the Illinois provider tax assessment was proper.</p>]]></description></item><item><title>2000D81</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d81</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d81</guid><description><![CDATA[<p>case_name: Rocky Mountain Care Routine Cost Limits Group- Transmittal No. 378 Application</p><p>case_numbers: 96-2281G</p><p>decision_date: Thu, 07 Sep 2000 12:00:00 -0400</p><p>decision_number: 2000D81</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether HCFA's methodology of determining the amount of the exception from the routine cost limits for freestanding skilled nursing facilities (SNF) as set forth in HCFA Pub. 15-1, Section 2534.5, Transmittal No. 378, is correct?</p>]]></description></item><item><title>2010D19</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d19</guid><description><![CDATA[<p>case_name: The Leaves, Inc., Richardson TX</p><p>case_numbers: 07-2538; 07-2544</p><p>decision_date: Wed, 17 Mar 2010 12:00:00 -0400</p><p>decision_number: 2010D19</p><p>fiscal_year_end: 12/31/2004; 12/31/2005</p><p>provider_number: 45-1990</p><p>summary: Whether the Fiscal Intermediary's denial of the Provider's nursing education program costs as pass-through costs was valid when that denial was based on a finding that the Commission for the Accreditation of Christian Science Nursing Organization/Facilities, Inc. (Commission) is not a "recognized national professional organization for the particular activity" under the provisions of 42 C.F.R. Section 413.85(e) for purposes of accrediting the Provider's nursing education programs.</p>]]></description></item><item><title>2009D23</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d23</guid><description><![CDATA[<p>case_name: Jeanes Hospital, Philadelphia PA</p><p>case_numbers: 99-0584R (on Remand)</p><p>decision_date: Wed, 27 May 2009 12:00:00 -0400</p><p>decision_number: 2009D23</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 39-0080</p><p>summary: Whether the Jeanes Hospital merger was a bona fide sale.</p>]]></description></item><item><title>2009D22</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d22</guid><description><![CDATA[<p>case_name: Mercy Hospital of Pittsburgh (n/k/a UPMC)</p><p>case_numbers: 99-1340</p><p>decision_date: Fri, 08 May 2009 12:00:00 -0400</p><p>decision_number: 2009D22</p><p>fiscal_year_end: 06/30/1985</p><p>provider_number: 39-0028</p><p>summary: Whether interest is due on the continuing underpayments that exist as a result of the fiscal Intermediary's 10 year delay in implementing the PRRB's case number 91-2673.</p>]]></description></item><item><title>2011D24</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d24</guid><description><![CDATA[<p>case_name: QRS 1996 DSH MediKan Days Group</p><p>case_numbers: 03-1199G</p><p>decision_date: Wed, 06 Apr 2011 12:00:00 -0400</p><p>decision_number: 2011D24</p><p>fiscal_year_end: 06/30/1996; 09/30/1996</p><p>provider_number: 17-0040; 17-0086; 17-0122</p><p>summary: Whether the Intermediary should include all MediKan patient days, primary and secondary, in the Providers' disproportionate share hospital (DSH) calculation.</p>]]></description></item><item><title>2007D42</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d42</guid><description><![CDATA[<p>case_name: Carolina Medicorp '97 Claimed Loss Disallowance Group</p><p>case_numbers: 00-1882G</p><p>decision_date: Fri, 15 Jun 2007 12:00:00 -0400</p><p>decision_number: 2007D42</p><p>fiscal_year_end: 06/30/1997</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's adjustments disallowing the loss claimed by Medicare Providers on the disposition of assets resulting from the statutory merger of California Medicorp into Presbyterian Health Services Corporation were proper.</p>]]></description></item><item><title>2000D77</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d77</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d77</guid><description><![CDATA[<p>case_name: InterCounty Total Health Care, Los Angeles CA</p><p>case_numbers: 97-2085</p><p>decision_date: Tue, 22 Aug 2000 12:00:00 -0400</p><p>decision_number: 2000D77</p><p>fiscal_year_end: 03/31/1995</p><p>provider_number: 05-7470</p><p>summary: Was the Intermediary's disallowance of interest expense proper?</p>]]></description></item><item><title>2009D29</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d29</guid><description><![CDATA[<p>case_name: St. Francis Regional Medical Center, Wichita KS</p><p>case_numbers: 98-0892</p><p>decision_date: Wed, 08 Jul 2009 12:00:00 -0400</p><p>decision_number: 2009D29</p><p>fiscal_year_end: 09/30/1995</p><p>provider_number: 17-0122</p><p>summary: Whether the Intermediary's adjustments disallowing a loss claimed by St. Francis Regional Medical Center upon its consolidation with St. Joseph Medical Center to form Via Christi Regional Medical Center was proper.</p>]]></description></item><item><title>2010D36</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d36</guid><description><![CDATA[<p>case_name: SW Consulting/CHI/Caritas Christi HC 2004 DSH Dual Eligible Days Groups</p><p>case_numbers: 07-2626G; 06-2111GC; 09-2298GC</p><p>decision_date: Mon, 14 Jun 2010 12:00:00 -0400</p><p>decision_number: 2010D36</p><p>fiscal_year_end: 2004</p><p>provider_number: Various</p><p>summary: Should the Provider Reimbursement Review Board grant the Providers' request for expedited judicial review (EJR) over the validity of the provisions of the Centers for Medicare &#x26; Medicaid Services Ruling CMS-1498-R, which if valid, render moot and deny jurisdiction over the dual-eligible group appeals?</p>]]></description></item><item><title>2000D78</title><pubDate>Mon, 04 Nov 2019 02:24:17 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d78</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d78</guid><description><![CDATA[<p>case_name: InterCounty THC 96 O/C Key Emp/ Rel Int Group</p><p>case_numbers: 98-2068G</p><p>decision_date: Tue, 22 Aug 2000 12:00:00 -0400</p><p>decision_number: 2000D78</p><p>fiscal_year_end: 03/31/1996</p><p>provider_number: 05-7470; 55-7643; 55-7625</p><p>summary: Was the Intermediary's disallowance of interst expense proper?</p>]]></description></item><item><title>2010D18</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d18</guid><description><![CDATA[<p>case_name: Arden Wood, Inc., San Francisco CA</p><p>case_numbers: 07-2532</p><p>decision_date: Wed, 17 Mar 2010 12:00:00 -0400</p><p>decision_number: 2010D18</p><p>fiscal_year_end: 03/31/2006</p><p>provider_number: 05-1993</p><p>summary: Whether the Fiscal Intermediary's denial of the Provider's nursing education program costs as pass-through costs was valid when that denial was based on a finding that the Commission for the Accreditation of Christian Science Nursing Organization/Facilities, Inc. (Commission) is not a "recognized national professional organization for the particular activity" under the provisions of 42 C.F.R. section 413.85(e) for purposes of accrediting the Provider's nursing education programs.</p>]]></description></item><item><title>1999D34</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d34</guid><description><![CDATA[<p>case_name: Longwood Management Corporation 94-95 Workers Comp Group</p><p>case_numbers: 97-0354G</p><p>decision_date: Tue, 06 Apr 1999 12:00:00 -0400</p><p>decision_number: 1999D34</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Did the Providers properly classify workers' compensation costs under the category of administrative and general costs instead of employees benefits costs?</p>]]></description></item><item><title>2000D79</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d79</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d79</guid><description><![CDATA[<p>case_name: Seniors Management 95 Workers Compensation Group</p><p>case_numbers: 98-1396G</p><p>decision_date: Wed, 06 Sep 2000 12:00:00 -0400</p><p>decision_number: 2000D79</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: Various</p><p>summary: Was the Intermediary's adjustment to worker's compensation expense proper?</p>]]></description></item><item><title>2000D80</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d80</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d80</guid><description><![CDATA[<p>case_name: California Hospitals 90-91 Outpatient Crossover Bad Debts Group</p><p>case_numbers: 96-0184G</p><p>decision_date: Wed, 06 Sep 2000 12:00:00 -0400</p><p>decision_number: 2000D80</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the claims of welfare bad debt under Provider Reimbursement Manual Part 1, Section 322, must be based on a bill to the Medicaid agency, and if not, what must the Provider document to recieve bad debt reimbursement?</p>]]></description></item><item><title>2007D43</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d43</guid><description><![CDATA[<p>case_name: Baptist Memorial Hospital, Memphis TN</p><p>case_numbers: 98-1942</p><p>decision_date: Fri, 29 Jun 2007 12:00:00 -0400</p><p>decision_number: 2007D43</p><p>fiscal_year_end: 09/30/1994</p><p>provider_number: 44-0048</p><p>summary: Whether the Provider is entitled under CMS Program Memorandum (PM) A-99-62 to include Social Security Act, Section 1115 waiver days for the expanded Medicaid populations (a/k/a TennCare) days in the Medicaid component of the disproportionate share hospital (DSH) calculation.</p>]]></description></item><item><title>2007D44</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d44</guid><description><![CDATA[<p>case_name: Tarrant County Hospital District, Fort Worth TX</p><p>case_numbers: 01-2519</p><p>decision_date: Mon, 02 Jul 2007 12:00:00 -0400</p><p>decision_number: 2007D44</p><p>fiscal_year_end: 09/30/1997</p><p>provider_number: 45-0039</p><p>summary: Whether the Provider timely filed additional information required to entitle it to an exemption from the skilled nursing facility (SNF) routine cost limit under 42 C.F.R. section 413.30(e).</p>]]></description></item><item><title>2011D26</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d26</guid><description><![CDATA[<p>case_name: Canon Healthcare Hospice, LLC, New Orleans LA</p><p>case_numbers: 08-0384</p><p>decision_date: Fri, 15 Apr 2011 12:00:00 -0400</p><p>decision_number: 2011D26</p><p>fiscal_year_end: 11/01/2004-10/31/2005</p><p>provider_number: 19-1555</p><p>summary: Whether a full or partial waiver is permissible for the Provider's hospice inpatient day limitation overpayment for the cap year November 1, 2004 through October 31, 2005.</p>]]></description></item><item><title>2009D27</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d27</guid><description><![CDATA[<p>case_name: St. Mary's Hospital- Milwaukee, Milwaukee WI</p><p>case_numbers: 05-1370</p><p>decision_date: Wed, 24 Jun 2009 12:00:00 -0400</p><p>decision_number: 2009D27</p><p>fiscal_year_end: 06/30/1999</p><p>provider_number: 52-0051</p><p>summary: Whether the Medicare statute requires the Provider's Long Term Respiratory Unit (LTRU) days to be excluded from the Medicaid Proxy of the Medicare DSH calculation under 42 U.S.C. Section 1395ww(d)(5)(F)(vi)(II).</p>]]></description></item><item><title>2010D14</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d14</guid><description><![CDATA[<p>case_name: Mercy Medical, Miami FL</p><p>case_numbers: 05-0828</p><p>decision_date: Thu, 11 Mar 2010 12:00:00 -0500</p><p>decision_number: 2010D14</p><p>fiscal_year_end: 12/31/2001</p><p>provider_number: 10-0061</p><p>summary: Whether the provider has a right to hearing on correction of its cost report to reclassify certain nurse expenses.</p>]]></description></item><item><title>2009D33</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d33</guid><description><![CDATA[<p>case_name: Cleveland Regional Medical Center, Cleveland TX</p><p>case_numbers: 06-0814</p><p>decision_date: Thu, 16 Jul 2009 12:00:00 -0400</p><p>decision_number: 2009D33</p><p>fiscal_year_end: 08/31/2001</p><p>provider_number: 45-0296</p><p>summary: Whether the Intermediary's adjustment of the disproportionate share hospital (DSH) reimbursement, based on its determination that the Provider had less than 100 available beds for DSH eligibility purposes, was proper.</p>]]></description></item><item><title>2010D21</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d21</guid><description><![CDATA[<p>case_name: Reflections Wellness Center, Inc.</p><p>case_numbers: 07-2829</p><p>decision_date: Fri, 19 Mar 2010 12:00:00 -0400</p><p>decision_number: 2010D21</p><p>fiscal_year_end: 12/31/2005</p><p>provider_number: 10-1472</p><p>summary: Was the Intermediary's adjustment disallowing bad debts arising from coinsurance and deductibles for dual eligible Medicare and Medicaid beneficiaries proper?</p>]]></description></item><item><title>2000D86</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d86</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d86</guid><description><![CDATA[<p>case_name: Fort Bend Community Hospital-SNF, Missouri City TX</p><p>case_numbers: 97-2707</p><p>decision_date: Thu, 21 Sep 2000 12:00:00 -0400</p><p>decision_number: 2000D86</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 45-0717</p><p>summary: 1. Was the Intermediary's adjustment reclassifying the Provider's cost from direct to indirect cost centers proper?; 2. Did the Intermediary properly apply the low occupancy adjustment in HCFA Transmittal No. 378 to HCFA Pub. 15-1 section 2534.5A?; 3. Was HCFA's refusal to grant an exception for that portion of the Provider's per diem costs which does not exceed 112% of the total peer group mean cost proper?</p>]]></description></item><item><title>1999D49</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d49</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d49</guid><description><![CDATA[<p>case_name: Baystate Medical Center, Springfield MA</p><p>case_numbers: 93-1505</p><p>decision_date: Fri, 07 May 1999 12:00:00 -0400</p><p>decision_number: 1999D49</p><p>fiscal_year_end: 09/30-1990</p><p>provider_number: 22-0077</p><p>summary: Was the Intermediary's disallowance of Medicare bad debts proper?</p>]]></description></item><item><title>2000D88</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d88</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d88</guid><description><![CDATA[<p>case_name: Extendicare 1996 Insurance Allocation Group</p><p>case_numbers: 99-3515G</p><p>decision_date: Tue, 26 Sep 2000 12:00:00 -0400</p><p>decision_number: 2000D88</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: Various</p><p>summary: Were the Intermediary's adjustments reclassifying workers' compensation and unemployment insurance expenses from the administrative and general cost center to the varying cost centers where employees were assigned proper?</p>]]></description></item><item><title>2000D76</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d76</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d76</guid><description><![CDATA[<p>case_name: Sterling Health Services, Inc., Kansas City MO</p><p>case_numbers: 98-0455</p><p>decision_date: Fri, 18 Aug 2000 12:00:00 -0400</p><p>decision_number: 2000D76</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 26-7281</p><p>summary: 1. Was the Intermediary's adjustment disallowing salaries and benefits proper?; 2. Was the Intermediary's adjustment to automobile expense peoper?; 3. Was the Intermediary's adjustment to square footage proper?; 4. Was the Intermediary's adjustment reversing the Provider's reclassification of physical therapy costs proper?; 5. Was the Intermediary's adjustment to physical therapy salaries and bebfits proper?</p>]]></description></item><item><title>2009D31</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d31</guid><description><![CDATA[<p>case_name: College Station Medical Center, College Station TX</p><p>case_numbers: 05-2010</p><p>decision_date: Thu, 09 Jul 2009 12:00:00 -0400</p><p>decision_number: 2009D31</p><p>fiscal_year_end: 10/31/1999</p><p>provider_number: 45-0299</p><p>summary: Whether the Intermediary's adjustment of Disproportionate Share Hospital (DSH) reimbursement, based on its determination that the Provider had less than 100 available beds for DSH eligibility purposes, was proper.</p>]]></description></item><item><title>2010D16</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d16</guid><description><![CDATA[<p>case_name: Chestnut Hill Benevolent Association, Chestnut Hill, MA</p><p>case_numbers: 07-2546; 07-2547; 07-2548; 07-2549</p><p>decision_date: Wed, 17 Mar 2010 12:00:00 -0400</p><p>decision_number: 2010D16</p><p>fiscal_year_end: 12/31/2002- 12/31/2005</p><p>provider_number: 22-1990</p><p>summary: Whether the Fiscal Intermediary's denial of the Provider's nursing education program costs as pass-through costs was valid when that denial was based on a finding that the Commission for the Accreditation of Christian Science Nursing Organization/Facilities, Inc. (Commission) is not a "recognized national professional organization for the particular activity" under the provisions of 42 C.F.R. section 413.85(e) for purposes of accrediting the Provider's nursing education programs.</p>]]></description></item><item><title>2006D31</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d31</guid><description><![CDATA[<p>case_name: Olive View Medical Center, Sylnar CA</p><p>case_numbers: 93-1227+; 93-1227C</p><p>decision_date: Fri, 16 Jun 2006 12:00:00 -0400</p><p>decision_number: 2006D31</p><p>fiscal_year_end: 06/30/1990</p><p>provider_number: 05-0040</p><p>summary: Whether the Provider is entitled to the benefit of the previously granted change in the TEFRA bas period, from fiscal year ending (FYE) June 30, 1985 to FYE June 30, 1988, for the purpose of applying the TEFRA limit for the Provider's FYE June 30, 1990.</p>]]></description></item><item><title>1999D27</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d27</guid><description><![CDATA[<p>case_name: St. Joseph Hospital, Houston TX</p><p>case_numbers: 94-2772</p><p>decision_date: Tue, 09 Mar 1999 12:00:00 -0500</p><p>decision_number: 1999D27</p><p>fiscal_year_end: 06/30/1989</p><p>provider_number: 45-0035</p><p>summary: Was the denial of the Provider's request for an adjustment to the TEFRA limits because of untimely filing, proper?</p>]]></description></item><item><title>2010D17</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d17</guid><description><![CDATA[<p>case_name: Broadview, Inc., Los Angeles CA</p><p>case_numbers: 07-2533; 08-0470</p><p>decision_date: Wed, 17 Mar 2010 12:00:00 -0400</p><p>decision_number: 2010D17</p><p>fiscal_year_end: 06/30/2005; 06/30/2006</p><p>provider_number: 05-1991</p><p>summary: Whether the Fiscal Intermediary's denial of the Provider's nursing education program costs as pass-through costs was valid when that denial was based on a finding that the Commission for the Accreditation of Christian Science Nursing Organization/Facilities, Inc. (Commission) is not a "recognized national professional organization for the particular activity" under the provisions of 42 C.F.R. section 413.85(e) for purposes of accrediting the Provider's nursing education programs.</p>]]></description></item><item><title>2006D40</title><pubDate>Mon, 04 Nov 2019 02:24:16 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d40</guid><description><![CDATA[<p>case_name: Loma Linda University Kidney Center, Loma Linda CA</p><p>case_numbers: 01-2872</p><p>decision_date: Thu, 27 Jul 2006 12:00:00 -0400</p><p>decision_number: 2006D40</p><p>fiscal_year_end: 08/30/2000</p><p>provider_number: 05-2550</p><p>summary: Whether the denial of the Provider's request for an exception to the end stage renal disease (ESRD) composite rate by the Centers for Medicare and Medicaid Services (CMS) was proper.</p>]]></description></item><item><title>2010D26</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d26</guid><description><![CDATA[<p>case_name: QRS Medicare Part A Title XIX Eligible Patient Days Group I</p><p>case_numbers: 05-1790G</p><p>decision_date: Wed, 14 Apr 2010 12:00:00 -0400</p><p>decision_number: 2010D26</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Should patient days associated with Medicare Part A and Title XIX eligible patients that were not included in the Supplemental Security Income (SSI) percentage factor of the Medicare disproportionate share formula be included in the Medicaid days factor or the SSI percentage factor used in the determination of their Medicare Disproportionate Share Hospital (DSH) payment in accordance with the Medicare DSH statute at 42 U.S.C. Section 1395ww(d)(5)(F)(vi)?</p>]]></description></item><item><title>2006D29</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d29</guid><description><![CDATA[<p>case_name: Montefiore Medical Center, New York City NY</p><p>case_numbers: 97-1202; 99-2900</p><p>decision_date: Mon, 05 Jun 2006 12:00:00 -0400</p><p>decision_number: 2006D29</p><p>fiscal_year_end: 12/31/1991; 12/31/1993</p><p>provider_number: 33-0059</p><p>summary: 1. Were the Intermediary's adjustments offsetting rental income received by the Provider for employee housing against both operating and capital costs proper?; 2. Was the Centers for Medicare &#x26; Medicaid Services' methodology for determining the Provider's exceptions to the hospital-based skilled nursing facility cost limits proper?</p>]]></description></item><item><title>2000D73</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d73</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d73</guid><description><![CDATA[<p>case_name: Citizens Medical Center, Victoria TX</p><p>case_numbers: 94-1477; 94-1520</p><p>decision_date: Tue, 08 Aug 2000 12:00:00 -0400</p><p>decision_number: 2000D73</p><p>fiscal_year_end: 06/30/1990; 06/30/1991</p><p>provider_number: 45-0023</p><p>summary: Were the Intermediary's initial, amended and reopening adjustments to interest expense and bond related cost proper?</p>]]></description></item><item><title>2000D84</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d84</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d84</guid><description><![CDATA[<p>case_name: St. Luke's Memorial Hospital, Racine WI</p><p>case_numbers: 95-0711</p><p>decision_date: Wed, 20 Sep 2000 12:00:00 -0400</p><p>decision_number: 2000D84</p><p>fiscal_year_end: 11/01/1993</p><p>provider_number: 52-0094</p><p>summary: Did HCFA inappropriately deny the Provider's end stage renal disease ("ESRD") composite rate exception request for atypical service intensity (patient mix) on the grounds that the Provider did not file a fully documented exception request?</p>]]></description></item><item><title>2000D59</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d59</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d59</guid><description><![CDATA[<p>case_name: Village Green Nursing Home, Phoenix AZ</p><p>case_numbers: 96-2619</p><p>decision_date: Mon, 05 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D59</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 03-5104</p><p>summary: Was the Intermediary's adjustment disallowing indigent Part B bad debts proper?</p>]]></description></item><item><title>2010D20</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d20</guid><description><![CDATA[<p>case_name: SD94/95/96-97 Inpatient Crossover Bad Debts Groups</p><p>case_numbers: 00-4034G; 00-4035G; 00-4036G; 05-0157G</p><p>decision_date: Thu, 18 Mar 2010 12:00:00 -0400</p><p>decision_number: 2010D20</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Providers have been properly paid for bad debts for Medicare deductible and coinsurance amounts associated with Medicaid eligible inpatients for services between May 1, 1994 and June 30, 1998.</p>]]></description></item><item><title>2007D40</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d40</guid><description><![CDATA[<p>case_name: Sierra Nevada Memorial Hospital, Nevada City CA</p><p>case_numbers: 04-2269</p><p>decision_date: Thu, 31 May 2007 12:00:00 -0400</p><p>decision_number: 2007D40</p><p>fiscal_year_end: 12/31/2000</p><p>provider_number: 05-0150</p><p>summary: Whether the Provider's regular Medicare outpatient bad debts are not allowable until all collection efforts including those of a collection agency have ceased.</p>]]></description></item><item><title>2010D22</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d22</guid><description><![CDATA[<p>case_name: Nazareth Hospital and St, Agnes Medical Center, Philadelphia PA</p><p>case_numbers: 04-2157; 05-0706</p><p>decision_date: Tue, 23 Mar 2010 12:00:00 -0400</p><p>decision_number: 2010D22</p><p>fiscal_year_end: 12/31/2002</p><p>provider_number: 39-0204; 39-0022</p><p>summary: Whether General Assistance (GA) days should be added to the numerator of the "Medicaid" proxy in the Disproportionate Share (DSH) payment calculation.</p>]]></description></item><item><title>2000D67</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d67</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d67</guid><description><![CDATA[<p>case_name: The Methodist Hospital, Houston TX</p><p>case_numbers: 94-0654</p><p>decision_date: Wed, 28 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D67</p><p>fiscal_year_end: 12/31/1989</p><p>provider_number: 45-0358</p><p>summary: Was the Intermediary's adjustment reclassifying costs related to equipment which was part of a aupply purchase agreement proper?</p>]]></description></item><item><title>2000D90</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d90</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d90</guid><description><![CDATA[<p>case_name: Rumford Community Hospital, Rumford ME</p><p>case_numbers: 97-2601</p><p>decision_date: Thu, 28 Sep 2000 12:00:00 -0400</p><p>decision_number: 2000D90</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 20-0016</p><p>summary: Was the Intermediary's denial of the Provider's request for a sole community hospital decreased volume adjustment proper?</p>]]></description></item><item><title>2011D20</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d20</guid><description><![CDATA[<p>case_name: QRS 1995-1998 DSH Medicare HMO Days Groups</p><p>case_numbers: 08-2752GC; 04-2131G; 04-2132G; 04-2133G; 04-2134G; 08-2845GC; 08-2756GC</p><p>decision_date: Wed, 16 Mar 2011 12:00:00 -0400</p><p>decision_number: 2011D20</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether for fiscal years 1995-1998 the Intermediary should include dual-eligible, Medicare health maintenance organization (HMO) patient days in the Medicaid proxy in determining Medicare reimbursement for disproportionate share hospital (DSH) payments in accordance with the Medicare statute at 42 U.S.C. Section 1395ww(d)(5)(F)(vi)(II).</p>]]></description></item><item><title>2007D41</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d41</guid><description><![CDATA[<p>case_name: Newport Bay Hospital, Newport Beach CA</p><p>case_numbers: 04-0805</p><p>decision_date: Fri, 08 Jun 2007 12:00:00 -0400</p><p>decision_number: 2007D41</p><p>fiscal_year_end: 04/30/2001</p><p>provider_number: 05-4135</p><p>summary: Whether the Intermediary's decision to deny the Provider's request for an adjustment/exception to its Tax Equity and Fiscal Responsibility Act (TEFRA) target amount was proper.</p>]]></description></item><item><title>2000D12</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d12</guid><description><![CDATA[<p>case_name: Holladay Park Medical Center, Porland, OR</p><p>case_numbers: 95-0068</p><p>decision_date: Tue, 14 Dec 1999 12:00:00 -0500</p><p>decision_number: 2000D12</p><p>fiscal_year_end: 03/31/1990</p><p>provider_number: 38-0024</p><p>summary: Was the Intermediary's or HCFA's determination regarding the Provider's TEFRA exception request proper?</p>]]></description></item><item><title>1999D09</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d09</guid><description><![CDATA[<p>case_name: Peachtree Rehabilitation Center, Peachtree City GA</p><p>case_numbers: 94-2203</p><p>decision_date: Tue, 24 Nov 1998 12:00:00 -0500</p><p>decision_number: 1999D09</p><p>fiscal_year_end: 12/31/1991</p><p>provider_number: 11-6571</p><p>summary: Was the Intermediary's adjustment to bad debt proper?</p>]]></description></item><item><title>1999D11</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d11</guid><description><![CDATA[<p>case_name: Corporacion de Las Vegas, Inc., Manati PR</p><p>case_numbers: 97-0831</p><p>decision_date: Wed, 25 Nov 1998 12:00:00 -0500</p><p>decision_number: 1999D11</p><p>fiscal_year_end: 05/31/1995</p><p>provider_number: 40-7014</p><p>summary: Was the Intermediary's audit adjustment to durable medidcal equipment ("DME") bad debts proper?</p>]]></description></item><item><title>2011D25</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d25</guid><description><![CDATA[<p>case_name: John L. Doyne Hospital, Milwaukee WI</p><p>case_numbers: 00-2803</p><p>decision_date: Wed, 13 Apr 2011 12:00:00 -0400</p><p>decision_number: 2011D25</p><p>fiscal_year_end: 12/22/1995</p><p>provider_number: 52-0174</p><p>summary: Whether the Provider's post-retirement health benefit costs are allowable costs in the Provider's terminating cost report under Provider Reimbursement Manual (PRM) Section2176.</p>]]></description></item><item><title>2011D27</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d27</guid><description><![CDATA[<p>case_name: Kaleida Health, Buffalo NY</p><p>case_numbers: 08-1474</p><p>decision_date: Tue, 26 Apr 2011 12:00:00 -0400</p><p>decision_number: 2011D27</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 33-0005</p><p>summary: 1. Whether the Intermediary's adjustment of the Provider's direct Graduate Medical Education per resident amount was proper.; 2. Whether the Intermediary properly excluded research time the Provider alleges was related to patient care from the Full Time Equivalent resident count for direct Graduate Medical Education and Indirect Medical Education.</p>]]></description></item><item><title>2006D16</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d16</guid><description><![CDATA[<p>case_name: Dameron Hospital, Stockton CA</p><p>case_numbers: 04-0426</p><p>decision_date: Fri, 17 Feb 2006 12:00:00 -0500</p><p>decision_number: 2006D16</p><p>fiscal_year_end: 12/31/1999</p><p>provider_number: 05-0122</p><p>summary: Whether the Intermediary's disallowance of the Provider's inpatient and outpatient Medicare bad debts was proper?</p>]]></description></item><item><title>2010D24</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d24</guid><description><![CDATA[<p>case_name: The Queen's Medical Center, Honolulu HA</p><p>case_numbers: 01-2257</p><p>decision_date: Fri, 02 Apr 2010 12:00:00 -0400</p><p>decision_number: 2010D24</p><p>fiscal_year_end: 06/27/1998</p><p>provider_number: 12-0001</p><p>summary: Whether First Coast Service Options, Inc. (Intermediary) improperly excluded patient days associated with patients who were dually eligible for both the Medicare and Medicaid programs but for such days there was no Medicare Part A payment or coverage available (dual eligible days) from the numerators of both the Medicaid and Supplemental Security Income (SSI) percentages of the Medicare disproportionate share hospital (DSH) computation for purposes of The Queen's Medical Center's (Provider) fiscal year ended June 27, 1998 (FYE 6/27/98) Medicare cost report.</p>]]></description></item><item><title>2006D18</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d18</guid><description><![CDATA[<p>case_name: The Medical Team, Reston, VA</p><p>case_numbers: 00-0548, 00-0609</p><p>decision_date: Fri, 03 Mar 2006 12:00:00 -0500</p><p>decision_number: 2006D18</p><p>fiscal_year_end: 03/31/1996, 03/31/1997</p><p>provider_number: 49-7033</p><p>summary: Was the Intermediary's adjustment applying Medicare's Physical Therapy Compensation Guidelines to the Provider's employee physical therapists proper?</p>]]></description></item><item><title>2010D13</title><pubDate>Mon, 04 Nov 2019 02:24:15 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d13</guid><description><![CDATA[<p>case_name: Royal Coast Rehabilitation Center</p><p>case_numbers: 06-1800</p><p>decision_date: Fri, 29 Jan 2010 12:00:00 -0500</p><p>decision_number: 2010D13</p><p>fiscal_year_end: 12/31/2004</p><p>provider_number: 10-1440</p><p>summary: Was the Intermediary's adjustment disallowing bad debts arising from coinsurance and deductibles for dual eligible Medicare and Medicaid beneficiaries proper?</p>]]></description></item><item><title>2000D31</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d31</guid><description><![CDATA[<p>case_name: Cabarrus County Home Health Agency, Concord NC</p><p>case_numbers: 96-2587</p><p>decision_date: Thu, 23 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D31</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 34-7021</p><p>summary: Was the Intermediary's adjustment disallowing the Provider's employee recruitment expense proper?</p>]]></description></item><item><title>2007D39</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d39</guid><description><![CDATA[<p>case_name: E.W. Sparrow Hospital, Lansing MI</p><p>case_numbers: 04-0644</p><p>decision_date: Thu, 31 May 2007 12:00:00 -0400</p><p>decision_number: 2007D39</p><p>fiscal_year_end: 12/31/2000</p><p>provider_number: 23-0230</p><p>summary: Whether the Intermediary properly determined the full-time equivalent (FTE) intern and resident count for purposes of computing the Provider's indirect medical education adjustment (IME) and the direct graduate medical education (DGME) payment.</p>]]></description></item><item><title>2000D72</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d72</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d72</guid><description><![CDATA[<p>case_name: Anaheim Memorial Hospital, Anaheim CA</p><p>case_numbers: 93-1920; 94-0007</p><p>decision_date: Mon, 03 Jul 2000 12:00:00 -0400</p><p>decision_number: 2000D72</p><p>fiscal_year_end: 09/30/1981; 09/30/1982</p><p>provider_number: 05-0226</p><p>summary: Do equitable tolling principles apply to a matter of law to PRRB appeals under section 1878 of the Social Security Act, codified at 42 C.F.R. section 1395oo, and Boards appeals under the regulations at 42 C.F.R. Subpart R?</p>]]></description></item><item><title>2000D74</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d74</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d74</guid><description><![CDATA[<p>case_name: Columbia/HCA 1984-1986 PPS Federal Rate/ Malpractice Group</p><p>case_numbers: 88-1494G; 88-1495G; 88-1496G</p><p>decision_date: Fri, 18 Aug 2000 12:00:00 -0400</p><p>decision_number: 2000D74</p><p>fiscal_year_end: 12/31/1984-12/31/1986</p><p>provider_number: Various</p><p>summary: Should the federal portion of the prospective payment system ("PPS") rate be adjusted because it was based on 1981 hospital cost report data which incorporated an invalid method of reimbursing malpractice costs, that is, the 1979 malpractice rule?</p>]]></description></item><item><title>2000D36</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d36</guid><description><![CDATA[<p>case_name: Alacare Home Health Service, Inc., Birmingham AL</p><p>case_numbers: 97-0795</p><p>decision_date: Fri, 24 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D36</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 01-7009</p><p>summary: Was the Intermediary's adjustment calculation proper to bring the expenses of Healthstar, Inc., a related party, to the cost of ownership?</p>]]></description></item><item><title>2007D38</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d38</guid><description><![CDATA[<p>case_name: St. Gertrude's Health Center, Shakopee MN</p><p>case_numbers: 00-01032; 01-2147</p><p>decision_date: Wed, 23 May 2007 12:00:00 -0400</p><p>decision_number: 2007D38</p><p>fiscal_year_end: 06/30/1997; 06/30/1998</p><p>provider_number: 24-5610</p><p>summary: Whether the denial of the Provider's request for a new provider exemption from the skilled nursing facility routine cost limits was proper.</p>]]></description></item><item><title>2000D60</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d60</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d60</guid><description><![CDATA[<p>case_name: VNA of Greater Kansas City, Kansas City MO</p><p>case_numbers: 95-0079; 95-2394; 96-0287</p><p>decision_date: Mon, 05 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D60</p><p>fiscal_year_end: 06/30/1992-06/30/1994</p><p>provider_number: 26-7002</p><p>summary: 1. Was the Intermediary's adjustment disallowing the salary and related expenses of the Director of the Volunteer Department proper?; 2. Was the Intermediary's adjustment disallowing the expenses of the television recruitment advertisement proper (FY 93 only)?</p>]]></description></item><item><title>2000D69</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d69</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d69</guid><description><![CDATA[<p>case_name: San Francisco Medical Center, San Francisco CA</p><p>case_numbers: 90-1357</p><p>decision_date: Thu, 29 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D69</p><p>fiscal_year_end: 12/31/1983</p><p>provider_number: 05-0076</p><p>summary: Was the Provider entitled to an adjustment to its TEFRA target rate as a result of the addition of cardiovascular surgery services during the last three months of its TEFRA base year?</p>]]></description></item><item><title>2007D36</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d36</guid><description><![CDATA[<p>case_name: VNA of Albany, Inc., Albany NY</p><p>case_numbers: 98-2095</p><p>decision_date: Tue, 22 May 2007 12:00:00 -0400</p><p>decision_number: 2007D36</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 33-7019</p><p>summary: 1. Whether the Intermediary's adjustment to related party transaction cost was proper.; 2. Whether the Intermediary's adjustment to disallow portions of membership dues expense was proper.; 3. Whether the Intermediary's adjustment to disallow certain meeting/conference expenses was proper.</p>]]></description></item><item><title>2000D65</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d65</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d65</guid><description><![CDATA[<p>case_name: Edgewater Hospital, Chicago</p><p>case_numbers: 91-2887R</p><p>decision_date: Wed, 28 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D65</p><p>fiscal_year_end: 01/21/1989</p><p>provider_number: 14-0087</p><p>summary: Was the Intermediary's netting of the balance due to Edgewater Hospital of liabilities owed to the program by Edgewater Medical Center proper?</p>]]></description></item><item><title>2011D22</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d22</guid><description><![CDATA[<p>case_name: Rankin County Hospital District, Rankin TX</p><p>case_numbers: 04-0661; 04-0663</p><p>decision_date: Fri, 18 Mar 2011 12:00:00 -0400</p><p>decision_number: 2011D22</p><p>fiscal_year_end: 09/30/1998; 09/30/1999</p><p>provider_number: 45-0705</p><p>summary: Whether the Provider is entitled to payment of "fair compensation" pursuant to 42 C.F.R. Section 413.13.</p>]]></description></item><item><title>2011D19</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d19</guid><description><![CDATA[<p>case_name: QRS 1999-2003 DSH Medicare Part C Days Group</p><p>case_numbers: 09-0003GC; 04-2135G; 04-2136G; 04-2137G; 06-1907G; 06-1906G; 08-2753GC; 08-2757GC; 08-2847GC</p><p>decision_date: Sun, 06 Mar 2011 12:00:00 -0500</p><p>decision_number: 2011D19</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary should include dual-eligible, Medicare + Choice (M + C) patient days in the numerator of the Medicaid proxy in determining Medicare reimbursement for disproportionate share hospital (DSH) payments in accordance with the Medicare statute at 42 U.S.C. Section 1395ww(d)(5)(F)(vi)(II).</p>]]></description></item><item><title>2007D35</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d35</guid><description><![CDATA[<p>case_name: Good Samaritan RMC/ Banner Health 94, 96, 97, 98, 99 DSH Calculation Group</p><p>case_numbers: 95-0795; 97-1098; 00-3556G; 01-2892G; 01-2936G; 01-2937G; 02-1810G; 03-1423G</p><p>decision_date: Thu, 17 May 2007 12:00:00 -0400</p><p>decision_number: 2007D35</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary improperly omitted certain inpatient hospital days from the numerator of the Medicaid low-income proxy used to calculate the Providers' disproportionate share hospital (DSH) adjustment.</p>]]></description></item><item><title>2000D75</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d75</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d75</guid><description><![CDATA[<p>case_name: Tenet 1985-1991 Retroactive Adjustment of DRG Base Rate National Portion Group</p><p>case_numbers: 93-0073G; 92-1509G; 93-0888G</p><p>decision_date: Fri, 18 Aug 2000 12:00:00 -0400</p><p>decision_number: 2000D75</p><p>fiscal_year_end: 05/311/1985-05/31/1991</p><p>provider_number: Various</p><p>summary: Should the federal portion of the prospective payment system ("PPS") rate be adjusted because it was based on 1981 hospital cost report data which incorporated an invalid method of reimbursing malpractice costs, that is, the 1979 malpractice rule?</p>]]></description></item><item><title>2007D37</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d37</guid><description><![CDATA[<p>case_name: High Country Home Health Care, Inc., Laramie WY</p><p>case_numbers: 00-0774</p><p>decision_date: Tue, 22 May 2007 12:00:00 -0400</p><p>decision_number: 2007D37</p><p>fiscal_year_end: 06/30/1997</p><p>provider_number: 53-7025</p><p>summary: Whether the Intermediary's disallowance of accrued employee benefit costs that were not liquidated within one year after the end of the Provider's cost reporting period was proper.</p>]]></description></item><item><title>2000D71</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d71</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d71</guid><description><![CDATA[<p>case_name: Benewah Community Hospital, St. Maries ID</p><p>case_numbers: 95-1279; 95-1280</p><p>decision_date: Mon, 03 Jul 2000 12:00:00 -0400</p><p>decision_number: 2000D71</p><p>fiscal_year_end: 09/30/1991; 09/30/1992</p><p>provider_number: 13-0037</p><p>summary: Were the Intermediary's adjustments disallowing costs associated with the Certified Nurse Anesthetist proper?</p>]]></description></item><item><title>2000D62</title><pubDate>Mon, 04 Nov 2019 02:24:14 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d62</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d62</guid><description><![CDATA[<p>case_name: Charlotte Memorial Hospital and Medical Center, Charlotte NC</p><p>case_numbers: 92-0668R</p><p>decision_date: Mon, 05 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D62</p><p>fiscal_year_end: 09/30/1982</p><p>provider_number: 34-0113</p><p>summary: Did the Intermediary properly reopen the Provider's cost report and recoup an overpayment made to the Provider?</p>]]></description></item><item><title>2000D23</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d23</guid><description><![CDATA[<p>case_name: United Hospitals Medical Center, Newark NJ</p><p>case_numbers: 96-1736</p><p>decision_date: Thu, 02 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D23</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 31-0062</p><p>summary: 1. Was the Intermediary's calculation of the number of maintained beds proper?; 2. Was the Intermediary's adjustment excluding certain resident Full-Time Equivalents (FTEs)proper?; 3. Was the Intermediary's adjustment excluding certain allowable fringe benefits proper?; 4. Was the Intermediary's adjustment disallowing certain amounts related to contract labor proper?; 5. Was the Intermediary's adjustment disallowing certain amounts related to Part B physician salaries and hours proper?</p>]]></description></item><item><title>2000D58</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d58</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d58</guid><description><![CDATA[<p>case_name: Campbell County Memorial Hospital, Gillette WY</p><p>case_numbers: 96-2027; 97-2271</p><p>decision_date: Thu, 01 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D58</p><p>fiscal_year_end: 06/30/1993; 06/30/1994</p><p>provider_number: 53-0002</p><p>summary: Was the Provider entitled to an exception to the home health agency ("HHA") cost limits for the fiscal years ended June 30, 1993 and June 30, 1994?</p>]]></description></item><item><title>2000D47</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d47</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d47</guid><description><![CDATA[<p>case_name: St. Joseph Hospital, St. Paul MN</p><p>case_numbers: 96-0644</p><p>decision_date: Sat, 20 May 2000 12:00:00 -0400</p><p>decision_number: 2000D47</p><p>fiscal_year_end: 08/31/1993</p><p>provider_number: 24-0063</p><p>summary: Was the Intermediary's adjustment to disallow the Minnesota Care Tax proper?</p>]]></description></item><item><title>2000D14</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d14</guid><description><![CDATA[<p>case_name: St. Joseph Hospital and Medical Center, Phoenix, AZ</p><p>case_numbers: 95-1201</p><p>decision_date: Tue, 11 Jan 2000 12:00:00 -0500</p><p>decision_number: 2000D14</p><p>fiscal_year_end: 06/30/1992</p><p>provider_number: 03-0024</p><p>summary: 1. Were the Intermediary's adjustments excluding certain interest expense proper?; 2. Were the Intermediary's adjustments grossing up days and charges for employee patients proper?</p>]]></description></item><item><title>2008D25</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d25</guid><description><![CDATA[<p>case_name: University of California, Davis Medical Center, Sacramento CA</p><p>case_numbers: 05-1788</p><p>decision_date: Thu, 17 Apr 2008 12:00:00 -0400</p><p>decision_number: 2008D25</p><p>fiscal_year_end: 06/30/1992</p><p>provider_number: 05-0599</p><p>summary: Whether the Intermediary can make an adjustment to the Provider's Medicare cost report more than three years after the original Notice of Program Reimbursement date.</p>]]></description></item><item><title>2000D40</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d40</guid><description><![CDATA[<p>case_name: University of Wisconsin Hospital and Clinics, Madison WI</p><p>case_numbers: 95-0535</p><p>decision_date: Tue, 28 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D40</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 52-0098</p><p>summary: Was HCFA's denial of the Provider's request for an exception rate for self-dialysis training using an accelerated method proper?</p>]]></description></item><item><title>2000D56</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d56</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d56</guid><description><![CDATA[<p>case_name: Methodist Hospital of Dyersburg, Dyersburg TN</p><p>case_numbers: 96-1215</p><p>decision_date: Tue, 30 May 2000 12:00:00 -0400</p><p>decision_number: 2000D56</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 44-0072</p><p>summary: 1. Was the Intermediary's adjustment disallowing Medicare reimbursement for a portion of the bad debts proper?; 2. Was the Intermediary's reclassification for home health agency costs proper?</p>]]></description></item><item><title>2000D27</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d27</guid><description><![CDATA[<p>case_name: The Ohio State University Hospital, Columbus OH</p><p>case_numbers: 96-0036</p><p>decision_date: Wed, 08 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D27</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 36-0085</p><p>summary: Was the Intermediary's adjustment to the outlier payments proper?</p>]]></description></item><item><title>2009D25</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d25</guid><description><![CDATA[<p>case_name: Connecticut 94-98 DSH group</p><p>case_numbers: 00-3473G</p><p>decision_date: Wed, 17 Jun 2009 12:00:00 -0400</p><p>decision_number: 2009D25</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary properly excluded Connecticut's State-Administered General assistance (SAGA) program days from the Medicare disproportionate share hospital (DSH) calculation for fiscal year-ends (FYEs) 1994 to 1998 for hospitals in this group appeal.</p>]]></description></item><item><title>2000D66</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d66</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d66</guid><description><![CDATA[<p>case_name: Lloyd Noland Hospital, Fairfield AL</p><p>case_numbers: 92-0209; 94-2362; 98-0428; 99-0130; 99-0131</p><p>decision_date: Wed, 28 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D66</p><p>fiscal_year_end: 06/30/1991- 10/03/1996</p><p>provider_number: 01-0068</p><p>summary: Was the Intermediary's adjustment disallowing portions of compensation paid to physicians based on the application of the 1984 reasonable compensation equivalents proper?</p>]]></description></item><item><title>2000D51</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d51</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d51</guid><description><![CDATA[<p>case_name: St. Barnabas Hospital, Bronx NY</p><p>case_numbers: 95-2202</p><p>decision_date: Thu, 27 Apr 2000 12:00:00 -0400</p><p>decision_number: 2000D51</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 33-0399</p><p>summary: Was the Intermediary's adjustment reducing the allowable cost to charge retio that should be applied to outpatient charges proper?</p>]]></description></item><item><title>2000D57</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d57</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d57</guid><description><![CDATA[<p>case_name: Daniel Freeman Memorial Hospital, Iglewood CA</p><p>case_numbers: 96-0939</p><p>decision_date: Fri, 02 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D57</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 05-0267</p><p>summary: 1. Did the Intermediary properly include the Provider's inpatient Part B charges with outpatient Part B charges, thereby subjecting the inpatient Part B charges to the 5.8% outpatient cost reduction?; 2. Was the Intermediary's calculation of the Provider's disproportionate share ("DSH") adjustment proper?</p>]]></description></item><item><title>2000D30</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d30</guid><description><![CDATA[<p>case_name: Menifee Valley Medical Center, Sun City CA</p><p>case_numbers: 95-0459</p><p>decision_date: Wed, 22 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D30</p><p>fiscal_year_end: 06/30/1992</p><p>provider_number: 05-0684</p><p>summary: Was the Intermediary's elimination of square footage statistics for the fourth floor storage area correct?</p>]]></description></item><item><title>2000D68</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d68</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d68</guid><description><![CDATA[<p>case_name: Mercer Street Friends, Trenton NJ</p><p>case_numbers: 99-0286</p><p>decision_date: Thu, 29 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D68</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 31-7062</p><p>summary: 1. Was the interest paid on working capital loans from the Friend Center Fund and commercial banks necessary and allowable?; 2. Was the interest paid to Cadwalder Properties, a related party, allowable as an ownership cost under 42 C.F.R. section 413.153?</p>]]></description></item><item><title>2006D03</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d03</guid><description><![CDATA[<p>case_name: Trenton Psychiatric Hospital, Trenton NJ</p><p>case_numbers: 02-1765, 02-1766, 02-1767, 03-0825</p><p>decision_date: Thu, 17 Nov 2005 12:00:00 -0500</p><p>decision_number: 2006D03</p><p>fiscal_year_end: 06/30/1996-06/30/1999</p><p>provider_number: 31-4013</p><p>summary: Whether the Intermediary's adjustments to disallow reimbursement for physicians' professioanl services on a reasonable cost basis was proper.</p>]]></description></item><item><title>2000D70</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d70</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d70</guid><description><![CDATA[<p>case_name: Ashtabula county Medical Center Skilled Nursing Facility, Ashtabula OH</p><p>case_numbers: 97-0407</p><p>decision_date: Thu, 29 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D70</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 36-0125; 36-6048</p><p>summary: Did HCFA properly deny a new provider exemption request for the Provider's distinct part skilled nursing facility inder 42 C.F.R. section 413.30(e)?</p>]]></description></item><item><title>1998D099</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d099</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d099</guid><description><![CDATA[<p>case_name: Loma Linda University Medical Center, Loma Linda CA</p><p>case_numbers: 89-1522</p><p>decision_date: Thu, 17 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D099</p><p>fiscal_year_end: 06/30/1985</p><p>provider_number: 05-0327</p><p>summary: Was the Provider's computation of the self-disallowance amount of investment income offset against interest expense proper?</p>]]></description></item><item><title>2000D63</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d63</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d63</guid><description><![CDATA[<p>case_name: All-Care Home Health Services, Rancho Cordova CA</p><p>case_numbers: 97-0643; 98-0770; 99-3555; 99-0613</p><p>decision_date: Thu, 08 Jun 2000 12:00:00 -0400</p><p>decision_number: 2000D63</p><p>fiscal_year_end: 03/31/1995-03/31/1998</p><p>provider_number: 55-7253</p><p>summary: 1. Was the Intermediary's adjustment to Physical Therapy costs proper?; 2. Was the Intermediary's adjustment to owner's compensation proper?</p>]]></description></item><item><title>2010D40</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d40</guid><description><![CDATA[<p>case_name: Adventist DSH Waiver Days Group</p><p>case_numbers: 01-1346G</p><p>decision_date: Fri, 02 Jul 2010 12:00:00 -0400</p><p>decision_number: 2010D40</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's calculation of the Providers' Medicare disproportionate share hospital ("DSH") payments improperly excluded "expansion waiver" days attributable to patients who received medical assistance through Tennessee's Medicaid demonstration project waiver program approved by the Secretary under section 1115 of the Social Security Act ("section 1115").</p>]]></description></item><item><title>2000D37</title><pubDate>Mon, 04 Nov 2019 02:24:13 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d37</guid><description><![CDATA[<p>case_name: Saint Francis Medical Center, Pittsburgh PA</p><p>case_numbers: 95-2401; 95-2402; 95-2403</p><p>decision_date: Mon, 27 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D37</p><p>fiscal_year_end: 06/30/1989-06/30/1991</p><p>provider_number: 39-0029</p><p>summary: 1. Did HCFA properly deny the PRovider's requests for a permanent adjustment to its TEFRA base year in fiscal years ("FY") 1989 and 1990, and the "assignment of a new base period" in FY 1991?; 2. Did HCFA properly grant only limited cost year specific adjustments?</p>]]></description></item><item><title>1998D100</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d100</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d100</guid><description><![CDATA[<p>case_name: St' Francis Memorial Hospital, San Francisco CA</p><p>case_numbers: 93-1013</p><p>decision_date: Thu, 17 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D100</p><p>fiscal_year_end: 06/30/1982; 06/30/1983</p><p>provider_number: 05-0152</p><p>summary: Did the Intermediary abuse its discretion in refusing to reopen the Provider's cost reports for the fiscal Years ("FYE") ended June 30, 1982 and 1983?</p>]]></description></item><item><title>2008D23</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d23</guid><description><![CDATA[<p>case_name: University of Texas M.D. Anderson Cancer Center, Houston TX</p><p>case_numbers: 04-1953; 05-1582</p><p>decision_date: Fri, 04 Apr 2008 12:00:00 -0400</p><p>decision_number: 2008D23</p><p>fiscal_year_end: 08/31/2000; 08/31/2001</p><p>provider_number: 45-0076</p><p>summary: 1. Whether the Intermediary properly disallowed the Provider's request for an adjustment to the TEFRA rate-of-increase ceiling to account for the cost of new drugs that were not approved in the 1983 base year.; 2. Whether the Intermediary properly calculated the Provider's 1996 reasonable cost that were included in the denominator of the fraction used to determine the payment-to-cost ratio for purposes of the Outpatient Prospective Payment System (OPPS) hold harmless payment.</p>]]></description></item><item><title>2010D41</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d41</guid><description><![CDATA[<p>case_name: Norfolk MSA 2004 Wage Index Group</p><p>case_numbers: 04-0495G</p><p>decision_date: Tue, 03 Aug 2010 12:00:00 -0400</p><p>decision_number: 2010D41</p><p>fiscal_year_end: FFY 2004</p><p>provider_number: Various</p><p>summary: Whether the Intermediary erred in excluding certain contract labor costs, home office costs, and wage-related costs that were claimed by Bon Secours-DePaul Medical Center, Maryview Medical Center, and Mary Immaculate Hospital (collectively, the "Bon Secours Hospitals") and used to calculate the federal fiscal year 2004 wage index for the Norfolk Metropolitan Statistical Area ("MSA").</p>]]></description></item><item><title>2000D42</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d42</guid><description><![CDATA[<p>case_name: St. Luke's Hospital</p><p>case_numbers: 95-0577</p><p>decision_date: Thu, 04 May 2000 12:00:00 -0400</p><p>decision_number: 2000D42</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 39-0049</p><p>summary: Was HCFA's denial of the Provider's request for an exception to the renal dialysis composite rate based on atypical service intensity proper?</p>]]></description></item><item><title>2000D41</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d41</guid><description><![CDATA[<p>case_name: Faxton Hospital, Utica NY</p><p>case_numbers: 96-2423</p><p>decision_date: Tue, 28 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D41</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 33-0048</p><p>summary: Was the Intermediary's refusal to increase the Provider's disproportionate share percentage to include eligible Medicaid days where Medicare was the primary payor proper?</p>]]></description></item><item><title>2000D39</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d39</guid><description><![CDATA[<p>case_name: Fairfax Hospital, Falls Church VA</p><p>case_numbers: 91-2592M; 94-0951; 94-0952; 94-0953; 94-1386</p><p>decision_date: Tue, 28 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D39</p><p>fiscal_year_end: 12/29/1984-12/31/1990</p><p>provider_number: 49-0063</p><p>summary: 1.Whether the Intermediary proper omitted all of the pathology teaching costs incurred in the Graduate Medical Education ("GME") base year from the GME costs used to compute the Provider's average per resident amount ("APRA")?; 2. In the alternative, whether the Intermediary properly included the 4.42 full-time equivalent ("FTE") residents who worked in the approved pathology program during the GME base year in the resident count used to compute the APRA?</p>]]></description></item><item><title>2000D33</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d33</guid><description><![CDATA[<p>case_name: Good Samaritan Hospital, Suffren NY</p><p>case_numbers: 97-2391</p><p>decision_date: Thu, 23 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D33</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 33-0158</p><p>summary: Were the Intermediary's adjustments to the reasonable compensation equivalent ("RCE") limits proper?</p>]]></description></item><item><title>2000D34</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d34</guid><description><![CDATA[<p>case_name: Rapid City Regional Hospital, Rapid City SD</p><p>case_numbers: 97-2064</p><p>decision_date: Fri, 24 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D34</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 43-0077</p><p>summary: Was the Intermediary's classification of School of Nursing Joint Education Program cost proper?</p>]]></description></item><item><title>2000D44</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d44</guid><description><![CDATA[<p>case_name: Edgewater Medical Center, Chicago IL</p><p>case_numbers: 94-0616</p><p>decision_date: Sun, 07 May 2000 12:00:00 -0400</p><p>decision_number: 2000D44</p><p>fiscal_year_end: 12/31/1990</p><p>provider_number: 14-0087</p><p>summary: Was the Intermediary's calculation of the Provider's disproportionate share ajustment ("DSH") proper?</p>]]></description></item><item><title>2000D32</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d32</guid><description><![CDATA[<p>case_name: Methodist Hospital, St. Louis Park MN</p><p>case_numbers: 98-0448</p><p>decision_date: Thu, 23 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D32</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 24-0053</p><p>summary: Was the Intermediary's disallowance of the physician Part A compensation due to inadequate physician time studies proper?</p>]]></description></item><item><title>2000D35</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d35</guid><description><![CDATA[<p>case_name: Rapid City Regional Hospital, Rapid City SD</p><p>case_numbers: 97-2148</p><p>decision_date: Fri, 24 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D35</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 43-0077</p><p>summary: 1.Was the Intermediary's classification of School of Nursing Joint Education Program cost proper; 2. Was the Intermediary's adjustment eliminating Part A hours for Medical Directors proper?</p>]]></description></item><item><title>2000D52</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d52</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d52</guid><description><![CDATA[<p>case_name: North Iowa Medical Center, Mason City IA</p><p>case_numbers: 96-2570</p><p>decision_date: Tue, 02 May 2000 12:00:00 -0400</p><p>decision_number: 2000D52</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 16-0059</p><p>summary: Was the Intermediary's adjustment disallowing the Provider's loss on the sale of its assets proper?</p>]]></description></item><item><title>2000D53</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d53</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d53</guid><description><![CDATA[<p>case_name: New England Rehabilitation Hospital, Woburn MA</p><p>case_numbers: 88-0649</p><p>decision_date: Wed, 24 May 2000 12:00:00 -0400</p><p>decision_number: 2000D53</p><p>fiscal_year_end: 08/31/1985</p><p>provider_number: 22-3026; 22-5190</p><p>summary: Was HCFA's methodolgy for measuring the entitlement of hospital-based skilled nursing facilities ("HB-SNF") to exception relief under 42 C.F.R. section 413.30(f) and HCFA's denial of the Provider's fiscal year ("FY") 1985 exception request proper?</p>]]></description></item><item><title>2001D14</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d14</guid><description><![CDATA[<p>case_name: North Shore University Hospital, Manhasset, NY</p><p>case_numbers: 95-1296</p><p>decision_date: Thu, 05 Apr 2001 12:00:00 -0400</p><p>decision_number: 2001D14</p><p>fiscal_year_end: 12/31/1991</p><p>provider_number: 33-0106</p><p>summary: Did the Intermediary use the correct reasonable compensation equivalent ("RCE") limits to disallow a portion of the Provider's hospital-based only physicians' compensation?</p>]]></description></item><item><title>1998D101</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d101</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d101</guid><description><![CDATA[<p>case_name: Martin Luther King, Jr./ Drew Medical Center, Los Angeles CA</p><p>case_numbers: 89-0706</p><p>decision_date: Fri, 18 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D101</p><p>fiscal_year_end: 06/30/1985</p><p>provider_number: 05-0578</p><p>summary: Was the Intermediary's determination of the amount of Medicare outlier payments proper?</p>]]></description></item><item><title>2006D01</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d01</guid><description><![CDATA[<p>case_name: Saint Mary's Hospital, Rochester MN</p><p>case_numbers: 98-0502</p><p>decision_date: Tue, 08 Nov 2005 12:00:00 -0500</p><p>decision_number: 2006D01</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 24-0010</p><p>summary: Was the Intermediary's denial of the Provider's request for an adjustment to its TEFRA target amount due to untimely filing of a request proper?</p>]]></description></item><item><title>2008D24</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d24</guid><description><![CDATA[<p>case_name: Summit Medical Center, Oakland CA</p><p>case_numbers: 01-0679; 02-0244</p><p>decision_date: Tue, 15 Apr 2008 12:00:00 -0400</p><p>decision_number: 2008D24</p><p>fiscal_year_end: 02/28/1998; 02/28/1999</p><p>provider_number: 05-0043</p><p>summary: Whether the TEFRA base year used by the fiscal intermediary to compute a target amount for the Provider's excluded psychiatric unit for the February 28, 1998 and February 28, 1999 cost years was proper.</p>]]></description></item><item><title>2008D15</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d15</guid><description><![CDATA[<p>case_name: Allentown Osteopathic Medical Center, Allentown PA</p><p>case_numbers: 00-1182</p><p>decision_date: Thu, 24 Jan 2008 12:00:00 -0500</p><p>decision_number: 2008D15</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 39-0242</p><p>summary: Whether the Intermediary's denial of the loss on disposal of assets claimed by Allentown Osteopathic Medical Center (AOMC) was proper?</p>]]></description></item><item><title>2000D25</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d25</guid><description><![CDATA[<p>case_name: Tri-State Memorial Hospital, Clarkston WA</p><p>case_numbers: 95-0326</p><p>decision_date: Mon, 06 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D25</p><p>fiscal_year_end: 11/29/1993-04/29/1994</p><p>provider_number: 50-0057</p><p>summary: Were HCFA's determinations of the Provider's ESRD exception requests proper?</p>]]></description></item><item><title>1998D102</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d102</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d102</guid><description><![CDATA[<p>case_name: Saint Luke's Medical Center, Cleveland OH</p><p>case_numbers: 94-1146</p><p>decision_date: Fri, 18 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D102</p><p>fiscal_year_end: 12/31/1989</p><p>provider_number: 36-0045</p><p>summary: Was the Intermediary's calculation of the number of full-time equivalents ("FTEs") when counting thw number of interns and residents for FYE December 31, 1989 proper?</p>]]></description></item><item><title>2000D49</title><pubDate>Mon, 04 Nov 2019 02:24:12 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d49</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d49</guid><description><![CDATA[<p>case_name: Divine Redeemer Hospital, St. Paul MN</p><p>case_numbers: 96-0804</p><p>decision_date: Sat, 20 May 2000 12:00:00 -0400</p><p>decision_number: 2000D49</p><p>fiscal_year_end: 08/31/1993</p><p>provider_number: 24-0003</p><p>summary: Was the Intermediary's adjustment to disallow the Minnesota Care Tax proper?</p>]]></description></item><item><title>1998D097</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d097</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d097</guid><description><![CDATA[<p>case_name: Stephens Home Health Care, Weatherford TX</p><p>case_numbers: 97-3047</p><p>decision_date: Thu, 17 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D097</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 67-7413</p><p>summary: Were the HHA cost limits issued prospectively by New Mexico Blue Cross Blue Shield for FY 95 and as applied in FY 95, correct or were the lower costs limits retroactively applied by Palmetto (the successor Intermediary) correct?</p>]]></description></item><item><title>2001D11</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d11</guid><description><![CDATA[<p>case_name: Miami Valley Hospital, Dayton, OH</p><p>case_numbers: 95-2183; 97-3095</p><p>decision_date: Thu, 25 Jan 2001 12:00:00 -0500</p><p>decision_number: 2001D11</p><p>fiscal_year_end: 12/31/1992; 12/31/1994</p><p>provider_number: 36-0051</p><p>summary: Did the Intermediary use the correct reasonable compensation equivalent ("RCE") limits to disallow a portion of the Provider's hospital-based physicians' compensation?</p>]]></description></item><item><title>2000D48</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d48</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d48</guid><description><![CDATA[<p>case_name: Sethesda Lutheran Medical Center, St. Paul MN</p><p>case_numbers: 96-0861</p><p>decision_date: Sat, 20 May 2000 12:00:00 -0400</p><p>decision_number: 2000D48</p><p>fiscal_year_end: 08/31/1993</p><p>provider_number: 24-2004</p><p>summary: Was the Intermediary's adjustment to disallow the Minnesota Care Tax proper?</p>]]></description></item><item><title>2000D28</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d28</guid><description><![CDATA[<p>case_name: Roswell Park Cancer Institiute, Buffalo NY</p><p>case_numbers: 91-2846M</p><p>decision_date: Wed, 08 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D28</p><p>fiscal_year_end: 03/31/1985</p><p>provider_number: 33-0354</p><p>summary: Was the Intermediary's failure to include supervising physician costs in the Provider's final base-year average per resident graduate medical education (GME) amount proper?</p>]]></description></item><item><title>2000D46</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d46</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d46</guid><description><![CDATA[<p>case_name: Stouder Memorial Hospital Subacute Unit, Troy OH</p><p>case_numbers: 97-2385</p><p>decision_date: Thu, 18 May 2000 12:00:00 -0400</p><p>decision_number: 2000D46</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 36-6007</p><p>summary: Is the Provider entitled to an exemption from the routine cost limits ("RCL") as a new provider under 42 C.F.R. section 413.30(e)?</p>]]></description></item><item><title>2000D29</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d29</guid><description><![CDATA[<p>case_name: Edgewater Hospital, Chicago IL</p><p>case_numbers: 91-2887</p><p>decision_date: Fri, 03 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D29</p><p>fiscal_year_end: 01/21/1989</p><p>provider_number: 14-0087</p><p>summary: Was the Intermediary's netting of the balance due to Edgewater Hospital of liabilities owed to the program by Edgewater Medical Center proper?</p>]]></description></item><item><title>2000D50</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d50</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d50</guid><description><![CDATA[<p>case_name: West Virgina University Hospital, Morgantown WV</p><p>case_numbers: 96-0918</p><p>decision_date: Sun, 21 May 2000 12:00:00 -0400</p><p>decision_number: 2000D50</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 51-0001</p><p>summary: Was the Intermediary's adjustment reclassifying the depreciable assets as "new" capital proper?</p>]]></description></item><item><title>2000D38</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d38</guid><description><![CDATA[<p>case_name: Professional Rehabilitation Outpatient Services, Spring TX</p><p>case_numbers: 98-0273</p><p>decision_date: Mon, 27 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D38</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 45-6689</p><p>summary: Was the Intermediary's adjustment to the accrued salaries proper?</p>]]></description></item><item><title>2000D24</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d24</guid><description><![CDATA[<p>case_name: N/A</p><p>case_numbers: 94-0302G; 94-0304G</p><p>decision_date: Fri, 03 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D24</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Were the Intermediary's adjustments to the Providers' home office cost statementsproper?</p>]]></description></item><item><title>1998D098</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d098</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d098</guid><description><![CDATA[<p>case_name: Mono General Hospital, Mono Count CA</p><p>case_numbers: 89-1753</p><p>decision_date: Thu, 17 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D098</p><p>fiscal_year_end: 06/30/1987</p><p>provider_number: 05-0450</p><p>summary: Was the Provider's request for additional payment due to volume decrease, properly made within 180 days from the date of the revised Notice of Program Reimbursement (NPR)?</p>]]></description></item><item><title>2001D34</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d34</guid><description><![CDATA[<p>case_name: Flowers Hospital Group, Dothan, AL</p><p>case_numbers: 95-1001G</p><p>decision_date: Wed, 27 Jun 2001 12:00:00 -0400</p><p>decision_number: 2001D34</p><p>fiscal_year_end: 05/31/1992</p><p>provider_number: 01-0055, 01-7013, 01-7020, 01-7048, 01-7072</p><p>summary: 1. Was the Intermediary's adjustment to the Provider's allowable costs based on the recapture of depreciation proper?; 2. Does the Intermediary's recapture of depreciation due to a gain on the sale of depreciable assets affect the Provider's calculation of equity capital for prior use?</p>]]></description></item><item><title>2010D44</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d44</guid><description><![CDATA[<p>case_name: Southcrest Hospital, Tulsa OK</p><p>case_numbers: 04-2270; 07-0278; 07-1351; 08-0169</p><p>decision_date: Wed, 15 Sep 2010 12:00:00 -0400</p><p>decision_number: 2010D44</p><p>fiscal_year_end: 12/31/2003 - 12/31/2005</p><p>provider_number: 37-0202</p><p>summary: Whether the hospital as a new provider is entitled to capital hold-harmless methodology under the prospective payment system beyond the 10-year transition period.</p>]]></description></item><item><title>2000D26</title><pubDate>Mon, 04 Nov 2019 02:24:10 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d26</guid><description><![CDATA[<p>case_name: Monmouth Medical Center, Long Branch NJ</p><p>case_numbers: 95-1566</p><p>decision_date: Mon, 06 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D26</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 31-0075</p><p>summary: Was the Intermediary's failure to apply updated reasonable compensation equivalents limits proper?</p>]]></description></item><item><title>2008D21</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d21</guid><description><![CDATA[<p>case_name: Vitality Rehab, Inc., Long Beach CA</p><p>case_numbers: 01-1910</p><p>decision_date: Mon, 17 Mar 2008 12:00:00 -0400</p><p>decision_number: 2008D21</p><p>fiscal_year_end: 12/31/1999</p><p>provider_number: 05-6833</p><p>summary: Whether the Intermediary properly disallowed bad debts claimed for uncollectible deductibles and coinsurance amounts related to outpatient therapy services furnished to Medicare beneficiaries dually eligible for Medicare and Medicaid, and paid under the Part B fee schedule.</p>]]></description></item><item><title>1998D108</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d108</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d108</guid><description><![CDATA[<p>case_name: Cascade Care Centers 93 Disallow S/O Therapy</p><p>case_numbers: 96-0568G</p><p>decision_date: Wed, 30 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D108</p><p>fiscal_year_end: 1993</p><p>provider_number: Various</p><p>summary: Was the Intermediary's audit adjustments reducing charges for occupational and speech therapy services based upon the prudent buyer concept proper?</p>]]></description></item><item><title>2008D18</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d18</guid><description><![CDATA[<p>case_name: Mercy Center for Health Care Services, Aurora IL</p><p>case_numbers: 01-0801</p><p>decision_date: Fri, 15 Feb 2008 12:00:00 -0500</p><p>decision_number: 2008D18</p><p>fiscal_year_end: 11/30/1997</p><p>provider_number: 14-0174</p><p>summary: Whether the Intermediary's adjustment disallowing the loss on disposal of depreciable assets through consolidation was proper.</p>]]></description></item><item><title>2002D12</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d12</guid><description><![CDATA[<p>case_name: A Priority Home Care, Inc.,Munster, IN</p><p>case_numbers: 00-0479</p><p>decision_date: Tue, 19 Mar 2002 12:00:00 -0500</p><p>decision_number: 2002D12</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 15-7425</p><p>summary: Was the Intermediary's adjustment reclassifying a portion of the Hospice Director's salary proper?</p>]]></description></item><item><title>2001D53</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d53</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d53</guid><description><![CDATA[<p>case_name: Strong Memorial Hospital, Rochester, NY</p><p>case_numbers: 96-0180</p><p>decision_date: Fri, 28 Sep 2001 12:00:00 -0400</p><p>decision_number: 2001D53</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 33-0285</p><p>summary: Did the Intermediary use the correct reasonable compensation equivalent ('RCE') limits to disallow a portion of the Provider's hospital-based physicians' compensation?</p>]]></description></item><item><title>2001D48</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d48</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d48</guid><description><![CDATA[<p>case_name: Continue Care Home Health II, Inc., Cleveland, MS</p><p>case_numbers: 00-1179</p><p>decision_date: Mon, 17 Sep 2001 12:00:00 -0400</p><p>decision_number: 2001D48</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: 25-7305</p><p>summary: 1. Was the Intermediary's adjustment, at the Home Office level, to the owner's bonus for untimely liquidation proper?; 2. Was the Intermediary's adjustment, at the Provider level, to employee bonuses for untimely liquidation proper?</p>]]></description></item><item><title>1998D089</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d089</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d089</guid><description><![CDATA[<p>case_numbers: 91-2907M</p><p>decision_date: Wed, 09 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D089</p><p>fiscal_year_end: 06/30/1985</p><p>provider_number: 39-0196</p><p>summary: 1. Did the Intermediary improperly exclude physician compensation costs, attributable to teaching and supervision of interns and residents in the departments of surgery, from the graduate medical education ("GME") costs used to compute the Provider's average per resident amount?: 2. Did the Intermediary improperly exclude physician compensation costs, attributable to teaching and supervision of interns and residents in the departments of radiation therapy, from the GME costs used to compute the Provider's average per resident amount?</p>]]></description></item><item><title>2001D43</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d43</guid><description><![CDATA[<p>case_name: Loma Linda University Medical Center, Loma Linda, CA</p><p>case_numbers: 89-1522R</p><p>decision_date: Thu, 30 Aug 2001 12:00:00 -0400</p><p>decision_number: 2001D43</p><p>fiscal_year_end: 06/30/1985</p><p>provider_number: 05-0327</p><p>summary: Was the Provider's computation of the self-disallowance amount of investment income offset against interest expense proper?</p>]]></description></item><item><title>2010D07</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d07</guid><description><![CDATA[<p>case_name: Mercy Medical Center, Des Moines, IA</p><p>case_numbers: 06-0301; 06-0302</p><p>decision_date: Fri, 04 Dec 2009 12:00:00 -0500</p><p>decision_number: 2010D07</p><p>fiscal_year_end: 06/30/1997; 06/30/1996</p><p>provider_number: 16-0083</p><p>summary: Whether the Intermediary improperly calculated the Provider's Medicare disproportionate share hospital (DSH) payment by excluding patient days attributable to hospital inpatients who were eligible for Medicaid and enrolled in Medicare Part A for all or a part of the period at issue.</p>]]></description></item><item><title>1998D103</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d103</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d103</guid><description><![CDATA[<p>case_name: Medical Center of Garden Grove, Garden Grove CA</p><p>case_numbers: 93-0429</p><p>decision_date: Tue, 22 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D103</p><p>fiscal_year_end: 02/28/1990</p><p>provider_number: 05-0230</p><p>summary: Was the Intermediary's adjustment offseting revenue associated with physician and guest meals, while, at the same time, setting up a nonreimbursable cost center for these nonallowable costs, proper?</p>]]></description></item><item><title>2010D11</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d11</guid><description><![CDATA[<p>case_name: HCA 2001 Outpatient Therapy Bad Debts Group</p><p>case_numbers: 04-0228G</p><p>decision_date: Thu, 28 Jan 2010 12:00:00 -0500</p><p>decision_number: 2010D11</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the various Intermediaries properly disallowed reimbursement to the Providers for uncollected coinsurance and deductible amounts relating to outpatient therapy services claimed as bad debt during the Providers' respective cost-reporting years ending in 2001.</p>]]></description></item><item><title>2000D22</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d22</guid><description><![CDATA[<p>case_name: University of North Carolina Hospitals, Chapel Hill NC</p><p>case_numbers: 96-1930; 97-1708; 98-2034</p><p>decision_date: Wed, 01 Mar 2000 12:00:00 -0500</p><p>decision_number: 2000D22</p><p>fiscal_year_end: 06/30/1993- 06/30/1995</p><p>provider_number: 34-0061</p><p>summary: Did the Intermediary properly use the Reasonable Compensation Equivalent limits from 1984 to reduce the amount of reasonable compensation paid by the Provider to its hospital-based physicians for 1993, 1994 and 1995?</p>]]></description></item><item><title>1998D091</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d091</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d091</guid><description><![CDATA[<p>case_name: Memorial Hospital of Gardena, Los Angeles CA</p><p>case_numbers: 95-1921</p><p>decision_date: Fri, 11 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D091</p><p>fiscal_year_end: 06/30/1992</p><p>provider_number: 05-0468</p><p>summary: Should the Provider's Medicaid patient days in its "subacute unit" be included in calculating disproportionate share hospital ("DSH") adjustment?</p>]]></description></item><item><title>2001D35</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d35</guid><description><![CDATA[<p>case_name: University Hospital, Cincinnati, OH</p><p>case_numbers: 96-0343</p><p>decision_date: Wed, 27 Jun 2001 12:00:00 -0400</p><p>decision_number: 2001D35</p><p>fiscal_year_end: 06/30/1992</p><p>provider_number: 36-0003</p><p>summary: 1. Was the Intermediary's reclassification of the Provider's allocation of certain administrative salaries and fringe benefits from various ambulatory service areas back to A&#x26;G costs proper?; 2. Was the Intermediary's emergency room physician billing revenue against emergency room expense rather than A&#x26;G expenses proper?</p>]]></description></item><item><title>2010D09</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d09</guid><description><![CDATA[<p>case_name: City of Hope National Medical Center, Duarte, CA</p><p>case_numbers: 00-3325</p><p>decision_date: Tue, 05 Jan 2010 12:00:00 -0500</p><p>decision_number: 2010D09</p><p>fiscal_year_end: 09/30/1996</p><p>provider_number: 05-0146; 05-7037</p><p>summary: Whether the Provider timely filed its Tax Equity and Fiscal Responsibility Act (TEFRA) exception request.</p>]]></description></item><item><title>2010D42</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d42</guid><description><![CDATA[<p>case_name: St. Joseph Mercy Hospital- Oakland, Pontiac MI</p><p>case_numbers: 98-1025</p><p>decision_date: Thu, 05 Aug 2010 12:00:00 -0400</p><p>decision_number: 2010D42</p><p>fiscal_year_end: 06/30/1995</p><p>provider_number: 23-0029</p><p>summary: 1. Whether the Medicare bad debt payment was computed properly.; 2. Whether the Medicaid Proxy component of the disproportionate share hospital (DSH) adjustment was computed properly.; 3. Whether the Medicare Proxy component of the disproportionate share hospital adjustment must be remanded to the Intermediary without adjudication by the Board pursuant to CMS Ruling No. 1498-R.</p>]]></description></item><item><title>1998D093</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d093</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d093</guid><description><![CDATA[<p>case_name: Mercy Hospital Medical Center, Des Moines IA</p><p>case_numbers: 92-0591</p><p>decision_date: Fri, 11 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D093</p><p>fiscal_year_end: 06/30/1990</p><p>provider_number: 16-0083</p><p>summary: Was the Intermediary's allowcation of the Provider's physician billing costs proper?</p>]]></description></item><item><title>1998D090</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d090</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d090</guid><description><![CDATA[<p>case_name: Harborview Medical Center, Seattle WA</p><p>case_numbers: 92-0948</p><p>decision_date: Wed, 09 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D090</p><p>fiscal_year_end: 06/30/1989</p><p>provider_number: 50-0064</p><p>summary: 1. Did the Provider maintain adequate documentation to properly determine the paramedical education costs claimed for the physical therapy clinical training program and did those costs qualify as paramedical education costs reimbursable on a pass-through basis?; 2. Was the Provider's inclusion of foreign medical graduates in its resident count proper?; 3. Was the Provider's documentation adequate to support additional claimed costs related to the County Treasurer's costs of services performed for the Provider?</p>]]></description></item><item><title>1998D096</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d096</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d096</guid><description><![CDATA[<p>case_name: Reavis Homecare, Inc., Salado TX</p><p>case_numbers: 97-3046</p><p>decision_date: Thu, 17 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D096</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 67-7584</p><p>summary: Were the cost limits issued prospectively by New Mexico Blue Cross Blue Shield for FY 95 and as applied in FY 95, correct or were the lower cost caps retroactively applied in FY 96 by Palmetto (the successor Intermediary) correct?</p>]]></description></item><item><title>1998D088</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d088</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d088</guid><description><![CDATA[<p>case_name: Baylor University Medical Center, Dallas TX</p><p>case_numbers: 90-1201;91-1310</p><p>decision_date: Fri, 04 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D088</p><p>fiscal_year_end: 06/30/1987; 06/30/1988</p><p>provider_number: 45-0021</p><p>summary: 1. Was the Intermediary's adjustment offsetting intercompany interest income proper?; 2. Was the Intermediary's adjustment disallowing staff physician Part A salary costs proper?; 3. Was the Intermediary's adjustment offsetting investment income earned on loans to physicians proper?; 4. Was the Intermediary's adjustment disallowing intercompany interest expense proper?</p>]]></description></item><item><title>1998D094</title><pubDate>Mon, 04 Nov 2019 02:24:09 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d094</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d094</guid><description><![CDATA[<p>case_name: Conemaugh Valley Memorial Hospital, Johnstown PA</p><p>case_numbers: 95-0100</p><p>decision_date: Tue, 15 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D094</p><p>fiscal_year_end: 06/30/1992</p><p>provider_number: 39-0110</p><p>summary: Did the Intermediary use the proper bed count when computing the Provider's indirect medical education ("IME") adjustment for fiscal year 1992?</p>]]></description></item><item><title>1998D085</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d085</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d085</guid><description><![CDATA[<p>case_name: Alhambra Hospital, Los Angeles CA</p><p>case_numbers: 96-0378</p><p>decision_date: Fri, 28 Aug 1998 12:00:00 -0400</p><p>decision_number: 1998D085</p><p>fiscal_year_end: 09/30/1993</p><p>provider_number: 05-0281; 55-5294</p><p>summary: Should the Provider's Medicaid patient days in its "subacute unit" be included in calculating the disproportionate share hospital ("DSH") adjustment?</p>]]></description></item><item><title>2010D04</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d04</guid><description><![CDATA[<p>case_name: Royal Oaks Hospital</p><p>case_numbers: 05-0917; 05-0916</p><p>decision_date: Tue, 27 Oct 2009 12:00:00 -0400</p><p>decision_number: 2010D04</p><p>fiscal_year_end: 12/31/1999; 12/31/2000</p><p>provider_number: 26-4020</p><p>summary: Whether the Intermediary properly declined to establish a per-resident amount (PRA) and full-time equivalent (FTE) cap applicable to Provider's graduate medical education (GME) costs.</p>]]></description></item><item><title>2007D32</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d32</guid><description><![CDATA[<p>case_name: John L. Doyne Hospital, Milwaukee WI</p><p>case_numbers: 00-2803</p><p>decision_date: Thu, 10 May 2007 12:00:00 -0400</p><p>decision_number: 2007D32</p><p>fiscal_year_end: 12/22/1995</p><p>provider_number: 52-0174</p><p>summary: Whether the Intermediary's determining disallow post-retirement health benefits costs for a terminated provider was proper.</p>]]></description></item><item><title>2010D03</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d03</guid><description><![CDATA[<p>case_name: Crozer-Keystone Hospital Specific 2007 Wage Index Rural Floor Group</p><p>case_numbers: 07-0793G</p><p>decision_date: Tue, 20 Oct 2009 12:00:00 -0400</p><p>decision_number: 2010D03</p><p>fiscal_year_end: FFY 2007</p><p>provider_number: Various</p><p>summary: Did the Centers for Medicare &#x26; Medicaid Services (CMS) err in calculating a budget neutrality adjustment to the PPS standardized amount to account for the effect of the rural floor on the wage index?</p>]]></description></item><item><title>1998D084</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d084</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d084</guid><description><![CDATA[<p>case_name: Los Angeles County NIC Unit Beds Group Appeal</p><p>case_numbers: 96-0066G</p><p>decision_date: Fri, 28 Aug 1998 12:00:00 -0400</p><p>decision_number: 1998D084</p><p>fiscal_year_end: 06/30/1988-06/30/1989</p><p>provider_number: Various</p><p>summary: Was the Intermediary's inclusion of neonatal intensive care unit ("NICU") beds in the indirect medical education ("IME") calculation proper?</p>]]></description></item><item><title>2010D06</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d06</guid><description><![CDATA[<p>case_name: Greenville Hospital Center, Greenville, SC</p><p>case_numbers: 08-0429</p><p>decision_date: Wed, 25 Nov 2009 12:00:00 -0500</p><p>decision_number: 2010D06</p><p>fiscal_year_end: 09/30/1996</p><p>provider_number: 42-0078</p><p>summary: Whether the intermediary's disallowance of resident time spent in didactic activities for purposes of the indirect medical education adjustment was proper.</p>]]></description></item><item><title>1998D083</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d083</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d083</guid><description><![CDATA[<p>case_name: St. Mary's Medical Center, Long Beach CA</p><p>case_numbers: 92-1569</p><p>decision_date: Wed, 26 Aug 1998 12:00:00 -0400</p><p>decision_number: 1998D083</p><p>fiscal_year_end: 06/30/1989</p><p>provider_number: 05-0191</p><p>summary: Was the Provider's request for an adjustment to the TEFRA limits for the fiscal year ended June 30, 1989 timely?</p>]]></description></item><item><title>1998D092</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d092</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d092</guid><description><![CDATA[<p>case_name: Las Encinas Hospital, Pasadena CA</p><p>case_numbers: 95-0303</p><p>decision_date: Fri, 11 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D092</p><p>fiscal_year_end: 07/31/1992</p><p>provider_number: 05-4078</p><p>summary: Was the Intermediary's adjustment to the property tax expense proper?</p>]]></description></item><item><title>2010D08</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d08</guid><description><![CDATA[<p>case_name: Autumn Bridge LLC</p><p>case_numbers: 08-2068</p><p>decision_date: Tue, 22 Dec 2009 12:00:00 -0500</p><p>decision_number: 2010D08</p><p>fiscal_year_end: 10/31/2006</p><p>provider_number: 37-1633</p><p>summary: 1. Has the Provider demonstrated that it is entitled to a hearing before the Board because there is $10,000 in controversy?; 2. To what extent, if at all, Medicare's $720,991 demand for repayment from the Provider for fiscal year 2006 would be decreased if the Provider's proposed manner of calculation of the amount of the hospice cap is adopted in lieu of the Intermediary's calculation which was issued pursuant to the existing regulation.</p>]]></description></item><item><title>2007D33</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d33</guid><description><![CDATA[<p>case_name: Bayside Community Hospital, Anahuac TX</p><p>case_numbers: 04-2009</p><p>decision_date: Thu, 10 May 2007 12:00:00 -0400</p><p>decision_number: 2007D33</p><p>fiscal_year_end: 09/30/2002-09/30/2004</p><p>provider_number: 45-1320</p><p>summary: Whether the Provider is eligible to receive payment on a reasonable cost basis for anesthesia services provided in its critical access hospital (CAH) by certain qualified non-physician anesthetists pursuant to 42 C.F.R. Section 412.113(c).</p>]]></description></item><item><title>2009D39</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d39</guid><description><![CDATA[<p>case_name: Southwest Consulting 95-01 DSH Georgia Indigent Care Trust Fund</p><p>case_numbers: 04-1799G</p><p>decision_date: Mon, 21 Sep 2009 12:00:00 -0400</p><p>decision_number: 2009D39</p><p>fiscal_year_end: 12/31/1995-12/31/2001</p><p>provider_number: Various</p><p>summary: Whether inpatient hospital days attributable to individuals who applied to the Providers for, and received, assistance under Georgia's Indigent Care Trust Fund ("ICTF") should be counted in the number of Medicaid-eligible days in the numerator of the Medicaid fraction used to calculate the Medicare disproportionate share hospital (DSH) payments to the Providers.</p>]]></description></item><item><title>1998D095</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d095</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d095</guid><description><![CDATA[<p>case_name: North Ridge Medical Center, Ft, Lauderdale FL</p><p>case_numbers: 97-2589</p><p>decision_date: Tue, 15 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D095</p><p>fiscal_year_end: 09/30/1991</p><p>provider_number: 10-0237</p><p>summary: Did the Intermediary improperly reopen the Provider's fiscal year ended ("FYE") september 30, 1001 cost report? adjustment to</p>]]></description></item><item><title>2010D01</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d01</guid><description><![CDATA[<p>case_name: University Hospital, Denver CO</p><p>case_numbers: 01-2484</p><p>decision_date: Wed, 07 Oct 2009 12:00:00 -0400</p><p>decision_number: 2010D01</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 06-0024</p><p>summary: Whether the Intermediary's determination that the resident time was not spent in the hospital complex was proper and with respect to some residents, the resident time was adequately documented as occurring in the contested area.</p>]]></description></item><item><title>2009D40</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d40</guid><description><![CDATA[<p>case_name: National Parkinson Foundation CORF; NPF Rehah FL/Pompano; NPF Rehab Florida/N Miami Beach</p><p>case_numbers: 05-1291; 05-1292; 05-1293</p><p>decision_date: Tue, 22 Sep 2009 12:00:00 -0400</p><p>decision_number: 2009D40</p><p>fiscal_year_end: 12/31/1994; 05/31/1995</p><p>provider_number: 10-4504; 10-4561; 10-4560</p><p>summary: Whether the Intermediary's adjustments reflected in the revised Notices of Program Reimbursement (NPR), that reduced allowable home office costs, were proper.</p>]]></description></item><item><title>2007D25</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d25</guid><description><![CDATA[<p>case_name: Central 99-00 Dixie Diamond Ranch HO Adj. #2 (CIRP) Group; Central 98-99 Dixie Diamond Ranch HO Adj.</p><p>case_numbers: 06-0110G; 06-0111G</p><p>decision_date: Thu, 12 Apr 2007 12:00:00 -0400</p><p>decision_number: 2007D25</p><p>fiscal_year_end: Various</p><p>provider_number: 67-7270: 37-7097</p><p>summary: Whether the Intermediary's adjustment to include the Dixie Diamond Ranch as an "other" component on Schedule G of the home office cost statement was proper?</p>]]></description></item><item><title>2010D10</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d10</guid><description><![CDATA[<p>case_name: Genesis Health 96 Salaries of Therapists Group</p><p>case_numbers: 98-3417G</p><p>decision_date: Wed, 06 Jan 2010 12:00:00 -0500</p><p>decision_number: 2010D10</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's deletion of therapy costs from line 25, column 9 of Worksheet B-1 of the Providers' Medicare cost reports is proper and in accordance with Medicare cost reporting practices and procedures.</p>]]></description></item><item><title>2009D41</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d41</guid><description><![CDATA[<p>case_name: Kingston Hospital, Kingston NY</p><p>case_numbers: 05-0350; 06-0452</p><p>decision_date: Wed, 23 Sep 2009 12:00:00 -0400</p><p>decision_number: 2009D41</p><p>fiscal_year_end: 12/31/2000; 12/31/2001</p><p>provider_number: 33-0004</p><p>summary: Whether the intermediary properly adjusted the Provider's direct graduate medical education (DGME) and indirect medical education (IME) full-time equivalent (FTE) count for the fiscal years ended December 31, 2000 and December 31, 2001.</p>]]></description></item><item><title>2010D05</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d05</guid><description><![CDATA[<p>case_name: New Jersey 2000/2001/2002 Charity Care DSH Group</p><p>case_numbers: 03-0859G; 04-1027G; 05-1256G</p><p>decision_date: Fri, 06 Nov 2009 12:00:00 -0500</p><p>decision_number: 2010D05</p><p>fiscal_year_end: 12/31/2000-12/31/2002</p><p>provider_number: Various</p><p>summary: Whether Intermediary properly excluded New Jersey Charity Care Program (NJCCP) days from the Medicare disproportionate share (DSH) calculation for fiscal year-ends (FYEs) 2000 to 2002 for the hospitals in this group appeal.</p>]]></description></item><item><title>2009D42</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d42</guid><description><![CDATA[<p>case_name: Kindred Hospital- Kansas City; Kindred Hospital -St Louis</p><p>case_numbers: Various</p><p>decision_date: Tue, 29 Sep 2009 12:00:00 -0400</p><p>decision_number: 2009D42</p><p>fiscal_year_end: 08/31/2000-08/31/2003</p><p>provider_number: 26-2011; 26-2010</p><p>summary: Whether the Intermediary's adjustments treating the Management Services Corporation (MSC) pool payments the Providers received as provider refunds, which were offset against the allowable provider tax expense, were proper.</p>]]></description></item><item><title>2010D02</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d02</guid><description><![CDATA[<p>case_name: Select Medical 2003-2006 New Hospital Capital Related Costs Group</p><p>case_numbers: 06-1078G; 06-1079G</p><p>decision_date: Thu, 15 Oct 2009 12:00:00 -0400</p><p>decision_number: 2010D02</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's adjustments to the Provider's reimbursable capital costs after denying "new hospital" status was proper.</p>]]></description></item><item><title>2007D34</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d34</guid><description><![CDATA[<p>case_name: Sharp Chula Vista Medical Center, San Diego CA</p><p>case_numbers: 06-0456</p><p>decision_date: Thu, 10 May 2007 12:00:00 -0400</p><p>decision_number: 2007D34</p><p>fiscal_year_end: 09/30/1997</p><p>provider_number: 05-0222</p><p>summary: Whether the Intermediary improperly excluded from the Disproportionate Share Hospital (DSH) Medicaid fraction days attributable to the labor and delivery portion of stays of maternity patients who occupied licensed inpatient beds located in Labor, Delivery, Recovery and Postpartum (LDRP) rooms.</p>]]></description></item><item><title>2007D31</title><pubDate>Mon, 04 Nov 2019 02:24:08 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d31</guid><description><![CDATA[<p>case_name: Atlantic 97 FTE Cap for IME Calculation Group</p><p>case_numbers: 01-3521G</p><p>decision_date: Wed, 09 May 2007 12:00:00 -0400</p><p>decision_number: 2007D31</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: 31-0015; 31-0051</p><p>summary: Whether the cost report instructions improperly apply the indirect medical education (IME) full-time equivalent (FTE) cap to discharges prior to October 1, 1997.</p>]]></description></item><item><title>2005D36</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d36</guid><description><![CDATA[<p>case_name: University Medical Center, Tucson AZ</p><p>case_numbers: 02-0216; 02-0217</p><p>decision_date: Tue, 12 Apr 2005 12:00:00 -0400</p><p>decision_number: 2005D36</p><p>fiscal_year_end: 06/30/1998; 06/30/1999</p><p>provider_number: 03-0064</p><p>summary: 1. Were the Intermediary's adjustments reducing the Provider's Indirect Medical Education (IME) full-time equivalent (FTE) resident count for time spent by residents in research proper?; 2. Were the Intermediary's adjustments reducing the Provider's FTE resident count for IME and Direct Graduate Medical Education (GME) for time spent by residents on vacation proper?</p>]]></description></item><item><title>2005D38</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d38</guid><description><![CDATA[<p>case_name: Select Speciality Hospital- Houston Heights, Houston TX</p><p>case_numbers: 02-2031</p><p>decision_date: Tue, 10 May 2005 12:00:00 -0400</p><p>decision_number: 2005D38</p><p>fiscal_year_end: 08/31/1999</p><p>provider_number: 45-2049</p><p>summary: Whether the Intermediary erred in denying the Provider a continuous improvement bonus ("CIB") for fiscal year ending August 31, 1999.</p>]]></description></item><item><title>2005D39</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d39</guid><description><![CDATA[<p>case_name: Arthur G James Cancer Hosp. and Richard J Solove Research Inst.</p><p>case_numbers: 99-2779; 02-1243</p><p>decision_date: Wed, 11 May 2005 12:00:00 -0400</p><p>decision_number: 2005D39</p><p>fiscal_year_end: 06/30/1996; 06/30/1998</p><p>provider_number: 36-0242</p><p>summary: Whether the Intermediary's adjustment to disallow the interest paid to the Ohio State University Hospitals was proper.</p>]]></description></item><item><title>2005D54</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d54</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d54</guid><description><![CDATA[<p>case_name: Nix Health Care System, San Antonio TX</p><p>case_numbers: 03-0045; 03-0046</p><p>decision_date: Fri, 12 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D54</p><p>fiscal_year_end: 12/31/1998; 12/31/1999</p><p>provider_number: 45-0130</p><p>summary: Whether the Intermediary's classification of the Provider's home health agency (HHA) as a 'new provider' for purposes of determining the per-beneficiary limits was proper?</p>]]></description></item><item><title>2002D25</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d25</guid><description><![CDATA[<p>case_name: Westside Nursing Center, Inc., Greenville, SC</p><p>case_numbers: 01-0200</p><p>decision_date: Thu, 27 Jun 2002 12:00:00 -0400</p><p>decision_number: 2002D25</p><p>fiscal_year_end: 09/30/1997</p><p>provider_number: 42-5102</p><p>summary: 1. Was the Intermediary's adjustment combining all SNF and NF cost charges, days, and statistics into one cost center proper?; 2. Was the Intermediary's determination that payroll records were not adequate to support nursing service cost allocation to the SNF distinct part proper?; 3. Was the Intermediary's determination that the allocation of nursing time resulted in an inequitable allocation of cost to the SNF distinct part proper?; 4. Was the Intermediary's decision to disregard statistics and supporting documentation for the allocation of all other general service costs to the SNF distinct part proper?</p>]]></description></item><item><title>2007D26</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d26</guid><description><![CDATA[<p>case_name: St. Francis Hospital, Greenville SC</p><p>case_numbers: 04-1774</p><p>decision_date: Thu, 19 Apr 2007 12:00:00 -0400</p><p>decision_number: 2007D26</p><p>fiscal_year_end: 08/31/2000</p><p>provider_number: 42-0023</p><p>summary: 1. Whether the Intermediary properly adjusted the Provider's Medicare bad debts.; 2. Whether the Intermediary properly adjusted the Provider's medical benefit plan costs.</p>]]></description></item><item><title>2002D21</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d21</guid><description><![CDATA[<p>case_name: HomeAid, Inc. of Cumberland Plateau</p><p>case_numbers: 96-1820</p><p>decision_date: Wed, 29 May 2002 12:00:00 -0400</p><p>decision_number: 2002D21</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 44-7442</p><p>summary: Was the Intermediary's adjustment to the Provider's cost report to remove legal fees proper?</p>]]></description></item><item><title>2007D29</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d29</guid><description><![CDATA[<p>case_name: Arizona 96-99 DSH Group</p><p>case_numbers: 02-0361G</p><p>decision_date: Fri, 04 May 2007 12:00:00 -0400</p><p>decision_number: 2007D29</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether Arizona state-funded days, such as Medically Needy/Medically Indigent (MN/MI), Eligible Low Income Children (ELIC), and/or Eligible Assistance Children (EAC) qualify as Medicaid days for purposes of determining the Provider's Medicare Disproportionate Share Hospital (DSH) adjustments for fiscal years 1994 through 2000.</p>]]></description></item><item><title>2002D16</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d16</guid><description><![CDATA[<p>case_name: Altoona Hospital, Altoona, PA</p><p>case_numbers: 98-2627</p><p>decision_date: Wed, 27 Mar 2002 12:00:00 -0500</p><p>decision_number: 2002D16</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 39-0073</p><p>summary: Was the Intermediary's adjustment to the Provider's number of beds by 116 and corresponding revision of the Provider's reimbursement for indirect medical education costs proper?</p>]]></description></item><item><title>1998D082</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d082</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d082</guid><description><![CDATA[<p>case_name: Stormont-Vail Regional Medical Center, Topeka KS</p><p>case_numbers: 94-2577</p><p>decision_date: Mon, 10 Aug 1998 12:00:00 -0400</p><p>decision_number: 1998D082</p><p>fiscal_year_end: 09/30/1987</p><p>provider_number: 17-0086</p><p>summary: Was the Intermediary's reopening of the Medicare cost report to reduce reimbursement for indirect medical education ("IME") expense proper?</p>]]></description></item><item><title>1998D087</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d087</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d087</guid><description><![CDATA[<p>case_name: Minnesota '94 Occupational Therapy/ Speech Therapy Salary Equivalency Limits Group</p><p>case_numbers: 97-0682G</p><p>decision_date: Wed, 02 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D087</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Were the Intermediary's adjustments to occupational and speech therapy costs proper?</p>]]></description></item><item><title>2009D20</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d20</guid><description><![CDATA[<p>case_name: Henry Ford Health System Managed Care GME/IME Payments Group</p><p>case_numbers: 04-1997G</p><p>decision_date: Thu, 16 Apr 2009 12:00:00 -0400</p><p>decision_number: 2009D20</p><p>fiscal_year_end: 12/31/1998-12/31/2000</p><p>provider_number: Various</p><p>summary: Whether the Intermediary improperly disallowed direct graduate medical education (DGME) and indirect medical education (IME) payments with respect to discharges of Medicare beneficiaries who were enrolled in Medicare+Choice or other Medicare risk plans in fiscal years ended December 31, 1998, December 31, 1999 and December 31, 2000.</p>]]></description></item><item><title>1998D078</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d078</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d078</guid><description><![CDATA[<p>case_name: Olive View Medical Center, Sylmar CA</p><p>case_numbers: 91-1509</p><p>decision_date: Thu, 30 Jul 1998 12:00:00 -0400</p><p>decision_number: 1998D078</p><p>fiscal_year_end: 06/30/1988</p><p>provider_number: 05-0040</p><p>summary: Was the Health Care Financing Administration's ("HCFA") denial of portions of the Provider's request for exceptions and adjustments to the rate of increase ceiling ("TEFRA Limit") for the exempt psychiatric unit proper?</p>]]></description></item><item><title>1998D072</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d072</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d072</guid><description><![CDATA[<p>case_name: St. Edward Mercy Medical Center, Fort Smith AR</p><p>case_numbers: 90-1070</p><p>decision_date: Thu, 02 Jul 1998 12:00:00 -0400</p><p>decision_number: 1998D072</p><p>fiscal_year_end: 6/30/1987</p><p>provider_number: 04-0062</p><p>summary: 1. Were the Intermediary's adjustments to record rent expense for lease equipment as administrative and general costs, rather than capital-related costs proper?; 2. Were the Intermediary's adjustments denying treatment of costs relating to the installation of the Hopital Information System as start-up costs proper?</p>]]></description></item><item><title>2007D30</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d30</guid><description><![CDATA[<p>case_name: Via Christi Regional Medical Center, Wichita KS</p><p>case_numbers: 99-2858</p><p>decision_date: Wed, 09 May 2007 12:00:00 -0400</p><p>decision_number: 2007D30</p><p>fiscal_year_end: 09/30/1996</p><p>provider_number: 17-0122</p><p>summary: Whether the Intermediary's computation of the IME and DGME count as it relates to the following components was correct: a) Family practice rotations to the continuity care clinic; b)Internal medicine rotations to the St. Joseph campus of the Provider; c)Exclusion of psychiatric rotations in clinical research activities from IME FTE Count</p>]]></description></item><item><title>1998D077</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d077</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d077</guid><description><![CDATA[<p>case_name: All Saints Episcopal Hospital/ Psychiatric Subprovider, Fort Worth TX</p><p>case_numbers: 94-2804</p><p>decision_date: Mon, 27 Jul 1998 12:00:00 -0400</p><p>decision_number: 1998D077</p><p>fiscal_year_end: 09/30/1987- 09/30/1989</p><p>provider_number: 45-0137</p><p>summary: Was the Health Care Financing Administration's ("HCFA") denial of the Provider's application for an exception/ adjustment to the TEFRA limit for the fiscal years ended ("FYE") September 30,1987, 1988 and 1989 proper?</p>]]></description></item><item><title>1998D081</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d081</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d081</guid><description><![CDATA[<p>case_name: Greenville Hospital Center, Greenville SC</p><p>case_numbers: 92-2398</p><p>decision_date: Fri, 07 Aug 1998 12:00:00 -0400</p><p>decision_number: 1998D081</p><p>fiscal_year_end: 09/27/1987-09/30/1989</p><p>provider_number: 42-T078</p><p>summary: Was HCFA's denial of the Provider's request for an adjustment to its TEFRA target rate for certain costs proper?</p>]]></description></item><item><title>1998D073</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d073</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d073</guid><description><![CDATA[<p>case_name: Blodgett Memorial Medical Center, Grand Rapids MI</p><p>case_numbers: 91-2671M</p><p>decision_date: Thu, 23 Jul 1998 12:00:00 -0400</p><p>decision_number: 1998D073</p><p>fiscal_year_end: 06/30/1985</p><p>provider_number: 23-0032</p><p>summary: Was the Intermediary's denial of the Provider's request to revise the 1985 base year average per resident amount to include pathologists teaching expenses proper?</p>]]></description></item><item><title>1998D107</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d107</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d107</guid><description><![CDATA[<p>case_name: Regency Care Centers 93 Therapy Limits Group</p><p>case_numbers: 96-2053G</p><p>decision_date: Wed, 30 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D107</p><p>fiscal_year_end: 1993</p><p>provider_number: Various</p><p>summary: Was the Intermediary's audit adjustments reducing charges for occupational and speech therapy services based upon the prudent buyer concept proper?</p>]]></description></item><item><title>2004D30</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d30</guid><description><![CDATA[<p>case_name: Global Home Care, Inc.</p><p>case_numbers: 01-0937</p><p>decision_date: Fri, 16 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D30</p><p>fiscal_year_end: 06/30/1998</p><p>provider_number: 23-7252</p><p>summary: Was the Intermediary's adjustment to the single business tax proper?</p>]]></description></item><item><title>1998D105</title><pubDate>Mon, 04 Nov 2019 02:24:07 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d105</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d105</guid><description><![CDATA[<p>case_name: Canterbury House, Seatle WA</p><p>case_numbers: 96-0590</p><p>decision_date: Wed, 30 Sep 1998 12:00:00 -0400</p><p>decision_number: 1998D105</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 50-5344</p><p>summary: Was the Intermediary's audit adjustment reducing charges for occupational and speech therapy services based upon the prudent buyer concept proper?</p>]]></description></item><item><title>1998D079</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d079</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d079</guid><description><![CDATA[<p>case_name: Stanislaus Medical Center, Modesto CA</p><p>case_numbers: 95-0436</p><p>decision_date: Thu, 30 Jul 1998 12:00:00 -0400</p><p>decision_number: 1998D079</p><p>fiscal_year_end: 06/30/1983</p><p>provider_number: 05-0183</p><p>summary: Was HCFA's denial of an exception to the routine cost limit filed within 180 days of the revised NPR in accordance with the Medicare statutes and regulations?</p>]]></description></item><item><title>2011D39</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d39</guid><description><![CDATA[<p>case_name: Baycare 2002 Medicare Choice Days Group</p><p>case_numbers: 09-0206GC</p><p>decision_date: Fri, 15 Jul 2011 12:00:00 -0400</p><p>decision_number: 2011D39</p><p>fiscal_year_end: 06/30/2002; 12/31/2002</p><p>provider_number: Various</p><p>summary: Whether inpatient days for Medicaid-eligible patients who were enrolled in a Medicare Choice (M C) plan under Part C of the Medicare statute were properly excluded from the numerator of the Medicaid fraction that is used to calculate the disproportionate share hospital (DSH) payment.</p>]]></description></item><item><title>2009D19</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d19</guid><description><![CDATA[<p>case_name: St. Cloud Hospital, St. Cloud MN</p><p>case_numbers: 05-1873; 05-1879; 05-1880; 05-1881</p><p>decision_date: Wed, 15 Apr 2009 12:00:00 -0400</p><p>decision_number: 2009D19</p><p>fiscal_year_end: 06/30/1997-06/30/2000</p><p>provider_number: 24-0036</p><p>summary: Whether the Intermediary should have included all general assistance days in the computation of the Provider's Medicare Disproportionate Share (DSH) adjustment calculation for the Provider's fiscal years ended June 30, 1997, 1998, 1999, and 2000.</p>]]></description></item><item><title>2010D33</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d33</guid><description><![CDATA[<p>case_name: UPMC 2001-2007 DSH Medical Assistance Under State Medicaid Plan Groups</p><p>case_numbers: 05-0171G; 05-0172G; 05-0173G; 06-0153G; 07-0453G; 08-1308G; 09-0964GC</p><p>decision_date: Thu, 27 May 2010 12:00:00 -0400</p><p>decision_number: 2010D33</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether days for which patients received charity care in Pennsylvania were required by the Medicare statute to be included in the numerator of the Medicaid proxy of the Medicare DSH calculation.</p>]]></description></item><item><title>1998D045</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d045</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d045</guid><description><![CDATA[<p>case_name: St. Mary's Hospital and Medical Center, San Francisco CA</p><p>case_numbers: 92-0507</p><p>decision_date: Fri, 24 Apr 1998 12:00:00 -0400</p><p>decision_number: 1998D045</p><p>fiscal_year_end: 06/25/1989</p><p>provider_number: 05-0457</p><p>summary: Did the Intermediary properly adjust outpatient surgery, anesthesia and supply charges?</p>]]></description></item><item><title>2009D15</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d15</guid><description><![CDATA[<p>case_name: St. Joseph's Hospital and Health Center, Paris TX</p><p>case_numbers: 92-1212; 92-1522</p><p>decision_date: Wed, 01 Apr 2009 12:00:00 -0400</p><p>decision_number: 2009D15</p><p>fiscal_year_end: 06/30/1987; 06/30/1988</p><p>provider_number: 45-0196</p><p>summary: Whether the denial of the Provider's request for an exception to the Tax Equity and Fiscal Responsibility Act (TEFRA) rate for its rehabilitation unit was proper.</p>]]></description></item><item><title>2010D28</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d28</guid><description><![CDATA[<p>case_name: Benedictine Hospital, Kingston NY</p><p>case_numbers: 05-0289</p><p>decision_date: Tue, 18 May 2010 12:00:00 -0400</p><p>decision_number: 2010D28</p><p>fiscal_year_end: 12/31/2000</p><p>provider_number: 33-0224</p><p>summary: Whether the Intermediary properly adjusted the Provider's Family Practice residency program direct graduate medical education (DGME) and indirect medical education (IME) full-time equivalent (FTE) count for the fiscal year ended December 31, 2000.</p>]]></description></item><item><title>2009D21</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d21</guid><description><![CDATA[<p>case_name: Triad 2007 Liability for Periodic Interim Payments to Former Owner Group</p><p>case_numbers: 09-0380GC</p><p>decision_date: Fri, 17 Apr 2009 12:00:00 -0400</p><p>decision_number: 2009D21</p><p>fiscal_year_end: 06/30/2007</p><p>provider_number: Various</p><p>summary: Whether the Board has jurisdiction over a challenge to an overpayment recoupment action involving the Provider's liability for erroneous payments made to the former owners of the skilled nursing facilities (SNFs) after the change of ownership.</p>]]></description></item><item><title>1998D069</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d069</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d069</guid><description><![CDATA[<p>case_name: Memorial Hospital of Rhode Island, Pawtucket RI</p><p>case_numbers: 90-0989</p><p>decision_date: Thu, 02 Jul 1998 12:00:00 -0400</p><p>decision_number: 1998D069</p><p>fiscal_year_end: 09/30/1988</p><p>provider_number: 41-0001</p><p>summary: Was the Health Care Financing Administration's ( 'HCFA' ) denial of the Provider's request for reconsideration of the TEFRA exception request proper?</p>]]></description></item><item><title>2010D30</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d30</guid><description><![CDATA[<p>case_name: Medical College of Georgia Hospital</p><p>case_numbers: 09-0071</p><p>decision_date: Tue, 25 May 2010 12:00:00 -0400</p><p>decision_number: 2010D30</p><p>fiscal_year_end: 06/30/2003</p><p>provider_number: 11-0034</p><p>summary: Whether the Board has jurisdiction over the Provider's appeal of the question of whether the disproportionate share (DSH) adjustment was incorrectly determined due to a significant error in the Supplemental Security Income (SSI) percentage where the request for hearing was filed more than three years after the issuance of the NPR.</p>]]></description></item><item><title>2010D35</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d35</guid><description><![CDATA[<p>case_name: Toyon 85-98 112% Hospital-based Peer Group Mean, et al</p><p>case_numbers: 98-0850G; 09-1633GC; 09-1634GC; 09-1635GC; 07-2034G; 07-2032G; 07-2033G</p><p>decision_date: Thu, 10 Jun 2010 12:00:00 -0400</p><p>decision_number: 2010D35</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Centers for Medicare and Medicaid Services' methodology for determining the exception from the routine cost limits (RCL) for hospital-based skilled nursing facilities (HB-SNF) was proper.</p>]]></description></item><item><title>1998D065</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d065</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d065</guid><description><![CDATA[<p>case_name: Senior's Home Health Care, Ltd., Chicago IL</p><p>case_numbers: 96-1352; 96-1353</p><p>decision_date: Thu, 18 Jun 1998 12:00:00 -0400</p><p>decision_number: 1998D065</p><p>fiscal_year_end: 12/31/1992; 12/31/1993</p><p>provider_number: 14-7472</p><p>summary: Were the Intermediary's adjustments to disallow legal fees deemed not related to patient care proper?</p>]]></description></item><item><title>2010D31</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d31</guid><description><![CDATA[<p>case_name: Medical College of Georgia Hospital</p><p>case_numbers: 09-0072</p><p>decision_date: Tue, 25 May 2010 12:00:00 -0400</p><p>decision_number: 2010D31</p><p>fiscal_year_end: 06/30/2004</p><p>provider_number: 11-0034</p><p>summary: Whether the Board has jurisdiction over the Provider's appeal of whether the disproportionate share (DSH) adjustment was incorrectly determined due to a significant error in the Supplemental Security Income (SSI) percentage where the appeal was not filed within 180 days of the issuance of the final determination.</p>]]></description></item><item><title>1998D076</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d076</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d076</guid><description><![CDATA[<p>case_name: Blodgett Memorial Medical Center, Grand Rapids MI</p><p>case_numbers: 94-0353</p><p>decision_date: Mon, 27 Jul 1998 12:00:00 -0400</p><p>decision_number: 1998D076</p><p>fiscal_year_end: 06/30/1986- 06/30/1991</p><p>provider_number: 23-0032</p><p>summary: Was the Intermediary's denial of the Provider's request to revise the 1985 base year average per resisent amount proper?</p>]]></description></item><item><title>1998D057</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d057</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d057</guid><description><![CDATA[<p>case_name: Valley Hospital Medical Center, LAs Vegas NV</p><p>case_numbers: 94-1800C</p><p>decision_date: Fri, 22 May 1998 12:00:00 -0400</p><p>decision_number: 1998D057</p><p>fiscal_year_end: 12/31/1986</p><p>provider_number: 29-0021</p><p>summary: Was the revision to the hospital-specific portion of the Provider's payment under the Medicare prospective payment system made by the Provider's fiscal Intermediary pursuant to a revised Notice of Reimbursement dated August 31, 1993, valid?</p>]]></description></item><item><title>2007D75</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d75</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d75</guid><description><![CDATA[<p>case_name: Logos Healthcare Rehabilitation of South Carolina, Inc., West Columbia, SC</p><p>case_numbers: 00-3353</p><p>decision_date: Tue, 25 Sep 2007 12:00:00 -0400</p><p>decision_number: 2007D75</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 42-6548</p><p>summary: 1. Did the Intermediary improperly reopen the cost report?; 2. Was the Intermediary's adjustment to salaries - physical therapy proper?; 3. Was the Intermediary's adjustment to salaries - speech therapy proper?; 4. Was the Intermediary's adjustment to salaries - occupational therapy proper?; 5. Was the Intermediary's adjustment to salaries - administrative proper?; 6. Was the Intermediary's adjustment to travel expenses proper?; 7. Was the Intermediary's adjustment to accounting expense proper?; 8. Was the Intermediary's adjustment to recruiting cost - Rehab Resources proper?; 9. Was the Intermediary's adjustment to occupational therapy expense proper?; 10. Was the Intermediary's adjustment to consultant expense proper?; 11. Was the Intermediary's adjustment to maintenance expense proper?; 12. Was the Intermediary's adjustment to contract services - administrative and general (A&#x26;G) proper?; 13. Was the Intermediary's adjustment to contract services - occupational therapy proper?; 14. Was the Intermediary's adjustment to contract services - physical therapy proper?; 15. Was the Intermediary's adjustment to rent expense proper?; 16. Was the Intermediary's adjustment to telephone expense proper?; 17. Was the Intermediary's adjustment to total charges - physical therapy proper?; 18. Was the Intermediary's adjustment to other charges - physical therapy proper?; 19. Were the Provider's requests for the inclusion of additional costs for depreciation and reimbursable bad debts for which no adjustments were made proper? (Provider's Issues 19 and 20); 21. Was the Intermediary's adjustment to total expenses proper?</p>]]></description></item><item><title>1998D080</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d080</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d080</guid><description><![CDATA[<p>case_name: Kingwood Hospital, Michigan City IN</p><p>case_numbers: 93-0054</p><p>decision_date: Fri, 07 Aug 1998 12:00:00 -0400</p><p>decision_number: 1998D080</p><p>fiscal_year_end: 05/31/1990</p><p>provider_number: 15-4033</p><p>summary: Was the issue relating to denial of new provider exemption proper and should the Provider's base year be changed from fiscal 1984 to 1990?</p>]]></description></item><item><title>1998D067</title><pubDate>Mon, 04 Nov 2019 02:24:06 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d067</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d067</guid><description><![CDATA[<p>case_name: Norristown State Hospital, Norristown PA</p><p>case_numbers: 94-1389E; 94-1390E; 94-1525E</p><p>decision_date: Fri, 19 Jun 1998 12:00:00 -0400</p><p>decision_number: 1998D067</p><p>fiscal_year_end: 06/30/1986- 06/30/1988</p><p>provider_number: 39-4001</p><p>summary: Did the Intermediary err in reopening the Provider's cost reports to calculate Graduate Medical Education reimbursement?</p>]]></description></item><item><title>1998D056</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d056</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d056</guid><description><![CDATA[<p>case_name: Mendocino Community Hospital, Mendocino CA</p><p>case_numbers: 93-0509</p><p>decision_date: Fri, 22 May 1998 12:00:00 -0400</p><p>decision_number: 1998D056</p><p>fiscal_year_end: 06/30/1985- 06/30/87</p><p>provider_number: 05-0381</p><p>summary: Was the Intermediary's refusal to reopen the Provider's cost reports an abuse of discretion?</p>]]></description></item><item><title>2007D13</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d13</guid><description><![CDATA[<p>case_name: Rush Presbyterian- St Luke's Medical Center</p><p>case_numbers: 97-2986</p><p>decision_date: Fri, 19 Jan 2007 12:00:00 -0500</p><p>decision_number: 2007D13</p><p>fiscal_year_end: 06/30/1992</p><p>provider_number: 14-0119</p><p>summary: 1. Should the Provider's transplant surgery residents be included in the full-time equivalent (FTE) count for the purposes of both direct graduate medical education (DGME) and indirect medical education (IME) reimbursement?; 2. To the extent transplant surgery residents are not included in the FTE counts for purposes of DGME and IME, is the Provider entitled to reimbursement for costs it incurred with such individuals pursuant to 42 C.F.R. Section 4105.523?; 3. In calculating the Provider's Disproportionate Share Hospital (DSH) payment, should all of the Medicaid Health Maintenance Organization (HMO) days, as reported by the Illinois Department of Public Aid, be included?; 4.Was the intermediary's disallowance of a portion of the depreciation expense claimed for the Atrium Pavilion proper?</p>]]></description></item><item><title>1998D041</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d041</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d041</guid><description><![CDATA[<p>case_name: St. Anthony Medical Center, Columbus OH</p><p>case_numbers: 93-0590</p><p>decision_date: Thu, 16 Apr 1998 12:00:00 -0400</p><p>decision_number: 1998D041</p><p>fiscal_year_end: 12/31/1990</p><p>provider_number: 36-0062</p><p>summary: Was the Intermediary's adjustment offsetting employee benefits proper?</p>]]></description></item><item><title>2008D16</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d16</guid><description><![CDATA[<p>case_name: Hillcrest Baptist Medical Center</p><p>case_numbers: 89-1584</p><p>decision_date: Mon, 04 Feb 2008 12:00:00 -0500</p><p>decision_number: 2008D16</p><p>fiscal_year_end: 08/31/1986</p><p>provider_number: 45-0101</p><p>summary: 1. Whether capitalized interest that may have been amortized in future years can be expensed in the current year when future cost reports are no longer subject to reopening.; 2. Whether the Intermediary's determination of allowable interest expense which deducted Hillcrest Medical Tower (HMT)interest from allowable versus total expense is proper.; 3. Whether the Intermediary's adjustment to disallow accrued FICA expense is proper.; 4. Whether the Intermediary's adjustment to the cafeteria revenue offset is proper.; 5. Whether the Intermediary's adjustment to limit bond cost amortization is proper.; 6. Whether the Intermediary's adjustment to disallow debt cancellation costs is proper.; 7. Whether the Intermediary's adjustment to disallow depreciation expense is proper.; 8. Whether the Intermediary's determination that a portion of the 1985 bonds were unnecessary is proper.; 9. Whether the Intermediary's adjustment to disallow accrued zero coupon bond interest expense is proper.</p>]]></description></item><item><title>2009D18</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d18</guid><description><![CDATA[<p>case_name: Valley Presbyterian Hospital</p><p>case_numbers: 09-0801 thru 09-0810; 09-0815; 09-0816</p><p>decision_date: Thu, 09 Apr 2009 12:00:00 -0400</p><p>decision_number: 2009D18</p><p>fiscal_year_end: 10/31/1987-10/31/1997</p><p>provider_number: 05-0126</p><p>summary: Whether the Board has jurisdiction over the Intermediary's refusal to reopen cost reports to adjust the Supplemental Security Income percentages where the request for reopening were filed more than three years after the issuance of the Notices of Program Reimbursement (NPR).</p>]]></description></item><item><title>1998D064</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d064</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d064</guid><description><![CDATA[<p>case_name: Mercy St. Tersa Center, Mariemont OH</p><p>case_numbers: 96-0340</p><p>decision_date: Tue, 16 Jun 1998 12:00:00 -0400</p><p>decision_number: 1998D064</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 36-5946</p><p>summary: Was HCFA's denial of the Provider's request for an exemption fron the routine cost limit ("RCL") as a new provider proper?</p>]]></description></item><item><title>1998D074</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d074</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d074</guid><description><![CDATA[<p>case_name: North Fulton Medical Center, Roswell GA</p><p>case_numbers: 93-0513</p><p>decision_date: Fri, 24 Jul 1998 12:00:00 -0400</p><p>decision_number: 1998D074</p><p>fiscal_year_end: 10/31/1989</p><p>provider_number: 11-0198</p><p>summary: Was the Intermediary's elimination of space rental costs proper?</p>]]></description></item><item><title>1998D047</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d047</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d047</guid><description><![CDATA[<p>case_name: Neumann Medical Center, Philadelphia PA</p><p>case_numbers: 96-2128</p><p>decision_date: Tue, 28 Apr 1998 12:00:00 -0400</p><p>decision_number: 1998D047</p><p>fiscal_year_end: 06/30/1991</p><p>provider_number: 39-0023</p><p>summary: Was the Provider's request for additional adjustment payments for routine and ancillary services under 42 C.F.R. Section 413.40(g)(3) timely?</p>]]></description></item><item><title>1998D070</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d070</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d070</guid><description><![CDATA[<p>case_name: Stanislaus Medical Center, Modesto CA</p><p>case_numbers: 94-1740</p><p>decision_date: Thu, 02 Jul 1998 12:00:00 -0400</p><p>decision_number: 1998D070</p><p>fiscal_year_end: 06/30/1985</p><p>provider_number: 05-0183</p><p>summary: Did the Intermediary's Notice of Reopening (NPR) and issuance of a revised NPR meet the requirements of 42 C.F.R. Sections 405.1885 and 405.1887?</p>]]></description></item><item><title>1998D052</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d052</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d052</guid><description><![CDATA[<p>case_name: Hermann Hospital, Houston TX</p><p>case_numbers: 92-1562</p><p>decision_date: Thu, 21 May 1998 12:00:00 -0400</p><p>decision_number: 1998D052</p><p>fiscal_year_end: 09/30/1989</p><p>provider_number: 45-0068</p><p>summary: 1. Was the Intermediary's adjustment of depreciation on equipment placed at the Provider by the University of Texas Health Science Center at Houston proper?; 2. Was the Intermediary's disallowance of the Provider's claimed loss on disposal of certain depreciable assets proper?</p>]]></description></item><item><title>1998D049</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d049</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d049</guid><description><![CDATA[<p>case_name: St. Mary's of Nazareth Hospital Center, Chicago IL</p><p>case_numbers: 91-2824M</p><p>decision_date: Fri, 08 May 1998 12:00:00 -0400</p><p>decision_number: 1998D049</p><p>fiscal_year_end: N/A</p><p>provider_number: 14-0180</p><p>summary: 1. Was the Intermediary's adjustment reclassifying physcian salaries for medical education from interns and residents to the administrative and general cost center proper?; 2. Was the Intermediary's adjustment disallowing 50 percent of the Chicago Medical School ("CMS") faculty salaries related to teaching of undergraduate medical students proper?; 3. Was the Intermediary's adjustment reclassifying the salary of a fellow from interns and residents to the adults and pediatric cost center proper?; 4. Was the Intermediary's adjustment of the weighted average full-time equivalence of the interns and residents proper?; 5. Was the Provider's request for Hill Burton 3 percent interest subsidy in total allowable costs proper?; 6. Was the Intermediary's failure to include expenses related to graduate medical education ("GME") which was not filed on the Medicare cost report proper?; 7. Should the laundry and linen statistic be adjusted to include laundry processed for residents?; 8. Should the meals served statistic be adjusted to include meals consumed by residents in the GME base period?; 9. Should the square footage statistic be adjusted to include residents sleeping and conference rooms?</p>]]></description></item><item><title>1998D055</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d055</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d055</guid><description><![CDATA[<p>case_name: Brentwood Health Care Center, Sagamore Hills OH</p><p>case_numbers: 93-0846</p><p>decision_date: Thu, 21 May 1998 12:00:00 -0400</p><p>decision_number: 1998D055</p><p>fiscal_year_end: 12/31/1990</p><p>provider_number: 36-5746</p><p>summary: Was the Intermediary's adjustment of the nursing cost proper?</p>]]></description></item><item><title>1998D059</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d059</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d059</guid><description><![CDATA[<p>case_name: Hospital San Francisco, Inc., Rio Piedras PR</p><p>case_numbers: 93-1280</p><p>decision_date: Tue, 02 Jun 1998 12:00:00 -0400</p><p>decision_number: 1998D059</p><p>fiscal_year_end: 12/31/1989</p><p>provider_number: 40-0098</p><p>summary: Was the Intermediary's disallowance of the Provider's request for a reevaluation of assets and allowance of interest expense due to a change in ownership proper?</p>]]></description></item><item><title>1998D071</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d071</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d071</guid><description><![CDATA[<p>case_name: St. Mary's Hospital and Medical Center, San Francisco CA</p><p>case_numbers: 95-2007</p><p>decision_date: Thu, 02 Jul 1998 12:00:00 -0400</p><p>decision_number: 1998D071</p><p>fiscal_year_end: 06/30/1990</p><p>provider_number: 05-0457</p><p>summary: Was the Intermediary's refusal to reopen the Provider's cost report an abuse of discretion?</p>]]></description></item><item><title>2011D41</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d41</guid><description><![CDATA[<p>case_name: Strategic Reimbursement, Inc/ Carondelet/Resurrection Health Medicare Part C Days-DSH Group</p><p>case_numbers: 04-1753G; 04-1824G; 04-1825G; 05-0375G; 05-1794G; 06-1093G; 07-0888GC; 09-2062GC; 10-0941GC; et al</p><p>decision_date: Thu, 04 Aug 2011 12:00:00 -0400</p><p>decision_number: 2011D41</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether Medicare+Choice (M+C) days should be included in the Medicaid fraction used to calculate the disproportionate share hospital (DSH) adjustment.</p>]]></description></item><item><title>2009D14</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d14</guid><description><![CDATA[<p>case_name: Harrison House of Georgetown, Georgetown DE</p><p>case_numbers: 04-1293</p><p>decision_date: Tue, 17 Mar 2009 12:00:00 -0400</p><p>decision_number: 2009D14</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 08-5029</p><p>summary: 1. Whether the Intermediary's notification of the reopening of the Provider's 1996 cost report was timely pursuant to regulatory standards.; 2. Whether the Intermediary's determination to disallow costs for the Provider's contracted therapy services was proper.</p>]]></description></item><item><title>2010D29</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d29</guid><description><![CDATA[<p>case_name: Hope Horizon Ctr and Homestead Behavioral Clinic</p><p>case_numbers: 08-1848; 09-1547; 10-0106; 06-1773; 07-2384; 08-2266; 09-1565</p><p>decision_date: Tue, 18 May 2010 12:00:00 -0400</p><p>decision_number: 2010D29</p><p>fiscal_year_end: Various</p><p>provider_number: 10-1406; 10-1416</p><p>summary: Was the Intermediary's adjustment disallowing bad debts arising from coinsurance and deductibles for dual eligible Medicare and Medicaid beneficiaries proper?</p>]]></description></item><item><title>2009D17</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d17</guid><description><![CDATA[<p>case_name: Hospice 2009 BNAF Group/ Bluegrass 2009 BNAF Group</p><p>case_numbers: 09-0764G; 09-1053GC</p><p>decision_date: Wed, 08 Apr 2009 12:00:00 -0400</p><p>decision_number: 2009D17</p><p>fiscal_year_end: 2009</p><p>provider_number: Various</p><p>summary: Should the Provider Reimbursement Review Board (Board) grant expedited judicial review over the question of whether Secretary's elimination of the budget neutrality adjustment factor (BNAF) used in the calculation of hospice payment rates was proper?</p>]]></description></item><item><title>2007D69</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d69</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d69</guid><description><![CDATA[<p>case_name: Logos Healthcare Rehabilitation, Inc., Boone, NC</p><p>case_numbers: 00-3348</p><p>decision_date: Mon, 17 Sep 2007 12:00:00 -0400</p><p>decision_number: 2007D69</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 34-6538</p><p>summary: 1. Did the Intermediary improperly reopen the cost report? (Provider Issue 1); 2. Was the Intermediary's adjustment to physical therapy salaries proper? (Provider Issue 2); 3. Was the Intermediary's adjustment to contracted occupational therapy services proper? (Provider Issue 3); 4. Was the Intermediary's adjustment to contracted speech therapy services proper? (Provider Issue 4); 5. Was the Intermediary's adjustment to contracted administrative services proper? (Provider Issue 5); 6. Was the Intermediary's adjustment to recruiting costs - physical therapy proper? (Provider Issue 6); 7. Was the Intermediary's adjustment to recruiting costs - occupational therapy proper? (Provider Issue 7); 8. Was the Intermediary's adjustment to recruiting costs - speech therapy proper? (Provider Issue 8); 9. Was the Intermediary's adjustment to recruiting costs - other proper? (Provider Issue 9); 10. Was the Intermediary's adjustment to recruiting costs - Rehab Resources proper? (Provider Issue 10); 11-14. Were the Intermediary's adjustments to seminars - physical therapy, occupational therapy, speech therapy and administrative proper? (Provider Issues 11, 12, 13 and 14); 15. Was the Intermediary's adjustment to administrative dues proper? (Provider Issue 15); 16-19. Were the Intermediary's adjustments to supplies - physical therapy, occupational therapy, speech therapy and administrative proper? (Provider Issues 16, 17, 18 and 19); 20. Was the Intermediary's adjustment to accounting expense proper? (Provider Issue 20); 21. Was the Intermediary's adjustment to telephone expense proper? (Provider Issue 21); 22. Was the Intermediary's adjustment to auto lease expense proper? (Provider Issue 23); 23. Was the Intermediary's adjustment to nursing home lease expense proper? (Provider Issue 24); 24. Was the Intermediary's adjustment to related party rent expense proper? (Provider Issue 25); 25. Was the Intermediary's adjustment to office equipment lease expense proper? (Provider Issue 26); 26. Was the Intermediary's adjustment to insurance expense proper? (Provider Issue 27); 27. Was the Intermediary's adjustment to home office costs proper? (Provider Issue 30); 28. Was the Provider's request for additional costs for depreciation proper? (Provider Issue 28)</p>]]></description></item><item><title>2007D74</title><pubDate>Mon, 04 Nov 2019 02:24:04 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d74</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d74</guid><description><![CDATA[<p>case_name: Logos Healthcare Rehabilitation of South Carolina, Inc., West Columbia, SC</p><p>case_numbers: 00-3354</p><p>decision_date: Fri, 21 Sep 2007 12:00:00 -0400</p><p>decision_number: 2007D74</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 42-6548</p><p>summary: 1. Was the Intermediary's adjustment to Medicare bad debts proper?; 2-5. Were the Intermediary's adjustments to salaries - administrative, physical therapy, occupational therapy, and speech therapy - proper?; 6. Was the Intermediary's adjustment to travel expense - administrative proper?; 7. Was the Intermediary's adjustment to telephone expense proper?; 8. Was the Intermediary's adjustment to consultant expense proper?; 9. Was the Intermediary's adjustment to rent expense proper?; 10-12. Was the Intermediary's adjustment to other charges - physical, speech and occupational therapy proper? (Provider's Issue 10)</p>]]></description></item><item><title>1998D038</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d038</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d038</guid><description><![CDATA[<p>case_name: McCurry's Home Health, Inc., Kansas City KS</p><p>case_numbers: 95-2447</p><p>decision_date: Fri, 03 Apr 1998 12:00:00 -0500</p><p>decision_number: 1998D038</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 17-7215</p><p>summary: 1. Was the Intermediary's adjustment to the administrative and general seminar costs proper?; 2. Was the Intermediary's adjustments disallowing health education compensation and nursing compensation proper?</p>]]></description></item><item><title>1998D058</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d058</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d058</guid><description><![CDATA[<p>case_name: The Mary Imogene Bassett Hospital, Cooperstown NY</p><p>case_numbers: 85-0058</p><p>decision_date: Tue, 02 Jun 1998 12:00:00 -0400</p><p>decision_number: 1998D058</p><p>fiscal_year_end: 12/31/1979; 12/31/1980</p><p>provider_number: 33-0136</p><p>summary: Was the Intermediary's refusal to reopen the Provider's cost reports for the fiscal years ending December 31, 1979, and December 31, 1980, an abuse of discretion?</p>]]></description></item><item><title>1998D060</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d060</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d060</guid><description><![CDATA[<p>case_name: Midwest City Regional Hospital, Midwest City OK</p><p>case_numbers: 89-1568</p><p>decision_date: Wed, 03 Jun 1998 12:00:00 -0400</p><p>decision_number: 1998D060</p><p>fiscal_year_end: 12/31/1986</p><p>provider_number: 37-0094</p><p>summary: Was the Intermediary's offset of investment income earned on the Provider's funded depreciation account against interest expense proper?</p>]]></description></item><item><title>1998D063</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d063</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d063</guid><description><![CDATA[<p>case_name: Bluegrass Regional Medical Center, Frankfort KY</p><p>case_numbers: 96-0535</p><p>decision_date: Thu, 11 Jun 1998 12:00:00 -0400</p><p>decision_number: 1998D063</p><p>fiscal_year_end: 07/31/1993</p><p>provider_number: 18-0127</p><p>summary: Were the Intermediary's adjustments to Medicare bad debts proper?</p>]]></description></item><item><title>1998D044</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d044</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d044</guid><description><![CDATA[<p>case_name: At Home Health, Inc., Oak Park IL</p><p>case_numbers: 96-0320</p><p>decision_date: Thu, 23 Apr 1998 12:00:00 -0400</p><p>decision_number: 1998D044</p><p>fiscal_year_end: 03/31/1994</p><p>provider_number: 14-7273</p><p>summary: Was the Intermediary's adjustment reducing allowable owner's compensation correct?</p>]]></description></item><item><title>2010D27</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2010d27</guid><description><![CDATA[<p>case_name: St. Barnabas 2000-2004 DSH Adjustment Group appeals &#x26; Peter's Univ. Hosp.</p><p>case_numbers: 04-0114G; 05-0286G; 06-0943G; 06-1377G; 07-0311G; 04-0940</p><p>decision_date: Fri, 07 May 2010 12:00:00 -0400</p><p>decision_number: 2010D27</p><p>fiscal_year_end: 12/31/00 - 12/31/04</p><p>provider_number: Various</p><p>summary: Whether the Intermediary underpaid the Providers' fiscal years 2000 through 2004 Medicare operating and capital disproportionate share hospital (DSH) adjustments by not including the Providers' New Jersey Charity Care Program (NJCCP) inpatient days in the calculations of the numerator of the Medicaid proxy.</p>]]></description></item><item><title>1998D061</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d061</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d061</guid><description><![CDATA[<p>case_name: Doctors Hospital, Columbus OH</p><p>case_numbers: 91-2894M; 92-1709; 94-1277; 94-1278; 94-1702; 94-2063</p><p>decision_date: Wed, 03 Jun 1998 12:00:00 -0400</p><p>decision_number: 1998D061</p><p>fiscal_year_end: 12/31/1986-12/31/1990</p><p>provider_number: 36-0152</p><p>summary: 1. Should the costs incurred by the Provider's General Practice Center ("GPC") for the Family Practice Residency Program be costs of a separate outpatient cost center or costs of the interns and residents medical education cost center and included in the graduate medical education ("GME") base year cost and "rate" year per resident amounts?; 2. Should the salaryand incentive compensation of GPC's director and assistant director be costs of a separate outpatient ancillary cost center or costs of the interns and residents medical education cost center and included in the graduate medical education ("GME") base year cost and "rate" year per resident amounts?</p>]]></description></item><item><title>1998D027</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d027</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d027</guid><description><![CDATA[<p>case_name: Saint Joseph Medical Center, Burbank CA</p><p>case_numbers: 95-1188</p><p>decision_date: Thu, 29 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D027</p><p>fiscal_year_end: 12/31/1989</p><p>provider_number: 05-0235</p><p>summary: Was the Intermediary's denial of the Provider's Routine Cost Limit exception proper?</p>]]></description></item><item><title>2009D37</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d37</guid><description><![CDATA[<p>case_name: Cannonsburg General Hospital SNF</p><p>case_numbers: 98-3491</p><p>decision_date: Thu, 20 Aug 2009 12:00:00 -0400</p><p>decision_number: 2009D37</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 39-0160; 39-5580</p><p>summary: Whether the Centers for Medicare and Medicaid Services' methodology for determining the Provider's exception to the hospital-based skill nursing facility (HB-SNF) routine cost limit was proper.</p>]]></description></item><item><title>2009D16</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d16</guid><description><![CDATA[<p>case_name: Yale-New Haven Health Services Group Appeals</p><p>case_numbers: 05-1296G; 05-1315G; 05-2197G; 06-1668G</p><p>decision_date: Thu, 02 Apr 2009 12:00:00 -0400</p><p>decision_number: 2009D16</p><p>fiscal_year_end: 09/30/1998- 09/30/2001</p><p>provider_number: 07-0010; 07-0022; 07-0018</p><p>summary: Whether the Intermediary properly disallowed direct graduate medical education (DGME) and indirect medical education (IME) payments with respect to discharges of Medicare beneficiaries who were enrolled in the Medicare + Choce or other Medicare risk plans in fiscal years ending September 30, 1998, 1999, 2000 and 2001.</p>]]></description></item><item><title>1998D030</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d030</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d030</guid><description><![CDATA[<p>case_name: Southern Inyo Hospital, Lone Pine CA</p><p>case_numbers: 90-2029</p><p>decision_date: Thu, 26 Feb 1998 12:00:00 -0500</p><p>decision_number: 1998D030</p><p>fiscal_year_end: 06/30/1987</p><p>provider_number: 05-0388</p><p>summary: Was the Intermediary's adjustment disallowing the costs associated with the repossessed equipment proper?</p>]]></description></item><item><title>2008D13</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d13</guid><description><![CDATA[<p>case_name: Covenant Health System 91, 93-97 DSH/Medicaid Proxy Group</p><p>case_numbers: 00-1904G</p><p>decision_date: Fri, 11 Jan 2008 12:00:00 -0500</p><p>decision_number: 2008D13</p><p>fiscal_year_end: 06/30/1991-06/30/1997</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's calculation of the disproportionate share hospital (DSH) payment was proper.</p>]]></description></item><item><title>2011D40</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d40</guid><description><![CDATA[<p>case_name: UMass Health System 2004 DSH Medicare Choice Group</p><p>case_numbers: 10-0069GC</p><p>decision_date: Fri, 15 Jul 2011 12:00:00 -0400</p><p>decision_number: 2011D40</p><p>fiscal_year_end: 09/30/2004</p><p>provider_number: Various</p><p>summary: Whether inpatient days for Medicaid-eligible patients who were enrolled in a Medicare Choice (M C) plan under Part C of the Medicare statute were properly excluded from the numerator of the Medicaid fraction that is used to calculate the disproportionate share hospital (DSH) payment.</p>]]></description></item><item><title>1998D046</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d046</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d046</guid><description><![CDATA[<p>case_name: Universal Rehabilitation Services, Inc., Horsham PA</p><p>case_numbers: 92-1582</p><p>decision_date: Fri, 24 Apr 1998 12:00:00 -0400</p><p>decision_number: 1998D046</p><p>fiscal_year_end: 09/30/1989</p><p>provider_number: 39-6563</p><p>summary: Was the Intermediary's adjustment to the Provider's reasonable costs proper?</p>]]></description></item><item><title>1998D062</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d062</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d062</guid><description><![CDATA[<p>case_name: Hurley Medical Center, Flint MI</p><p>case_numbers: 94-3278</p><p>decision_date: Thu, 04 Jun 1998 12:00:00 -0400</p><p>decision_number: 1998D062</p><p>fiscal_year_end: 06/30/1990</p><p>provider_number: 23-0132</p><p>summary: Was the denial of the TEFRA exception request proper?</p>]]></description></item><item><title>2008D17</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d17</guid><description><![CDATA[<p>case_name: Sparrow Health 98-99 IME Managed Care Group</p><p>case_numbers: 04-0088G</p><p>decision_date: Tue, 12 Feb 2008 12:00:00 -0500</p><p>decision_number: 2008D17</p><p>fiscal_year_end: 12/31/1998; 12/31/1999</p><p>provider_number: Various</p><p>summary: Whether the Providers are entitled to receive additional indirect medical education (IME) and direct graduate medical education (DGME) payments for Medicare managed care enrollees for fiscal years ended December 31, 1998 and 1999.</p>]]></description></item><item><title>1998D031</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d031</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d031</guid><description><![CDATA[<p>case_name: Ellis Hospital, Schenectady NY</p><p>case_numbers: 91-2986M</p><p>decision_date: Fri, 27 Feb 1998 12:00:00 -0500</p><p>decision_number: 1998D031</p><p>fiscal_year_end: N/A</p><p>provider_number: 33-0153</p><p>summary: Were the Intermediary's adjustments made foe graduate medical education (GME) settlement purposes proper?</p>]]></description></item><item><title>2011D42</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d42</guid><description><![CDATA[<p>case_name: Memorial Hermann - Memorial City Hospital, Houston TX</p><p>case_numbers: 98-2219; 98-2218; 01-2534; 03-1358</p><p>decision_date: Thu, 11 Aug 2011 12:00:00 -0400</p><p>decision_number: 2011D42</p><p>fiscal_year_end: 06/30/1994; 06/30/1995; et al</p><p>provider_number: 45-0610</p><p>summary: Does the Board have jurisdiction over the issue of whether the Provider is entitled to be reimbursed for the interest implicit in the capital lease of the hospital facilities and equipment?</p>]]></description></item><item><title>1998D054</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d054</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d054</guid><description><![CDATA[<p>case_name: St. Joseph Hospital, North Providence RI</p><p>case_numbers: 91-1799</p><p>decision_date: Thu, 21 May 1998 12:00:00 -0400</p><p>decision_number: 1998D054</p><p>fiscal_year_end: 09/30/1988</p><p>provider_number: 41-0005</p><p>summary: Was the Intermediary correct in applying reasonable compensation equivalent calculations to physicians who are employees of the management firm with which the hospital contracted to provide administrative services in the hospital's exempt psychiatric unit?</p>]]></description></item><item><title>2008D20</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d20</guid><description><![CDATA[<p>case_name: HealthEast Woodwinds Hospital, Woodbury MN</p><p>case_numbers: 06-0763; 06-2010</p><p>decision_date: Tue, 04 Mar 2008 12:00:00 -0500</p><p>decision_number: 2008D20</p><p>fiscal_year_end: 8/31/2003; 8/31/2004</p><p>provider_number: 24-0213</p><p>summary: Whether the Intermediary's refusal to reimburse the Provider for capital-related costs under the hold harmless methodology was proper.</p>]]></description></item><item><title>2007D71</title><pubDate>Mon, 04 Nov 2019 02:24:03 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d71</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d71</guid><description><![CDATA[<p>case_name: Logos Healthcare Rehabilitation, Inc., Boone, NC</p><p>case_numbers: 00-3350</p><p>decision_date: Wed, 19 Sep 2007 12:00:00 -0400</p><p>decision_number: 2007D71</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 34-6538</p><p>summary: 1. Was the Intermediary's adjustment to Medicare bad debts proper? (Provider Issue 1); 2. Were the Intermediary's adjustments to salaries - administrative proper? (Provider Issue 2); 3. Was the Intermediary's adjustment to salaries - physical therapy proper? (Provider Issue 2); 4. Was the Intermediary's adjustment to salaries - speech therapy proper? (Provider Issue 2); 5. Was the Intermediarys adjustment to salaries - occupational therapy proper? (Provider Issue 2); 6. Was the Intermediary's adjustment to other charges - physical therapy proper? (Provider Issue 3); 7. Was the Intermediary's adjustment to other charges - speech therapy proper? (Provider Issue 3); 8. Was the Intermediary's adjustment to other charges - occupational therapy proper? (Provider Issue 3); 9. Was the Provider's request for additional costs for depreciation proper? (Provider Issue 4 and Intermediary Issue 17 in Initial Position Paper)</p>]]></description></item><item><title>2011D17</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d17</guid><description><![CDATA[<p>case_name: Charleston Area Medical Center</p><p>case_numbers: 05-1761</p><p>decision_date: Thu, 06 Jan 2011 12:00:00 -0500</p><p>decision_number: 2011D17</p><p>fiscal_year_end: 12/31/2000</p><p>provider_number: 51-0022</p><p>summary: Whether the provider has a right to a hearing on certain graduate medical education costs and kidney acquisition costs that were not claimed on the cost report.</p>]]></description></item><item><title>2003D20</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d20</guid><description><![CDATA[<p>case_name: Meriter Hospital, Madison, WI</p><p>case_numbers: 99-4064</p><p>decision_date: Wed, 19 Mar 2003 12:00:00 -0500</p><p>decision_number: 2003D20</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 52-0089</p><p>summary: Was the Intermediary's determination of the TEFRA exception request proper?</p>]]></description></item><item><title>2007D11</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d11</guid><description><![CDATA[<p>case_name: Foothill Presbyterian Hospital, Glenora, CA</p><p>case_numbers: 97-2446</p><p>decision_date: Tue, 19 Dec 2006 12:00:00 -0500</p><p>decision_number: 2007D11</p><p>fiscal_year_end: 09/30/1995</p><p>provider_number: 05-0597</p><p>summary: Whether the Intermediary's determination of reimbursable Medicare bad debts for beneficiaries without Medicaid eligibility (non-crossover beneficiaries) was proper.</p>]]></description></item><item><title>2009D38</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d38</guid><description><![CDATA[<p>case_name: Southwest Consulting 1999-2002 MA Uncompensated Care Days Group</p><p>case_numbers: 06-0316G; 06-0317G; 06-0318G; 06-0319G</p><p>decision_date: Fri, 28 Aug 2009 12:00:00 -0400</p><p>decision_number: 2009D38</p><p>fiscal_year_end: 09/30/1999-09/30/2002</p><p>provider_number: Various</p><p>summary: Whether the Intermediary improperly computed the numerator of the Medicaid fractions that were used to calculate the Provider's disproportionate share hospital (DSH) payments for fiscal years 1999, 2000, 2001, and 2002 by excluding inpatient days attributable to individuals who received assistance under the Massachusetts Uncompensated Care pool for such days.</p>]]></description></item><item><title>2007D14</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d14</guid><description><![CDATA[<p>case_name: CHI 1997-2002 Offshore Captive Insurance Groups</p><p>case_numbers: 00-3662G; 00-3663G; 00-3664G; 02-0983G; 04-0180G; 04-0443G</p><p>decision_date: Wed, 24 Jan 2007 12:00:00 -0500</p><p>decision_number: 2007D14</p><p>fiscal_year_end: 12/31/1997 to 12/31/2002</p><p>provider_number: Various</p><p>summary: Whether the offshore captive investment limitations prescribed in section 2162.2.A.4 of the Provider Reimbursement Manual may properly be applied to disallow all of the premiums paid by the Providers to First Initiatives Insurance, Ltd. For the 1997-2002 cost reporting periods.</p>]]></description></item><item><title>2011D13</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d13</guid><description><![CDATA[<p>case_name: Western Medical Center - Santa Ana, Santa Ana CA</p><p>case_numbers: 08-1695</p><p>decision_date: Fri, 03 Dec 2010 12:00:00 -0500</p><p>decision_number: 2011D13</p><p>fiscal_year_end: 09/30/2008</p><p>provider_number: 05-0746</p><p>summary: Whether it was proper for the Centers for Medicare and Medicaid Service to reduce by two percent the Medicare annual payment update for Western Medical Center - Santa Ana for federal fiscal year 2008.</p>]]></description></item><item><title>2007D19</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d19</guid><description><![CDATA[<p>case_name: Sewickley Valley Hospital and The Medical Center, Beaver, PA</p><p>case_numbers: 99-3470; 99-3471</p><p>decision_date: Wed, 21 Feb 2007 12:00:00 -0500</p><p>decision_number: 2007D19</p><p>fiscal_year_end: 10/31/1996</p><p>provider_number: 39-0037; 39-0036</p><p>summary: Whether the Intermediary's denial of a loss on disposition of assets due to a consolidation of Sewickley Valley Hospital and The Medical Center of Beaver was correct.</p>]]></description></item><item><title>2007D72</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d72</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d72</guid><description><![CDATA[<p>case_name: Logos Healthcare Rehabilitation, Inc., Boone, NC</p><p>case_numbers: 00-3351</p><p>decision_date: Wed, 19 Sep 2007 12:00:00 -0400</p><p>decision_number: 2007D72</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: 34-6538</p><p>summary: 1. Was the Intermediary's adjustment to bad debts proper?; 2. Was the Intermediary's adjustment to salaries proper?; 3. Was the Intermediary's adjustment to contracted labor proper?; 4. Was the Intermediary's adjustment to travel and lodging expense proper?; 5. Was the Intermediary's adjustment to utilities expense proper?; 6. Was the Intermediary's adjustment to office supply expense proper?; 7. Was the Intermediary's adjustment to dues and subscriptions expense proper?; 8. Was the Intermediary's adjustment to professional fees proper?; 9. Was the Intermediary's adjustment to other expenses proper?; 10. Was the Intermediary's adjustment to rent expense proper?; 11. Was the Intermediary's adjustment to additional accounts payable/capital related costs proper?; 12. Was the Intermediary's adjustment to interest expense proper?; 13. Was the Intermediary's adjustment to advertising expense proper?; 14. Was the Intermediary's adjustment to home office costs proper? (Provider's Issue 15); 15. Were the Provider's requests for the inclusion of costs incurred in settling the cost report after termination from the Medicare program proper? (Provider's Issue 14)</p>]]></description></item><item><title>1998D040</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d040</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d040</guid><description><![CDATA[<p>case_name: Milwaukee Subacute and Rehabilitation Center, Milwaukee WI</p><p>case_numbers: 96-2419</p><p>decision_date: Tue, 14 Apr 1998 12:00:00 -0400</p><p>decision_number: 1998D040</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 52-5569</p><p>summary: Should the Provider be granted a "new Provider" exemption from the routine cost limits in accordance with 42 C.F.R. Section 413.30(e)?</p>]]></description></item><item><title>1998D048</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d048</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d048</guid><description><![CDATA[<p>case_name: Mariner Health Care/ Liberty Health Care 1994 Occupational and Speech Therapy Group</p><p>case_numbers: 97-0050G</p><p>decision_date: Fri, 08 May 1998 12:00:00 -0400</p><p>decision_number: 1998D048</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Did the Intermediary properly adjust the Provider's occupational and speech therapy costs?</p>]]></description></item><item><title>1998D050</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d050</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d050</guid><description><![CDATA[<p>case_name: Cal-A-Nurse, Inc., St. Louis MO</p><p>case_numbers: 94-2093G; 94-2094G; 94-2095G; 96-1323G; 96-1325G</p><p>decision_date: Wed, 20 May 1998 12:00:00 -0400</p><p>decision_number: 1998D050</p><p>fiscal_year_end: 12/31/1991- 12/31/1993</p><p>provider_number: Various</p><p>summary: 1. Should the Intermediary have appled the exception to the related organizations principal in computing the Provider's reimbursement for the serices of Data-Med, Inc. the organization which supplies the data processing and other computer services to the Providers?; 2. Was the Intermediary's adjustment to directly allocate salaries proper?; 3. Was the Intermediary's disallowance of owners' compensation costs proper?</p>]]></description></item><item><title>1998D033</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d033</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d033</guid><description><![CDATA[<p>case_name: High Country Home Health Care, Inc., Laramie WY</p><p>case_numbers: 95-2125</p><p>decision_date: Wed, 18 Mar 1998 12:00:00 -0500</p><p>decision_number: 1998D033</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 53-7025</p><p>summary: Did the Intermediary properly disallow a portion of the owner's compensation?</p>]]></description></item><item><title>2007D73</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d73</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d73</guid><description><![CDATA[<p>case_name: Logos Healthcare Rehabilitation of South Carolina, Inc., West Columbia, SC</p><p>case_numbers: 00-3352</p><p>decision_date: Thu, 20 Sep 2007 12:00:00 -0400</p><p>decision_number: 2007D73</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 42-6548</p><p>summary: 1. Did the Intermediary improperly reopen the cost report?; 2. Was the Intermediary's adjustment to Medicare bad debts proper?; 3. Was the Intermediary's adjustment to physical therapy salaries proper?; 4. Was the Intermediary's adjustment to recruiting costs - other proper?; 5. Was the Intermediary's adjustment to recruiting costs - Rehab Resources proper?; 6. Was the Intermediary's adjustment to supplies - physical therapy proper?; 7. Was the Intermediary's adjustment to supplies - administrative proper?; 8. Was the Intermediary's adjustment to office supplies proper?; 9. Was the Intermediary's adjustment to accounting expense proper?; 10. Was the Intermediary's adjustment to contract services - physical therapy proper?; 11. Was the Intermediary's adjustment to contract services - occupational therapy proper?; 12. Was the Intermediary's adjustment to contract services - administrative proper?; 13. Was the Intermediary's adjustment to rent expense proper?: 14. Was the Intermediary's adjustment to telephone expense proper?; 15. Was the Intermediary's adjustment to home office costs proper? (Provider's Issue 16); 16. Was the Provider's request for the inclusion of additional costs for depreciation for which there were no adjustments made proper? (Provider's Issue 15)</p>]]></description></item><item><title>2011D12</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d12</guid><description><![CDATA[<p>case_name: Various Genesis Health Care C orporation Providers</p><p>case_numbers: 06-2376; 06-2377; 06-2378; 06-2379; 06-2381; 06-2383; 06-2385; 06-2410</p><p>decision_date: Thu, 02 Dec 2010 12:00:00 -0500</p><p>decision_number: 2011D12</p><p>fiscal_year_end: 12/31/2004</p><p>provider_number: Various</p><p>summary: Whether the Fiscal Intermediary properly adjusted the Providers' bad debts for the fiscal year ended December 31, 2004.</p>]]></description></item><item><title>2007D16</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d16</guid><description><![CDATA[<p>case_name: Martin Luther King Jr./ Drew Medical Center, Los Angeles, CA</p><p>case_numbers: 03-0818</p><p>decision_date: Fri, 26 Jan 2007 12:00:00 -0500</p><p>decision_number: 2007D16</p><p>fiscal_year_end: 06/30/2000</p><p>provider_number: 05-0578</p><p>summary: Whether the Intermediary properly increased the number of available beds used to determine the Provider's indirect medical education (IME) payment.</p>]]></description></item><item><title>2005D16</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d16</guid><description><![CDATA[<p>case_name: Hospital Corporation of America (HCA) Providers with Late Notices of Program Reimbursement</p><p>case_numbers: Various</p><p>decision_date: Mon, 27 Dec 2004 12:00:00 -0500</p><p>decision_number: 2005D16</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: What relief is available through appeal to thre Provider Reimbursement Review Board (Board) for failure of the Intermediaries to timely settle the Provider's cost reports, especially where prejudice will result from the failure to settle such cost report?</p>]]></description></item><item><title>1998D042</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d042</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d042</guid><description><![CDATA[<p>case_name: Parkview Community Hospital Medical Center, Riverside CA</p><p>case_numbers: 93-0048</p><p>decision_date: Tue, 21 Apr 1998 12:00:00 -0400</p><p>decision_number: 1998D042</p><p>fiscal_year_end: 12/31/1990</p><p>provider_number: 05-0102</p><p>summary: Was the Intermediary's adjustment disallowing Medicare bad debts proper?</p>]]></description></item><item><title>2011D16</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d16</guid><description><![CDATA[<p>case_name: Columbia Memorial Hospital, Hudson NY</p><p>case_numbers: 09-1058</p><p>decision_date: Wed, 15 Dec 2010 12:00:00 -0500</p><p>decision_number: 2011D16</p><p>fiscal_year_end: 09/30/2009</p><p>provider_number: 33-0094</p><p>summary: Was CMS' determination to reduce the Provider's inpatient prospective payment system market basket update for federal fiscal year (FY) 2009 by two (2.0) percentage points proper?</p>]]></description></item><item><title>1998D043</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d043</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d043</guid><description><![CDATA[<p>case_name: Deaconess Medical Center, Spokane WA</p><p>case_numbers: 92-0033</p><p>decision_date: Wed, 22 Apr 1998 12:00:00 -0400</p><p>decision_number: 1998D043</p><p>fiscal_year_end: 12/31/1988</p><p>provider_number: 50-0044</p><p>summary: Was the Intermediary's denial of the Provider's request for an adjustment to its TEFRA target rate for its rehabilitation unit proper?</p>]]></description></item><item><title>2011D14</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d14</guid><description><![CDATA[<p>case_name: Yale New Haven Health Services 2001-2004 DSH SAGA Days Groups</p><p>case_numbers: 06-1927G; 08-0138G; 09-1545GC</p><p>decision_date: Wed, 08 Dec 2010 12:00:00 -0500</p><p>decision_number: 2011D14</p><p>fiscal_year_end: 09/30/2001 - 09/30/2004</p><p>provider_number: Various</p><p>summary: Whether the Intermediary properly excluded Connecticut's State-Administered General Assistance (SAGA) program days from the Medicare disproportionate share hospital (DSH) calculation for fiscal year-ends (FYEs) September 30, 2001 through September 30, 2004 for the two hospitals in these group appeals.</p>]]></description></item><item><title>2007D68</title><pubDate>Mon, 04 Nov 2019 02:24:02 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d68</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d68</guid><description><![CDATA[<p>case_name: St. Joseph' Hospital; St. John's Northeast Hospital, MN</p><p>case_numbers: 99-2630; 00-3142;01-1808; 02-1095; 03-1383; 01-2158</p><p>decision_date: Fri, 14 Sep 2007 12:00:00 -0400</p><p>decision_number: 2007D68</p><p>fiscal_year_end: 08/31/1996-08/31/2000</p><p>provider_number: 24-0063; 24-0210</p><p>summary: 1. Whether the Intermediary's exclusion of certain non-Medicaid general assistance and other state-only funded patient days (General Assistance Days or GADs) from the Provider's Medicaid Proxy was proper based on the instruction contained in Program Memorandum A-99-62. (St. Joseph's for FYE 1997 through 2000); 2. Whether Medicare + Choice days were properly treated in the Provider's disproportionate share hospital (DSH) calculation. (St. Joseph's for FYE 1998, 1999 and 2000); 3. Whether the Intermediary properly excluded, for indirect medical education (IME) and direct graduate medical education (DGME) reimbursement purposes, certain resident rotations at related non-hospital locations. (St. Joseph's for FYE 1997, 1998 and St. John's for FYE 1998)</p>]]></description></item><item><title>2007D24</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d24</guid><description><![CDATA[<p>case_name: QRS 96 DSH MediKan Days Group</p><p>case_numbers: 03-1199G</p><p>decision_date: Fri, 30 Mar 2007 12:00:00 -0400</p><p>decision_number: 2007D24</p><p>fiscal_year_end: 06/30/1996; 09/30/1996</p><p>provider_number: Various</p><p>summary: Whether the Intermediary should include all MediKan patient days, primary and secondary, in the Providers' disproportionate share hospital (DSH) calculation.</p>]]></description></item><item><title>1998D032</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d032</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d032</guid><description><![CDATA[<p>case_name: Ashland Regional Medical Center</p><p>case_numbers: 95-0495</p><p>decision_date: Fri, 27 Feb 1998 12:00:00 -0500</p><p>decision_number: 1998D032</p><p>fiscal_year_end: 02/14/1992</p><p>provider_number: 39-0181</p><p>summary: Was the Intermediary's adjustment disallowing the Provider's claimed loss on disposal proper?</p>]]></description></item><item><title>1998D034</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d034</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d034</guid><description><![CDATA[<p>case_name: Infunction Rehabilitation Services, Inc., Acworth GA</p><p>case_numbers: 97-1914</p><p>decision_date: Tue, 24 Mar 1998 12:00:00 -0500</p><p>decision_number: 1998D034</p><p>fiscal_year_end: 09/30/1995</p><p>provider_number: 11-6670</p><p>summary: 1. Did the Intermediary properly adjust Medicare charges?; 2. Did the Intermediary properly adjust Medicare deductables, co-insurance and payments?; 3. Did the Intermediary properly adjust physical therapy salary equivalency limits?; 4. Was the Intermediary's adjustment to legal and accounting costs and other offset items proper?; 5. Was the Intermediary's adjustment to other self-disallowed costs proper?</p>]]></description></item><item><title>1998D035</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d035</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d035</guid><description><![CDATA[<p>case_name: Parkway Regional Medical Center, Miami FL</p><p>case_numbers: 93-2004</p><p>decision_date: Tue, 24 Mar 1998 12:00:00 -0500</p><p>decision_number: 1998D035</p><p>fiscal_year_end: 11/17/1989</p><p>provider_number: 10-0114</p><p>summary: Does the recapture of depreciation due to the gain on the sale of depreciable assets have any effect on the Provider's equity capital for prior years?</p>]]></description></item><item><title>2000D21</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d21</guid><description><![CDATA[<p>case_name: Newark Bethe Israel Medical Center, Newark, NJ</p><p>case_numbers: 95-0897</p><p>decision_date: Wed, 23 Feb 2000 12:00:00 -0500</p><p>decision_number: 2000D21</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 31-0002</p><p>summary: Was the Intermediary's failure to apply updated reasonable compensation equivalent limits proper?</p>]]></description></item><item><title>2011D11</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d11</guid><description><![CDATA[<p>case_name: Coosa Valley Medical Center, Sylacauga AL</p><p>case_numbers: 06-2033</p><p>decision_date: Mon, 22 Nov 2010 12:00:00 -0500</p><p>decision_number: 2011D11</p><p>fiscal_year_end: 07/31/2006; 07/31/2007</p><p>provider_number: 01-0164</p><p>summary: Whether the Centers for Medicare and Medicaid Services (CMS), reversal of the Provider's rural referral center (RRC) classification was proper.</p>]]></description></item><item><title>2005D14</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d14</guid><description><![CDATA[<p>case_name: Countryside Manor Health Care Center, Anderson, IN</p><p>case_numbers: 00-0945</p><p>decision_date: Fri, 17 Dec 2004 12:00:00 -0500</p><p>decision_number: 2005D14</p><p>fiscal_year_end: 12/31/97</p><p>provider_number: 15-5258</p><p>summary: 1. Whether the Intermediary adjustment to disallow a portion of the owners' compensation was proper?; 2. Whether the Intermediary adjustment to disallow bad debts was proper?</p>]]></description></item><item><title>2007D20</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d20</guid><description><![CDATA[<p>case_name: Western Reserve Care System, Youngtown, OH</p><p>case_numbers: 03-0573</p><p>decision_date: Fri, 23 Feb 2007 12:00:00 -0500</p><p>decision_number: 2007D20</p><p>fiscal_year_end: 12/31/1999</p><p>provider_number: 36-0141</p><p>summary: 1. Did the Intermediary err in refusing to include Provider's cost for contracted perfusionist services in its wage index calculations?; 2. Did the Intermediary err in refusing to include Provider's cost for contracted pharmacy services in its wage index calculations?</p>]]></description></item><item><title>2009D36</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d36</guid><description><![CDATA[<p>case_name: Select Medical 2002-2003 Freestanding "new Hospital" Capital-Related Costs Groups</p><p>case_numbers: 06-1080G; 06-1081G</p><p>decision_date: Wed, 19 Aug 2009 12:00:00 -0400</p><p>decision_number: 2009D36</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary"s adjustments to the Provider's reimbursable capital cost after denying "new hospital" status was proper.</p>]]></description></item><item><title>1998D036</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d036</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d036</guid><description><![CDATA[<p>case_name: Dominguez Valley Hospital, Long Beach CA</p><p>case_numbers: 93-0337</p><p>decision_date: Tue, 24 Mar 1998 12:00:00 -0500</p><p>decision_number: 1998D036</p><p>fiscal_year_end: 05/31/1989</p><p>provider_number: 05-0034</p><p>summary: Was the Provider's request for an adjustment to the TEFRA target amount for the 1989 fiscal year filed on a timely basis?</p>]]></description></item><item><title>2007D18</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d18</guid><description><![CDATA[<p>case_name: Mesquite Community Hospital, Mesquite, TX</p><p>case_numbers: 02-2080</p><p>decision_date: Fri, 16 Feb 2007 12:00:00 -0500</p><p>decision_number: 2007D18</p><p>fiscal_year_end: 05/31/2000</p><p>provider_number: 45-0688</p><p>summary: Whether the Intermediary's determination of allowable Medicare bad debts based upon collection effort was proper.</p>]]></description></item><item><title>2008D08</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d08</guid><description><![CDATA[<p>case_name: Visiting Nurses Association of Texas, Dallas TX</p><p>case_numbers: 99-3188</p><p>decision_date: Fri, 16 Nov 2007 12:00:00 -0500</p><p>decision_number: 2008D08</p><p>fiscal_year_end: 06/30/1997</p><p>provider_number: 45-7001</p><p>summary: 1. Whether the disallowance of $595,069 as an adjustment to administrative and general pooled costs related to a management service organization, Home Health First, was proper?; 2. Whether the disallowance of $35,390 to remove the portion of Home Health First management fees attributable to the cost of a deffered compensation plan for executives was proper.; 3. Whether the disallowance of $351,012 as cost in excess of the physical therapy salary equivalency guidelines (SEGs) was proper.</p>]]></description></item><item><title>2007D67</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d67</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d67</guid><description><![CDATA[<p>case_name: Rochester 02-03 MSA Wage Index Group</p><p>case_numbers: 03-0522G</p><p>decision_date: Fri, 31 Aug 2007 12:00:00 -0400</p><p>decision_number: 2007D67</p><p>fiscal_year_end: 09/30/2003</p><p>provider_number: Various</p><p>summary: Whether the Intermediary failed to properly adjust the wage data for Rochester General Hospital used in the calculation of the Federal Fiscal Year (FFY) 2003 Wage Index for The Rochester, New York Metropolitan Statistical Area (MSA).</p>]]></description></item><item><title>2007D17</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d17</guid><description><![CDATA[<p>case_name: Hi-Desert Medical Center, Joshua Tree, CA</p><p>case_numbers: 97-2936</p><p>decision_date: Fri, 02 Feb 2007 12:00:00 -0500</p><p>decision_number: 2007D17</p><p>fiscal_year_end: 06/30/1995</p><p>provider_number: 05-0279</p><p>summary: Whether the Intermediary improperly limited the Provider's hospital-based Skilled Nursing Facility's (SNF) routine cost limit exception amount to costs in excess of 112 percent of its peer group costs rather than costs in excess of the routine cost limit.</p>]]></description></item><item><title>1998D029</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d029</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d029</guid><description><![CDATA[<p>case_name: The Parkway Hospital, Inc., Forest Hills NY</p><p>case_numbers: 89-1782</p><p>decision_date: Tue, 24 Feb 1998 12:00:00 -0500</p><p>decision_number: 1998D029</p><p>fiscal_year_end: 12/31/1986; 12/31/1987</p><p>provider_number: 33-0041</p><p>summary: Were the Intermediary's adjustments reclassifying the lease rental costs reported as capital costs proper?</p>]]></description></item><item><title>2000D19</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d19</guid><description><![CDATA[<p>case_name: Emanuel Hospital &#x26; Health Center, Portland, OR</p><p>case_numbers: 95-0072</p><p>decision_date: Thu, 10 Feb 2000 12:00:00 -0500</p><p>decision_number: 2000D19</p><p>fiscal_year_end: 03/31/1990</p><p>provider_number: 38-0007</p><p>summary: Was the Intermediary's or HCFA's determination regarding the Provider's TEFRA exception request proper?</p>]]></description></item><item><title>1998D028</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d028</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d028</guid><description><![CDATA[<p>case_name: A.O. Fox Memorial Hospital, Oneonta NY</p><p>case_numbers: 87-0480E</p><p>decision_date: Fri, 13 Feb 1998 12:00:00 -0500</p><p>decision_number: 1998D028</p><p>fiscal_year_end: 12/31/1986</p><p>provider_number: 33-0085</p><p>summary: Was the Intermediary's denial of the Provider's request for rural referral center status for the fiscal year ended December 3, 1986 proper?</p>]]></description></item><item><title>2011D15</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d15</guid><description><![CDATA[<p>case_name: Pacific Alliance Medical Center, Los Angeles CA</p><p>case_numbers: 09-1796</p><p>decision_date: Tue, 14 Dec 2010 12:00:00 -0500</p><p>decision_number: 2011D15</p><p>fiscal_year_end: 09/30/2009</p><p>provider_number: 05-0018</p><p>summary: Whether the Provider is entitled to the full market basket update for Federal Fiscal Year ending 2009 under the Reporting Hospital Quality Data for Annual Payment Update Program.</p>]]></description></item><item><title>2011D18</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d18</guid><description><![CDATA[<p>case_name: George Washington University Hospital</p><p>case_numbers: 05-1032; 06-1173</p><p>decision_date: Thu, 20 Jan 2011 12:00:00 -0500</p><p>decision_number: 2011D18</p><p>fiscal_year_end: 12/31/2001; 12/31/2002</p><p>provider_number: 09-0001</p><p>summary: Whether the Intermediary properly extrapolated the sample error rate to the population in adjusting Medicaid eligible days.</p>]]></description></item><item><title>2007D15</title><pubDate>Mon, 04 Nov 2019 02:24:01 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d15</guid><description><![CDATA[<p>case_name: P-B Health Home Care Agency, Inc., Baltimore, MD</p><p>case_numbers: 00-1836</p><p>decision_date: Thu, 25 Jan 2007 12:00:00 -0500</p><p>decision_number: 2007D15</p><p>fiscal_year_end: 06/30/1997</p><p>provider_number: 21-7134</p><p>summary: Whether the Intermediary's adjustment to disallow the cost of accrued compensatory time was proper.</p>]]></description></item><item><title>2004D02</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d02</guid><description><![CDATA[<p>case_name: Bournewood Hospital; Brookline, MA</p><p>case_numbers: 99-3609; 00-3050; 01-2972</p><p>decision_date: Fri, 21 Nov 2003 12:00:00 -0500</p><p>decision_number: 2004D02</p><p>fiscal_year_end: 08/31/97; 08/31/98; 8/31/99</p><p>provider_number: 22-4022</p><p>summary: Were the Intermediary's adjustments to physician stand-by costs in the routine area correct?</p>]]></description></item><item><title>2009D34</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d34</guid><description><![CDATA[<p>case_name: Whidden Memorial Hospital, Everett WA</p><p>case_numbers: 99-1786; 99-2499; 00-2047; 01-1820</p><p>decision_date: Tue, 28 Jul 2009 12:00:00 -0400</p><p>decision_number: 2009D34</p><p>fiscal_year_end: 7/31/1996- 09/30/1998</p><p>provider_number: 22-0042; 22-5699</p><p>summary: 1. Whether the Intermediary's audit adjustment disallowing the entire loss on the disposition of assets claimed by the Provider, when the Provider corporation merged with another provider corporation, were appropriate.; 2. Whether the Intermediary properly denied the Provider's application for a new provider exemption from the routine service cost limits (RCLs) for its hospital-based skilled nursing facility (HB-SNF).</p>]]></description></item><item><title>1998D013</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d013</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d013</guid><description><![CDATA[<p>case_name: Englewood Community Hospital - SNF, Englewood FL</p><p>case_numbers: 96-2058</p><p>decision_date: Thu, 11 Dec 1997 12:00:00 -0500</p><p>decision_number: 1998D013</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 10-5883</p><p>summary: Is the Provider exempt from the skilled nursing facility ("SNF") routine cost limits as a "new provider"?</p>]]></description></item><item><title>2002D41</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d41</guid><description><![CDATA[<p>case_name: Mercer Street Friends Center, Trenton, NJ</p><p>case_numbers: 99-0286R</p><p>decision_date: Thu, 19 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D41</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 31-7062</p><p>summary: Was the interest paid on working capital loans from the Friend Center Fund and commercial banks necessary and allowable?</p>]]></description></item><item><title>2003D12</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d12</guid><description><![CDATA[<p>case_name: Susquehanna Regional Home Health Services, Williamsport, PA</p><p>case_numbers: 97-1686</p><p>decision_date: Wed, 08 Jan 2003 12:00:00 -0500</p><p>decision_number: 2003D12</p><p>fiscal_year_end: 06/30/1995</p><p>provider_number: 39-7006</p><p>summary: Was the Intermediary's adjustment to rent paid by the Provider to a related party proper?</p>]]></description></item><item><title>2002D43</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d43</guid><description><![CDATA[<p>case_name: Southern Indiana Rehabilitation Hospital, New Albany, IN</p><p>case_numbers: 98-2295; 99-2144</p><p>decision_date: Thu, 26 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D43</p><p>fiscal_year_end: 02/28/1995; 02/29/1996</p><p>provider_number: 15-2009</p><p>summary: 1. Was the Intermediary's determination of the provider's Medicare TEFRA base year proper?; 2. Was the Intermediary's determination of the Provider's TEFRA target rate limitation proper?</p>]]></description></item><item><title>1998D016</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d016</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d016</guid><description><![CDATA[<p>case_name: Robert Packer Hospital, Sayre PA</p><p>case_numbers: 85-1109</p><p>decision_date: Tue, 13 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D016</p><p>fiscal_year_end: 06/30/1983</p><p>provider_number: 39-0079</p><p>summary: Were the Intermediary's adjustments to the Provider's interest expense to account for the hospital's 1983 advance refunding of debt proper?</p>]]></description></item><item><title>2008D22</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2008d22</guid><description><![CDATA[<p>case_name: Cooper University Hospital, Camden NJ</p><p>case_numbers: 04-0183</p><p>decision_date: Fri, 28 Mar 2008 12:00:00 -0400</p><p>decision_number: 2008D22</p><p>fiscal_year_end: 12/31/2000</p><p>provider_number: 31-0014</p><p>summary: Whether the Medicare fiscal intermediary erred by not including in the calculation of the disproportionate share hospital (DSH) payment for fiscal year 2000 all of the Provider's inpatient days relating to patients who were not entitled to Medicare, but who qualified for medical assistance under the New Jersey Charity Care Program.</p>]]></description></item><item><title>2003D44</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d44</guid><description><![CDATA[<p>case_name: Wilmac Corporation Group, York, PA</p><p>case_numbers: 02-0901G</p><p>decision_date: Thu, 21 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D44</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: Various</p><p>summary: Was the Intermediary's disallowance of liabilities not liquidated timely on the Medicare cost report proper?</p>]]></description></item><item><title>2000D17</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d17</guid><description><![CDATA[<p>case_name: DePaul Health Center, St. Louis, MO</p><p>case_numbers: 92-1549</p><p>decision_date: Wed, 09 Feb 2000 12:00:00 -0500</p><p>decision_number: 2000D17</p><p>fiscal_year_end: 06/30/1988</p><p>provider_number: 26-0104</p><p>summary: Was the computation and allocation of the cashiering, accounts receivable, and collections cost center done correctly and done in accordance with the regulations?</p>]]></description></item><item><title>2003D28</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d28</guid><description><![CDATA[<p>case_name: All Care Home Health, Lansing, MI</p><p>case_numbers: 00-3416</p><p>decision_date: Fri, 02 May 2003 12:00:00 -0400</p><p>decision_number: 2003D28</p><p>fiscal_year_end: 04/30/1998</p><p>provider_number: 14-7614</p><p>summary: Was the Intermediary's adjustment to disallow accrued bonuses for employees proper?</p>]]></description></item><item><title>2007D22</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d22</guid><description><![CDATA[<p>case_name: Alacare Home Health Services. Inc., Birmingham, AL</p><p>case_numbers: 01-0654; 02-0235</p><p>decision_date: Tue, 27 Feb 2007 12:00:00 -0500</p><p>decision_number: 2007D22</p><p>fiscal_year_end: 12/31/1998; 12/31/1999</p><p>provider_number: 01-7009</p><p>summary: Whether the relevant claims were timely filed by Alacare under 42 C.F.R. Section 424.44.</p>]]></description></item><item><title>2006D46</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d46</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d46</guid><description><![CDATA[<p>case_name: Sisters of Charity Hospital, Buffalo NY</p><p>case_numbers: 03-0940</p><p>decision_date: Thu, 07 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D46</p><p>fiscal_year_end: 12/31/1999</p><p>provider_number: 33-0078</p><p>summary: Whether the Intermediary properly calculated the Provider's indirect medical education (IME) reimbursement for its fiscal year ending December 31, 1999.</p>]]></description></item><item><title>2006D48</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d48</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d48</guid><description><![CDATA[<p>case_name: District of Columbia General Hospital, Washington DC</p><p>case_numbers: 98-2103; 99-1746; 00-2563; 03-0127; 03-0484; 03-1471; 03-1472</p><p>decision_date: Tue, 12 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D48</p><p>fiscal_year_end: 09/30/1994-07/15/2001</p><p>provider_number: 09-0007</p><p>summary: Whether the Intermediary properly adjusted the Provider's available beds for the purpose of determining the amount of its indirect medical education payment.</p>]]></description></item><item><title>2006D53</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d53</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d53</guid><description><![CDATA[<p>case_name: DePaul Health Center, Bridgeton MO</p><p>case_numbers: 96-0480</p><p>decision_date: Fri, 15 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D53</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 26-0104</p><p>summary: Whether the Intermediary's adjustment that disallowed the consolidation of all of the Provider's therapy services into a single cost center was proper.</p>]]></description></item><item><title>2006D55</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d55</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d55</guid><description><![CDATA[<p>case_name: Saint Anthony's Health Center- SNF, Alton IL</p><p>case_numbers: 98-0580; 98-0463</p><p>decision_date: Tue, 26 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D55</p><p>fiscal_year_end: 12/31/1991; 12/31/1992</p><p>provider_number: 14-5314</p><p>summary: Whether the Provider's exception requests to the skilled nursing facility (SNF) routine service cost limits under 42 C.F.R. Section 413.30(f) was properly denied because the Provider did not request the exceptions within 180 days of the original notices of program reimbursement.</p>]]></description></item><item><title>2006D57</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d57</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d57</guid><description><![CDATA[<p>case_name: Glenwood Park, Inc, Princeton WV</p><p>case_numbers: 05-0051</p><p>decision_date: Thu, 28 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D57</p><p>fiscal_year_end: 12/31/2002</p><p>provider_number: 51-5028</p><p>summary: Whether the Intermediary properly disallowed bad debts claimed for uncollectible deductibles and coinsurance related to therapy services furnished to Medicare beneficiaries dually eligible for Medicare and Medicaid, and paid under the Part B fee schedule.</p>]]></description></item><item><title>2009D11</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d11</guid><description><![CDATA[<p>case_name: Quality Reimbursement Services- Catholic Healthcare West DSH Labor Room Days Grp</p><p>case_numbers: 05-1360G; 05-1362G; 05-1363G; 05-1527G</p><p>decision_date: Fri, 27 Feb 2009 12:00:00 -0500</p><p>decision_number: 2009D11</p><p>fiscal_year_end: 1998-2001</p><p>provider_number: Various</p><p>summary: Whether the Intermediary improperly disallowed from the calculation of the Providers' Disproportionate Share Hospital (DSH) payments, patient days associated with Medicaid patients who were admitted to the hospital prior to the day of giving birth and that were characterized by the Intermediary as "labor days".</p>]]></description></item><item><title>2003D48</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d48</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d48</guid><description><![CDATA[<p>case_name: Mercy Home Health, Springfield, PA</p><p>case_numbers: 99-2780, 99-2781, 01-1334, 01-1335; 02-0450</p><p>decision_date: Fri, 22 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D48</p><p>fiscal_year_end: 12/31/1995-12/31/1999</p><p>provider_number: 39-7015</p><p>summary: Was the Intermediary's adjustment to home office costs proper?</p>]]></description></item><item><title>2003D50</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d50</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d50</guid><description><![CDATA[<p>case_name: Pleasant Care Corporation- Restorative Nursing Aid Group</p><p>case_numbers: 00-0961G</p><p>decision_date: Wed, 27 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D50</p><p>fiscal_year_end: N/A</p><p>provider_number: Various</p><p>summary: Was the Intermediary's adjustment to restorative nurses aides proper?</p>]]></description></item><item><title>2003D66</title><pubDate>Mon, 04 Nov 2019 02:24:00 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d66</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d66</guid><description><![CDATA[<p>case_name: Westminister at Lake Ridge, Lake Ridge, VA</p><p>case_numbers: 99-4073</p><p>decision_date: Tue, 30 Sep 2003 12:00:00 -0400</p><p>decision_number: 2003D66</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: 49-5280</p><p>summary: Was the Intermediary's adjustment disallowing Medicare Part A and Part B bad debts proper?</p>]]></description></item><item><title>2006D52</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d52</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d52</guid><description><![CDATA[<p>case_name: Mark Reed Hospital, McCleary WA</p><p>case_numbers: 04-0565</p><p>decision_date: Thu, 14 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D52</p><p>fiscal_year_end: 12/31/2001</p><p>provider_number: 50-1304</p><p>summary: 1. Whether the Intermediary's adjustment to direct nursing costs was proper.; 2. Whether the Intermediary's adjustment increasing the total patient days to include respite care days was proper.</p>]]></description></item><item><title>1999D47</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d47</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d47</guid><description><![CDATA[<p>case_name: Brookwood Medical Center, Homewood AL</p><p>case_numbers: 95-0931</p><p>decision_date: Thu, 06 May 1999 12:00:00 -0400</p><p>decision_number: 1999D47</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 01-0139</p><p>summary: Was the Provider's request for an exception to its TEFRA target rate proper?</p>]]></description></item><item><title>1998D025</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d025</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d025</guid><description><![CDATA[<p>case_name: Saint Joseph Medical Center, Burbank CA</p><p>case_numbers: 95-0308</p><p>decision_date: Tue, 27 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D025</p><p>fiscal_year_end: 12/31/1986</p><p>provider_number: 05-0235</p><p>summary: Was the Intermediary's denial of the Provider's Routine Cost Limit exception proper?</p>]]></description></item><item><title>1998D002</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d002</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d002</guid><description><![CDATA[<p>case_name: St. Cloud Hospital, St. Cloud MN</p><p>case_numbers: 91-1163E; 92-0895</p><p>decision_date: Thu, 23 Oct 1997 12:00:00 -0400</p><p>decision_number: 1998D002</p><p>fiscal_year_end: 06/30/1988;06/30/1989</p><p>provider_number: 24-0036</p><p>summary: Was the Intermediary's adjustment excluding from capital-related costs the Provider's payments for the rental of a mobile magnetic resonance imaging ("MRI") unit proper?</p>]]></description></item><item><title>2006D45</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d45</guid><description><![CDATA[<p>case_name: The Milton S. Hershey Medical Center, Hershey PA</p><p>case_numbers: 02-0224</p><p>decision_date: Fri, 01 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D45</p><p>fiscal_year_end: 06/20/2001</p><p>provider_number: 39-0256</p><p>summary: Was the Centers for Medicare and Medicaid Services' (CMS) denial of the Provider's request for an exception to the End Stage Renal Disease (ESRD) composite rate proper?</p>]]></description></item><item><title>2006D50</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d50</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d50</guid><description><![CDATA[<p>case_name: CT Subacute Corp. 98 Protested Items Group</p><p>case_numbers: 01-1326G</p><p>decision_date: Wed, 13 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D50</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 07-5234; 07-5210; 07-5198</p><p>summary: Whether the Intermediary's adjustments to disallow rental expense as a cost incurred with a related organization were proper.</p>]]></description></item><item><title>1999D38</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d38</guid><description><![CDATA[<p>case_name: South Shore Hospital Transitional Care Center, South Weymouth MA</p><p>case_numbers: 96-2150</p><p>decision_date: Wed, 21 Apr 1999 12:00:00 -0400</p><p>decision_number: 1999D38</p><p>fiscal_year_end: 09/30/1995</p><p>provider_number: 22-5664</p><p>summary: Was the Provider entitled to an exemption from the skilled nursing facility routine service cost limits as a "new provider"?</p>]]></description></item><item><title>2007D06</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d06</guid><description><![CDATA[<p>case_name: Stormont-Vail Health Care, Topeka, KS</p><p>case_numbers: 04-0575</p><p>decision_date: Thu, 30 Nov 2006 12:00:00 -0500</p><p>decision_number: 2007D06</p><p>fiscal_year_end: 09/30/1995</p><p>provider_number: 17-0086</p><p>summary: Whether the Intermediary's revised Notice of Program Reimbursement issued on July 25, 2003, that increased the Provider's Disproportionate Share Hospital (DSH) payment, included all Medicaid eligible days that would qualify for inclusion under HCFA Ruling 97-2.</p>]]></description></item><item><title>2006D51</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d51</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d51</guid><description><![CDATA[<p>case_name: Gundersen Lutheran Hosptal, LaCrosse WI</p><p>case_numbers: 02-1212</p><p>decision_date: Thu, 14 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D51</p><p>fiscal_year_end: 07/02/2001</p><p>provider_number: 52-0087</p><p>summary: Whether the denial of the Provider's End Stage Renal Disease (ESRD) exception request was in compliance with 42 C.F.R. section 413.180(h), which states: "(h) Approval of an exception request. An exception request is deemed approved unless it is disapproved within 60 working days after it is filed with its Intermediary."</p>]]></description></item><item><title>2009D12</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d12</guid><description><![CDATA[<p>case_name: SRI 1987-1994 DSH SSi Percentage Group</p><p>case_numbers: 08-2907G</p><p>decision_date: Thu, 05 Mar 2009 12:00:00 -0500</p><p>decision_number: 2009D12</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Board has jurisdiction over a challenge to the validity of the Supplemental Security Income percentage under the doctrine of equitable tolling where the appeals were not filed within three years of the issuance of Providers' Notices of Program Reimbursement.</p>]]></description></item><item><title>2006D56</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d56</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d56</guid><description><![CDATA[<p>case_name: Sutter Merced Medical Center, Merced CA</p><p>case_numbers: 04-0660</p><p>decision_date: Wed, 27 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D56</p><p>fiscal_year_end: 12/31/1999</p><p>provider_number: 05-0444</p><p>summary: Whether the Provider's regular Medicare outpatient bad debts are not allowable until all collection efforts including those of a collection agency have ceased.</p>]]></description></item><item><title>2007D10</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d10</guid><description><![CDATA[<p>case_name: St. Benedicts Family Medical Center, Jerome, ID</p><p>case_numbers: 04-0209</p><p>decision_date: Fri, 15 Dec 2006 12:00:00 -0500</p><p>decision_number: 2007D10</p><p>fiscal_year_end: 06/30/2000</p><p>provider_number: 13-0029</p><p>summary: Whether the Intermediary was correct in its determination that no costs for physician assistant emergency room availability are allowable as Medicare Part A reimbursable expenses.</p>]]></description></item><item><title>2009D13</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d13</guid><description><![CDATA[<p>case_name: Langley Porter Psychiatric Institute, San Francisco CA</p><p>case_numbers: 02-0488; 03-1001</p><p>decision_date: Fri, 06 Mar 2009 12:00:00 -0500</p><p>decision_number: 2009D13</p><p>fiscal_year_end: 06/30/1999; 06/30/2000</p><p>provider_number: 05-4144</p><p>summary: Whether the Intermediary's determination of the Provider's direct graduate medical education (DGME) payment was proper.</p>]]></description></item><item><title>1999D45</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d45</guid><description><![CDATA[<p>case_name: Rehabilitation Associates, Inc., Battle Creek MI</p><p>case_numbers: 98-0105</p><p>decision_date: Wed, 05 May 1999 12:00:00 -0400</p><p>decision_number: 1999D45</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 23-6616</p><p>summary: Was the Intermediary's adjustment to owner's compensation Proper?</p>]]></description></item><item><title>2007D12</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d12</guid><description><![CDATA[<p>case_name: El Camino Hospital, Mountain View, CA</p><p>case_numbers: 03-1464</p><p>decision_date: Thu, 21 Dec 2006 12:00:00 -0500</p><p>decision_number: 2007D12</p><p>fiscal_year_end: 06/24/2000</p><p>provider_number: 05-0308</p><p>summary: Whether all of the Provider's outpatient total cost, total charges, and Medicare charges for separately billable End Stage Renal Disease (ESRD) drugs should be reported together on line 56 (drugs charges to patients), on line 57 (renal dialysis), or on a separate cost center line of the Medicare cost report.</p>]]></description></item><item><title>2007D09</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d09</guid><description><![CDATA[<p>case_name: Atlantic 97 Residents in Nonhosp. Setting Grp; AHS 99 IME Grp; AHS 00 FTE Calc Grp</p><p>case_numbers: 01-3592G; 02-2153G; 03-0960G</p><p>decision_date: Thu, 14 Dec 2006 12:00:00 -0500</p><p>decision_number: 2007D09</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary properly calculated the Providers' 1996 Indirect Medical Education (IME) base year Full-Time Equivalency (FTE) cap specifically regarding residents rotating to nonhospital settings.</p>]]></description></item><item><title>1998D021</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d021</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d021</guid><description><![CDATA[<p>case_name: Emanuel Medical Center, Turlock CA</p><p>case_numbers: 89-2023</p><p>decision_date: Fri, 16 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D021</p><p>fiscal_year_end: 01/31/1987</p><p>provider_number: 05-0179</p><p>summary: Was the Intermediary's adjustment to the amortization of the loss on the sale of Turlock Community Hospital proper?</p>]]></description></item><item><title>2007D08</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d08</guid><description><![CDATA[<p>case_name: Marion General Hospital, Columbia, MS</p><p>case_numbers: 05-0448</p><p>decision_date: Fri, 08 Dec 2006 12:00:00 -0500</p><p>decision_number: 2007D08</p><p>fiscal_year_end: 09/30/1999</p><p>provider_number: 25-0085</p><p>summary: Whether the Provider Reimbursement Review Board may grant jurisdiction for the adjustment included in the Provider's initial Notice of Program Reimbursement.; 2. Whether the Intermediary's adjustment to remove unliquidated liabilities in the year incurred was proper.</p>]]></description></item><item><title>1998D010</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d010</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d010</guid><description><![CDATA[<p>case_name: North Florida Physical Therapy Services, Marianna FL</p><p>case_numbers: 93-1749</p><p>decision_date: Fri, 05 Dec 1997 12:00:00 -0500</p><p>decision_number: 1998D010</p><p>fiscal_year_end: 06/30/1988</p><p>provider_number: 10-6639</p><p>summary: Was the Provider entitled to the lower of cost or charges (LCC) carryforward which was generated under the prior ownership?</p>]]></description></item><item><title>2011D09</title><pubDate>Mon, 04 Nov 2019 02:23:58 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d09</guid><description><![CDATA[<p>case_name: Charity Care/ Ohio HCAP DSH Groups</p><p>case_numbers: 08-2162GC; 08-2165GC; 08-2186G; 08-2233GC et al</p><p>decision_date: Tue, 16 Nov 2010 12:00:00 -0500</p><p>decision_number: 2011D09</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary properly excluded the Ohio Hospital Care Assurance Program (HCAP) days from the Medicare disproportionate share hospital (DSH) calculation.</p>]]></description></item><item><title>2007D07</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d07</guid><description><![CDATA[<p>case_name: St. Joseph Regional Health Center, Bryan, TX</p><p>case_numbers: 01-1443; 01-1444</p><p>decision_date: Thu, 07 Dec 2006 12:00:00 -0500</p><p>decision_number: 2007D07</p><p>fiscal_year_end: 12/31/1996; 12/31/1997</p><p>provider_number: 45-0011</p><p>summary: Whether the Intermediary's made a proper determination that Provider should be paid at the prospective payment rate for rural providers after it was certified as a provider-based entity of a hospital entitled to receive the higher urban prospective payment rate.</p>]]></description></item><item><title>1998D006</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d006</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d006</guid><description><![CDATA[<p>case_name: Methodist Hospital, St. Louis Park MN</p><p>case_numbers: 93-0228</p><p>decision_date: Thu, 06 Nov 1997 12:00:00 -0500</p><p>decision_number: 1998D006</p><p>fiscal_year_end: 10/31/1989</p><p>provider_number: 24-0053</p><p>summary: Did the Intermediary properly disallow the physician's Part A compensation?</p>]]></description></item><item><title>1998D023</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d023</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d023</guid><description><![CDATA[<p>case_name: Colorado Therapy Services, Pueblo CO</p><p>case_numbers: 95-1661</p><p>decision_date: Fri, 23 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D023</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 06-6549</p><p>summary: Does the Provider Reimbursement Review Board have jurisdiction over Provider extension locations that are not surveyed for purposes of certification?</p>]]></description></item><item><title>1998D007</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d007</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d007</guid><description><![CDATA[<p>case_name: Girling Health Care, Inc.- New York Subunit, New York NY</p><p>case_numbers: 94-3386</p><p>decision_date: Thu, 20 Nov 1997 12:00:00 -0500</p><p>decision_number: 1998D007</p><p>fiscal_year_end: 07/31/1990</p><p>provider_number: 33-7243</p><p>summary: Was the Intermediary's adjustment reversing the direct assignment of the New York sub-unit costs proper?</p>]]></description></item><item><title>2006D54</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d54</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d54</guid><description><![CDATA[<p>case_name: North Okaloosa Medical Center, Crestview FL</p><p>case_numbers: 02-1420</p><p>decision_date: Tue, 26 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D54</p><p>fiscal_year_end: 03/31/1998</p><p>provider_number: 10-0122</p><p>summary: Whether the Intermediary's adjustment of disproportionate share hospital (DSH) reimbursement based on its determination that the Provider had less than 100 available beds for DSH eligibility purposes was proper.</p>]]></description></item><item><title>1998D008</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d008</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d008</guid><description><![CDATA[<p>case_name: University Hospital of Syracuse, Syracuse NY</p><p>case_numbers: 91-2866M</p><p>decision_date: Tue, 02 Dec 1997 12:00:00 -0500</p><p>decision_number: 1998D008</p><p>fiscal_year_end: 12/31/1984</p><p>provider_number: 33-0214</p><p>summary: Were the Intermediary's adjustments to the graduate medical education ("GME") base year costs proper?</p>]]></description></item><item><title>1998D024</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d024</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d024</guid><description><![CDATA[<p>case_name: The Brattleboro Retreat, Brattleboro VT</p><p>case_numbers: 92-0662</p><p>decision_date: Tue, 27 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D024</p><p>fiscal_year_end: 06/30/1985-06/30/1988</p><p>provider_number: 47-4001</p><p>summary: Did the Health Care Financing Administration (HCFA) correctly conclude that the Provider's requests for adjustment to its Tax Equity and Fiscal Responsibility Act of 1982 (TEFRA) limits were not timely filed and were therefore improper?</p>]]></description></item><item><title>2007D05</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d05</guid><description><![CDATA[<p>case_name: Washington State Medicare DSH Group II</p><p>case_numbers: 02-1833G</p><p>decision_date: Wed, 22 Nov 2006 12:00:00 -0500</p><p>decision_number: 2007D05</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether all the patient days related to patients that were eligible for medical assistance under an approved state Medicaid plan for such days were included in the Medicaid ratio of the Medicare disproportionate share hospital (DSH) payment calculation.</p>]]></description></item><item><title>2011D06</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d06</guid><description><![CDATA[<p>case_name: UPMC 2003-2006 Count of FTE Residents CIRP Groups</p><p>case_numbers: 05-0508G; 06-0784G; 07-0510G; 08-1412G</p><p>decision_date: Thu, 28 Oct 2010 12:00:00 -0400</p><p>decision_number: 2011D06</p><p>fiscal_year_end: 06/30/2003 - 06/30/2006</p><p>provider_number: Various</p><p>summary: Whether the Intermediary/Medicare Administrative Contractor properly calculated the Providers' 1996 resident cap for purposes of direct graduate medical education and indirect graduate medical education payments.</p>]]></description></item><item><title>1998D026</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d026</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d026</guid><description><![CDATA[<p>case_name: Mercy Hospital of Pittsburgh, Pittsburgh PA</p><p>case_numbers: 91-2673M</p><p>decision_date: Wed, 28 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D026</p><p>fiscal_year_end: 06/30/1985</p><p>provider_number: 39-0028</p><p>summary: 1. Were the GME regulations at 42 CFR Section 413.86 valid?; 2. Were the HCFA GME Program Instructions (GME-PI) implementing the reaudit provisions of 42 CFR Section 413.86 valid?; 3. Was the Intermediary's adjustment reclassifying the GME costs for the Medical Library (ML) and Department of Continuing Education (DCE) to Administrative and General (A&#x26;G) proper?; 4. Was the Intermediary's adjustment reclassifying a portion of the teaching physicians salaries from GME to A&#x26;G proper?; 5. Was the Intermediary's adjustment reclassifying costs for the salaries and expenses related to GME support personnel from GME to A&#x26;G costs proper?; 6. Do the Intermediary's adjustments no. 3 and 6 violate the consistantcy rule stated in 42 CFR Section 412.113(b)(3) (1989)?; 7. Was the Intermediary's adjustment revising the number of FTE residents used in determining the Provider Average Per Resident amount proper?; 8. Was the Intermediary's failure to include the costs associated with the Provider's Anesthesiology and Radiology GME programs in the GME base year proper?; 9. Should the GME clinic costs, mistakenly classified as operating costs in the base year, be included when calculating the APRA?; 10. Should the GME laboratory costs, mistakenly classified as operating costs in the base year, be included when calculating the APRA?</p>]]></description></item><item><title>1998D022</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d022</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d022</guid><description><![CDATA[<p>case_name: Rogue Valley Medical Center, Medford OR</p><p>case_numbers: 93-1156</p><p>decision_date: Wed, 21 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D022</p><p>fiscal_year_end: 09/30/1990</p><p>provider_number: 38-0018</p><p>summary: Was the Provider's request to reopen the calculation of the disproportionate share adjustment to exclude employee self-insured days proper?</p>]]></description></item><item><title>2006D27</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d27</guid><description><![CDATA[<p>case_name: Phoenix Baptist Hospital, Phoenix AZ</p><p>case_numbers: 00-1020</p><p>decision_date: Fri, 02 Jun 2006 12:00:00 -0400</p><p>decision_number: 2006D27</p><p>fiscal_year_end: 08/31/1997</p><p>provider_number: 03-0030</p><p>summary: Whether the Intermediary improperly failed to offset investment losses incurred by the Provider's home office against interest income earned on funds the Provider deposited with a trustee to retire the debt associated with an advance refunding transaction.</p>]]></description></item><item><title>2009D10</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2009d10</guid><description><![CDATA[<p>case_name: Kindred Healthcare 05 Bad Debts (Write Off Dates)</p><p>case_numbers: 07-1969G</p><p>decision_date: Fri, 27 Feb 2009 12:00:00 -0500</p><p>decision_number: 2009D10</p><p>fiscal_year_end: 07/31/2005-12/31/2005</p><p>provider_number: 19-5350; 11-5612; 15-5473; 11-5535</p><p>summary: Whether the Intermediary's adjustments to disallow Medicare bad debts written off by Kindred Healthcare and claimed as worthless after the year end date of the terminating cost report it filed for each skilled nursing facility, due to change of ownership, were proper.</p>]]></description></item><item><title>1999D72</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d72</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d72</guid><description><![CDATA[<p>case_name: Cameron Community Hospital Home Health Agency, Cameron MO</p><p>case_numbers: 97-2381</p><p>decision_date: Thu, 30 Sep 1999 12:00:00 -0400</p><p>decision_number: 1999D72</p><p>fiscal_year_end: 09/30/1994</p><p>provider_number: 26-7140</p><p>summary: Did the Health Care Financing Administration ("HCFA") properly deny the Provider's request for an exception to the home health agency cost limits based on atypical services ?</p>]]></description></item><item><title>1999D36</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d36</guid><description><![CDATA[<p>case_name: Watsonville Community Hospital, Santa Cruz CA</p><p>case_numbers: 91-1440</p><p>decision_date: Wed, 07 Apr 1999 12:00:00 -0400</p><p>decision_number: 1999D36</p><p>fiscal_year_end: 06/30/1988</p><p>provider_number: 05-0194</p><p>summary: Was the Intermediary's adjustment modifying the disproportionate share adjustment amount proper?</p>]]></description></item><item><title>2007D04</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d04</guid><description><![CDATA[<p>case_name: Central Maine Medical Center, Lewiston ME</p><p>case_numbers: 99-1159; 01-2664; 02-0866</p><p>decision_date: Tue, 14 Nov 2006 12:00:00 -0500</p><p>decision_number: 2007D04</p><p>fiscal_year_end: 06/30/1996- 06/30/1998</p><p>provider_number: 20-0024</p><p>summary: Whether the Intermediary's denial of the Provider's request for an adjustment to its TEFRA target amount was proper.</p>]]></description></item><item><title>2006D49</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d49</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d49</guid><description><![CDATA[<p>case_name: CT Subacute Corp 93 Capital Lease Group</p><p>case_numbers: 96-2013G</p><p>decision_date: Wed, 13 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D49</p><p>fiscal_year_end: 07/22/1993</p><p>provider_number: 07-5234; 07-5210</p><p>summary: Whether the Intermediary's adjustments to disallow rental expense as a cost incurred with a related organization were proper.</p>]]></description></item><item><title>1998D001</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d001</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d001</guid><description><![CDATA[<p>case_name: Little Company of Mary Hospital and Health Care Centers, Evergreen Park IL</p><p>case_numbers: 92-1498</p><p>decision_date: Tue, 21 Oct 1997 12:00:00 -0400</p><p>decision_number: 1998D001</p><p>fiscal_year_end: 06/30/1989</p><p>provider_number: 14-0179</p><p>summary: 1. Was the Intermediary's necessity of borrowing determination with regard to the Provider's Illinois Health Facility Authority (IHFA) loan proper?; 2. Did the Intermediary properly include the Provider's neonatal unit beds and days in the indirect medical education (IME) and graduate medical education (GME) patient load calculation for the fiscal year ended June 30, 1989?; 3. Did the Intermediary properly allocate the Providers investment income consistent with the allocation of interest expense?</p>]]></description></item><item><title>2011D08</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2011d08</guid><description><![CDATA[<p>case_name: Autumn Bridge, LLC</p><p>case_numbers: 09-1927</p><p>decision_date: Wed, 10 Nov 2010 12:00:00 -0500</p><p>decision_number: 2011D08</p><p>fiscal_year_end: 10/31/2007</p><p>provider_number: 37-1633</p><p>summary: 1. Has the Provider demonstrated that it is entitled to a hearing before the Board because there is at least $10,000 in controversy?; 2. To what extent, if at all, Medicare's $397,228 demand for repayment from the Provider for fiscal year 2007, calculated pursuant to the existing regulation, would be decreased if the Provider's proposed manner of calculation is adopted.</p>]]></description></item><item><title>1998D005</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d005</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d005</guid><description><![CDATA[<p>case_name: Confident Home Health Care, Dallas TX</p><p>case_numbers: 96-2054</p><p>decision_date: Fri, 31 Oct 1997 12:00:00 -0500</p><p>decision_number: 1998D005</p><p>fiscal_year_end: 07/31/1994</p><p>provider_number: 45-7789</p><p>summary: Was the Intermediary's adjustment shifting nursing and home health aide costs to a privite duty nursing cost center proper?</p>]]></description></item><item><title>2006D47</title><pubDate>Mon, 04 Nov 2019 02:23:57 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d47</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d47</guid><description><![CDATA[<p>case_name: Rush University Medical Center, Chicago IL</p><p>case_numbers: 03-1587; 03-1592</p><p>decision_date: Thu, 07 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D47</p><p>fiscal_year_end: 06/30/1989; 06/30/1990</p><p>provider_number: 14-0119</p><p>summary: Whether the Intermediary should have used the "aggregation methodology" when implementing the updated reasonable compensation equivalent (RCE) limits on compensation paid to Provider's hospital-based physicians.</p>]]></description></item><item><title>1999D61</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d61</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d61</guid><description><![CDATA[<p>case_name: Mercy Medical Skilled Nursing Facility, Daphne AL</p><p>case_numbers: 97-2340</p><p>decision_date: Fri, 20 Aug 1999 12:00:00 -0400</p><p>decision_number: 1999D61</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 01-5049</p><p>summary: 1. Was HCFA's methodology as set forth in Transmittal 378 for determining the amount of the exception from the routine cost limits for hospital-based skilled nursing facilities, and as applied by the Intermediary to the Provider for FYE December 31, 1994, a proper interpretation of the Medicare statute and regulations?; 2. Did the Intermediary properly deny the Provider a rollover interim exception for FYE December 31, 1994?</p>]]></description></item><item><title>1999D60</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d60</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d60</guid><description><![CDATA[<p>case_name: Bamna Home Health Care, Inc., Southfield MI</p><p>case_numbers: 96-2056</p><p>decision_date: Thu, 19 Aug 1999 12:00:00 -0400</p><p>decision_number: 1999D60</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 23-7141</p><p>summary: 1. Was the Intermediary's adjustment to interest expense relating to employment taxes proper?; 2. Was the Intermediary's adjustment to interest expense relating to property taxes proper?</p>]]></description></item><item><title>1998D009</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d009</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d009</guid><description><![CDATA[<p>case_name: Albert Einstein Medical Center, Phhiladelphia PA</p><p>case_numbers: 92-1679</p><p>decision_date: Fri, 05 Dec 1997 12:00:00 -0500</p><p>decision_number: 1998D009</p><p>fiscal_year_end: 06/30/1989</p><p>provider_number: 39-0142</p><p>summary: Was the Intermediary's application of the 1984 Reasonable Compensation Equivalent (RCE) limits proper?</p>]]></description></item><item><title>1998D012</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d012</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d012</guid><description><![CDATA[<p>case_name: Seton Medical Center, Daly City CA</p><p>case_numbers: 86-0429</p><p>decision_date: Wed, 10 Dec 1997 12:00:00 -0500</p><p>decision_number: 1998D012</p><p>fiscal_year_end: 06/30/1984</p><p>provider_number: 05-0289</p><p>summary: Was the Intermediary's denial of the full TEFRA incentive payment to the Provider proper?</p>]]></description></item><item><title>1998D003</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d003</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d003</guid><description><![CDATA[<p>case_name: Palo Verde Hospital, Tucson AZ</p><p>case_numbers: 91-0133</p><p>decision_date: Fri, 24 Oct 1997 12:00:00 -0400</p><p>decision_number: 1998D003</p><p>fiscal_year_end: 06/30/86; 06/30/1987</p><p>provider_number: 03-4001</p><p>summary: Is the Provider entitled to an adjustment to its TEFRA limits for malpractice insurance costs for FYEs June 30, 1986 and June 30, 1987?</p>]]></description></item><item><title>1998D014</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d014</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d014</guid><description><![CDATA[<p>case_name: Greynolds Park Manor, Inc., North Miami Beach FL</p><p>case_numbers: 92-0430</p><p>decision_date: Tue, 30 Dec 1997 12:00:00 -0500</p><p>decision_number: 1998D014</p><p>fiscal_year_end: 05/31/1989</p><p>provider_number: 10-5201</p><p>summary: Was the Health Care Financing Administration's (HCFA) denial of the Provider's exception request proper?</p>]]></description></item><item><title>1999D65</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d65</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d65</guid><description><![CDATA[<p>case_name: Capitol Home Health-Markville, Markville LA</p><p>case_numbers: 94-3026</p><p>decision_date: Fri, 27 Aug 1999 12:00:00 -0400</p><p>decision_number: 1999D65</p><p>fiscal_year_end: 09/30/1991</p><p>provider_number: 19-7317</p><p>summary: Was the Intermediary's adjustment to Worksheet A-8-3 proper?</p>]]></description></item><item><title>1998D004</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d004</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d004</guid><description><![CDATA[<p>case_name: St. Anthony Hospital Systems, Denver CO</p><p>case_numbers: 91-1441</p><p>decision_date: Fri, 31 Oct 1997 12:00:00 -0500</p><p>decision_number: 1998D004</p><p>fiscal_year_end: 06/30/1988</p><p>provider_number: 06-0015</p><p>summary: Was the Intermediary's adjustment reclassifying air ambulance lease rental payments from capital costs to operating expenses proper?</p>]]></description></item><item><title>2006D58</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d58</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d58</guid><description><![CDATA[<p>case_name: Wilmington Treatment Center, Wilmington NC</p><p>case_numbers: 03-0895</p><p>decision_date: Thu, 28 Sep 2006 12:00:00 -0400</p><p>decision_number: 2006D58</p><p>fiscal_year_end: 09/30/1999</p><p>provider_number: 34-0168</p><p>summary: Whether the Intermediary's disallowance of Medicare bad debts claimed by the Provider was justified.</p>]]></description></item><item><title>1998D020</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d020</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d020</guid><description><![CDATA[<p>case_name: White Memorial Medical Center, Los Angeles CA</p><p>case_numbers: 91-2842M</p><p>decision_date: Thu, 15 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D020</p><p>fiscal_year_end: 12/31/1984</p><p>provider_number: 05-0103</p><p>summary: 1. Was the retroactive audit of Graduate Medical Education (GME) costs proper?; 2. Was the Intermediary's determination classifying malpractice insurance costs as administrative and general costs rather than direct GME costs proper?</p>]]></description></item><item><title>1999D56</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d56</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d56</guid><description><![CDATA[<p>case_name: Sunbelt Health Care Centers, Inc., Group Appeal</p><p>case_numbers: 96-0174G</p><p>decision_date: Thu, 01 Jul 1999 12:00:00 -0400</p><p>decision_number: 1999D56</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: Various</p><p>summary: Were the Intermediaries' adjustments eliminating or disallowing the Providers' "gross-up" of drug charges and costs in order to allocate indirect costs to those cost centers correct?</p>]]></description></item><item><title>1998D011</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d011</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d011</guid><description><![CDATA[<p>case_name: Curative Workshop of Racine, Racine WI</p><p>case_numbers: 95-0380</p><p>decision_date: Tue, 09 Dec 1997 12:00:00 -0500</p><p>decision_number: 1998D011</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 52-6514</p><p>summary: Was the Intermediary's modification of cost reporting form 2088-79 for the calculation of reimbursable cost proper?</p>]]></description></item><item><title>2007D02</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2007d02</guid><description><![CDATA[<p>case_name: JFK-Raritan Bay- Hunterdon 03 Wage Index Group</p><p>case_numbers: 03-0482G</p><p>decision_date: Wed, 11 Oct 2006 12:00:00 -0400</p><p>decision_number: 2007D02</p><p>fiscal_year_end: 09/30/2003</p><p>provider_number: 31-0108; 31-0039; 31-0005</p><p>summary: Whether it was proper for the Centers for Medicare and Medicaid Services (CMS) to include the 1999 information for Memorial Medical Center at South Amboy in the 2003 calculation of the Middlesex-Somerset-Hunterdon, New Jersey Metropolitan Statistical Area (MSA) Wage Index.</p>]]></description></item><item><title>1998D015</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d015</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d015</guid><description><![CDATA[<p>case_name: Methodist Hospital, St. Louis Park, MN</p><p>case_numbers: 91-2414M</p><p>decision_date: Tue, 13 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D015</p><p>fiscal_year_end: 10/31/1984</p><p>provider_number: 24-0053</p><p>summary: Was the Intermediary's denial of the reclassification of the accrued surgery residency costs from the operating room cost center to the interns and residents cost center in calculating the Provider's base year graduate medical education costs proper?</p>]]></description></item><item><title>1999D58</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d58</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d58</guid><description><![CDATA[<p>case_name: Saint Joseph Medical Center, Burbank CA</p><p>case_numbers: 95-0308R</p><p>decision_date: Thu, 19 Aug 1999 12:00:00 -0400</p><p>decision_number: 1999D58</p><p>fiscal_year_end: 12/31/1986</p><p>provider_number: 05-0235; 55-5046</p><p>summary: Was the Intermediary's denial of the Provider's Routine Cost Limit exception proper?</p>]]></description></item><item><title>1999D59</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d59</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d59</guid><description><![CDATA[<p>case_name: Bryn Mawr Terrace Convalescent Center, Bryn Mawr PA</p><p>case_numbers: 97-0139</p><p>decision_date: Thu, 19 Aug 1999 12:00:00 -0400</p><p>decision_number: 1999D59</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 39-5095</p><p>summary: 1. Was the Intermediary's reclassification of employment taxes proper?; 2. Was the Intermediary's adjustment to owner's compensation proper?</p>]]></description></item><item><title>1999D63</title><pubDate>Mon, 04 Nov 2019 02:23:56 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d63</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d63</guid><description><![CDATA[<p>case_name: The Ohio University Hospital, Columbus OH</p><p>case_numbers: 94-3180</p><p>decision_date: Tue, 24 Aug 1999 12:00:00 -0400</p><p>decision_number: 1999D63</p><p>fiscal_year_end: 06/30/1992</p><p>provider_number: 36-0085</p><p>summary: Was the Intermediary's adjustment to the outlier payments proper?</p>]]></description></item><item><title>1999D37</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d37</guid><description><![CDATA[<p>case_name: Ozark Mountain Regional Rehabilitation Center</p><p>case_numbers: 84-0407; 88-1478</p><p>decision_date: Wed, 21 Apr 1999 12:00:00 -0400</p><p>decision_number: 1999D37</p><p>fiscal_year_end: 08/31/1980-08/31/1982</p><p>provider_number: 26-6512</p><p>summary: Jurisdiction: 1. Were the Intermediary's PSRO and PIP deductions from the remittance advices in payment checks in the amount of $25,455 proper?; 2. Did the Intermediary fail to make timely reimbursement to the Provider for its covered services?; 3. Should the Intermediary reimburse the Provider for its cost of money by paying interest on all payments or awards granted by the PRRB?; 4. Was the Intermediary's adjustment to interim payments proper?; 5.Was the Intermediary's adjustment toerrors on non-covered charges proper?; 6. Did the Intermediary fail to make proper state Medicaid filings?; 7. Was the Intermediary's adjustment to the Provider of remittance advices and payment checks proper?; 8. Did the Intermediary fail to make timely reimbursement to the Provider for its covered services thereby entitling the Provider to interest on such late payments and on all payment checks granted by the PRRB?</p>]]></description></item><item><title>1999D46</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d46</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d46</guid><description><![CDATA[<p>case_name: Crestview Convalescent Center, Wyncote PA</p><p>case_numbers: 95-1043</p><p>decision_date: Wed, 05 May 1999 12:00:00 -0400</p><p>decision_number: 1999D46</p><p>fiscal_year_end: 05/31/1992</p><p>provider_number: 39-5481</p><p>summary: Was the Intermediary's determination that the transportation costs for services provided by Today's Staffing Services Incorporated were not reasonable, necessary or related to patient care proper?</p>]]></description></item><item><title>1999D54</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d54</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d54</guid><description><![CDATA[<p>case_name: Health Visions Home Care, San Leandro CA</p><p>case_numbers: 97-3024</p><p>decision_date: Wed, 30 Jun 1999 12:00:00 -0400</p><p>decision_number: 1999D54</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 55-7160</p><p>summary: Was the Intermediary's adjustment reclassifying non-allowable costs of community liason employees to a non-reimbursable cost center proper?</p>]]></description></item><item><title>1999D41</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d41</guid><description><![CDATA[<p>case_name: Story County Hospital, Nevada IA</p><p>case_numbers: 96-2199</p><p>decision_date: Thu, 29 Apr 1999 12:00:00 -0400</p><p>decision_number: 1999D41</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 16-0088</p><p>summary: 1. Did the Intermediary, in the course of considering the Provider's request for a Medicare Dependent Hospital (MDH) volume adjustment, have jurisdiction to waive compliance with the applicable time requirement and to grant the Provider a one-day extension of time?; 2. If so, did the circumstances in this case merit such a waiver and extension?</p>]]></description></item><item><title>1998D019</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d019</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d019</guid><description><![CDATA[<p>case_name: Glendale Adventist Medical Center, Glendale CA</p><p>case_numbers: 91-2800M</p><p>decision_date: Thu, 15 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D019</p><p>fiscal_year_end: 12/31/1984</p><p>provider_number: 05-0239</p><p>summary: 1. Was the retroactive audit of Graduate Medical Education (GME) costs proper?; 2. Was the Intermediary's determination classifying malpractice insurance costs as administrative and general costs rather than direct GME costs proper?</p>]]></description></item><item><title>1999D31</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d31</guid><description><![CDATA[<p>case_name: Circle City Hospital, Corona CA</p><p>case_numbers: 93-1475</p><p>decision_date: Thu, 25 Mar 1999 12:00:00 -0500</p><p>decision_number: 1999D31</p><p>fiscal_year_end: 11/30/1990</p><p>provider_number: 05-0329</p><p>summary: Was the Intermediary's adjustment offsetting revenue associated with physician and guest meals, while, at the same time, setting up a nonreimbursable cost center for these nonallowable costs, proper?</p>]]></description></item><item><title>2006D25</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d25</guid><description><![CDATA[<p>case_name: MGH Home Health, Olney MD</p><p>case_numbers: 01-1397; 01-1398</p><p>decision_date: Thu, 01 Jun 2006 12:00:00 -0400</p><p>decision_number: 2006D25</p><p>fiscal_year_end: 06/30/1996; 06/30/1997</p><p>provider_number: 21-7118</p><p>summary: 1. Whether the Intermediary's application of Medicare's physical therapy guidelines to physical therapists paid on a per-visit basis was proper. (Applies to both cost reporting periods at issue - - case numbers 01-1397 and 01-1398.); 2. Whether the Intermediary's adjustment to include charity care home health visits in the calculation of the Provider's program reimbursement was proper. (Applies only to the Provider's fiscal year 1996 cost reporting period - - case number 01-1397.)</p>]]></description></item><item><title>1999D44</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d44</guid><description><![CDATA[<p>case_name: Clearview Nursing Home, Juneau WI</p><p>case_numbers: 96-0529</p><p>decision_date: Tue, 04 May 1999 12:00:00 -0400</p><p>decision_number: 1999D44</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 52-5394</p><p>summary: Were the Intermediary's adjustments to ancillary cost centers proper?</p>]]></description></item><item><title>2006D43</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d43</guid><description><![CDATA[<p>case_name: Greenwood County Hospital, Eureka KS</p><p>case_numbers: 04-0025</p><p>decision_date: Tue, 29 Aug 2006 12:00:00 -0400</p><p>decision_number: 2006D43</p><p>fiscal_year_end: 10/04/2001</p><p>provider_number: 17-0032</p><p>summary: Whether the Provider was improperly denied a Medicare low-volume adjustment.</p>]]></description></item><item><title>2006D38</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d38</guid><description><![CDATA[<p>case_name: St. Vincent's Medical Center, Bridgeport CT</p><p>case_numbers: 98-1822</p><p>decision_date: Wed, 26 Jul 2006 12:00:00 -0400</p><p>decision_number: 2006D38</p><p>fiscal_year_end: 09/30/1995</p><p>provider_number: 07-0028</p><p>summary: Whether the Intermediary's adjustment to disallow the Connecticut Sales Tax was proper.</p>]]></description></item><item><title>1999D43</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d43</guid><description><![CDATA[<p>case_name: O'Connor Hospital, San Jose CA</p><p>case_numbers: 89-0910</p><p>decision_date: Tue, 04 May 1999 12:00:00 -0400</p><p>decision_number: 1999D43</p><p>fiscal_year_end: 06/30/1985</p><p>provider_number: 05-0153</p><p>summary: Was the Health Care Financing Administration's ("HCFA") refusal to excude the Campbell alcohol and chemical dependency recovery unit from the prospective payment system ("PPS") because it did not meet applicable State licensure law proper?</p>]]></description></item><item><title>1999D32</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d32</guid><description><![CDATA[<p>case_name: RN Home Health Care Ltd., Westland MI</p><p>case_numbers: 97-1195; 97-1192; 95-1564; 97-1191</p><p>decision_date: Thu, 25 Mar 1999 12:00:00 -0500</p><p>decision_number: 1999D32</p><p>fiscal_year_end: 12/31/90-12/13/92;12/31/94</p><p>provider_number: 23-7201</p><p>summary: 1. Was the Intermediary's adjustment to the asset valuation of the employee stock ownership plan (ESOP) proper? (For 1990, 1991, and 1992 only); 2. Was the Intermediary's adjustment to interest expense proper? (For 1992 and 1994 only)</p>]]></description></item><item><title>1999D48</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d48</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d48</guid><description><![CDATA[<p>case_name: Community Health and Counseling Services, Bangor ME</p><p>case_numbers: 95-0492E; 97-0952E;97-2389E</p><p>decision_date: Thu, 06 May 1999 12:00:00 -0400</p><p>decision_number: 1999D48</p><p>fiscal_year_end: 06/30/1991-06/30/1993</p><p>provider_number: 20-7026</p><p>summary: 1. Were the Intermediary's adjustments to building costs by the creation of separate cost centers and the elimination of common area costs proper?; 2. Was the Intermediary's adjustment reclassifying supervisor salaies and benefits proper?</p>]]></description></item><item><title>2006D33</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d33</guid><description><![CDATA[<p>case_name: Visiting Nurse Association of Washington, D.C.</p><p>case_numbers: 00-2873; 00-2874; 01-1931</p><p>decision_date: Wed, 19 Jul 2006 12:00:00 -0400</p><p>decision_number: 2006D33</p><p>fiscal_year_end: 06/30/1996-06/30/1998</p><p>provider_number: 09-7000</p><p>summary: Whether the Intermediary's adjustment applying Medicare's Physical Therapy Compensation Guidelines to the Provider's employee physical therapists was proper.</p>]]></description></item><item><title>1999D39</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d39</guid><description><![CDATA[<p>case_name: Belmont Hills Hospital, Belmont CA</p><p>case_numbers: 93-1522</p><p>decision_date: Wed, 28 Apr 1999 12:00:00 -0400</p><p>decision_number: 1999D39</p><p>fiscal_year_end: 11/30/1988; 11/30/1989</p><p>provider_number: 05-4003</p><p>summary: Was the Intermediary's or the Health Care Financing Administration's ("HCFA") determination of the Provider's request for an adjustment to the rate-of-increase ceiling proper?</p>]]></description></item><item><title>1999D71</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d71</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d71</guid><description><![CDATA[<p>case_name: Methodist Hospital of McKenzie, McKenzie TN</p><p>case_numbers: 96-1086</p><p>decision_date: Thu, 30 Sep 1999 12:00:00 -0400</p><p>decision_number: 1999D71</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 44-0182</p><p>summary: 1. Was the Intermediary's adjustment disallowing Medicare reimbursement for a portion of the Provider's bad debts proper?; 2. Was the Intermediary's reclassification of home health agency costs proper?</p>]]></description></item><item><title>1998D017</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d017</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1998d017</guid><description><![CDATA[<p>case_name: Robert Packer Hospital, Sayre PA</p><p>case_numbers: 89-0303</p><p>decision_date: Tue, 13 Jan 1998 12:00:00 -0500</p><p>decision_number: 1998D017</p><p>fiscal_year_end: 06/30/1986; 06/30/1987</p><p>provider_number: 39-0079</p><p>summary: Were the Intermediary's adjustments to the Provider's interest expense to account for the hospital's 1983 advance refunding of debt proper?</p>]]></description></item><item><title>1999D70</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d70</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d70</guid><description><![CDATA[<p>case_name: LAC ESRD Pre-Composite Rate Group</p><p>case_numbers: 92-0110G</p><p>decision_date: Tue, 21 Sep 1999 12:00:00 -0400</p><p>decision_number: 1999D70</p><p>fiscal_year_end: 6/30/1981-6/30/1983</p><p>provider_number: Various</p><p>summary: Were the pre-composite rate End Stage Renal Disease (ESRD) screens invalid and therefore not applicable to limit the Providers reimbursement for ESRD treatments?</p>]]></description></item><item><title>2006D41</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d41</guid><description><![CDATA[<p>case_name: Comprehensive Home Care, Inc., Chicago IL</p><p>case_numbers: 00-3942</p><p>decision_date: Fri, 28 Jul 2006 12:00:00 -0400</p><p>decision_number: 2006D41</p><p>fiscal_year_end: 05/31/1998</p><p>provider_number: 14-7589</p><p>summary: Whether the Intermediary's disallowance of accrued compensation for the Provider's President/Chief Executive Officer (CEO) and Vice-President/Operations Manager was proper.</p>]]></description></item><item><title>1999D64</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d64</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d64</guid><description><![CDATA[<p>case_name: Chippewa Manor Nursing Home, Chippewa Falls WI</p><p>case_numbers: 96-1263</p><p>decision_date: Wed, 25 Aug 1999 12:00:00 -0400</p><p>decision_number: 1999D64</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 52-5419</p><p>summary: Was the Intermediary's adjustment to apply the lower-of-costs or charges principle to the Provider's Part B cost of physical, occupational, and speech therapy properly applied?</p>]]></description></item><item><title>1999D42</title><pubDate>Mon, 04 Nov 2019 02:23:55 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d42</guid><description><![CDATA[<p>case_name: Anaheim Memorial Hospital Association, Anahein CA</p><p>case_numbers: 92-0215; 94-0239</p><p>decision_date: Thu, 29 Apr 1999 12:00:00 -0400</p><p>decision_number: 1999D42</p><p>fiscal_year_end: 09/26/1997</p><p>provider_number: 05-0226</p><p>summary: Was the Intermediary's adjustment to offset investment income earned from a related organization proper?</p>]]></description></item><item><title>1999D18</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d18</guid><description><![CDATA[<p>case_name: Albert Einstein Medical Center, Philadelphia PA</p><p>case_numbers: 94-2471</p><p>decision_date: Thu, 17 Dec 1998 12:00:00 -0500</p><p>decision_number: 1999D18</p><p>fiscal_year_end: 06/30/1991</p><p>provider_number: 39-0142</p><p>summary: Was the Intermediary's methodology for determining physicians'Part A costs (reasonable compensation equivalents) proper?</p>]]></description></item><item><title>2006D24</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d24</guid><description><![CDATA[<p>case_name: Advanced Rehabilitation Services, Inc.; Prospect Rehabilitation Services, Inc.</p><p>case_numbers: 03-0259; 03-0260</p><p>decision_date: Thu, 01 Jun 2006 12:00:00 -0400</p><p>decision_number: 2006D24</p><p>fiscal_year_end: 12/31/1999</p><p>provider_number: 31-6597; 31-6625</p><p>summary: Whether the Intermediary's adjustments were proper that disallowed the Providers' claimed Medicare Bad Debts, disallowed in a prior year period.</p>]]></description></item><item><title>1999D55</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d55</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d55</guid><description><![CDATA[<p>case_name: Northwest Medical Center, Springdale AR</p><p>case_numbers: 94-2504</p><p>decision_date: Wed, 30 Jun 1999 12:00:00 -0400</p><p>decision_number: 1999D55</p><p>fiscal_year_end: 06/30/1991</p><p>provider_number: 04-0022</p><p>summary: Were the Intermediary's adjustments disallowing the pass-through of nursing education costs proper?</p>]]></description></item><item><title>2006D35</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d35</guid><description><![CDATA[<p>case_name: East Lake Community Health Center, Chicago IL</p><p>case_numbers: 01-0991</p><p>decision_date: Thu, 20 Jul 2006 12:00:00 -0400</p><p>decision_number: 2006D35</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 14-4646</p><p>summary: 1. Whether the Intermediary's adjustment to complete all cost reporting forms in conformity with current regulations and instructions was proper.; 2. Whether the Intermediary's adjustment to correct all math and flow-through errors arising on revision of the cost report was proper.; 3. Whether the Intermediary's adjustment to the amortization of start-up costs applicable to the 1998 cost reporting period was proper.; 4. Whether the Intermediary's adjustment to unsupported/unliquidated expenses related to accounting and consulting services, legal fees, computer billing expenses, housekeeping costs and accrued A&#x26;G costs was proper.; 5. Whether the Intermediary's adjustment reclassifying costs associated with medical and professional services was proper.; 6. Whether the Intermediary's adjustment to expenses associated with the Chicago Community Education Program was proper.; 7. Whether the Intermediary's adjustment to food costs from Sam's Club was proper.; 8. Whether the Intermediary's adjustment to unsupported interest and banking charges, contract labor, psychiatrist's services, professional services - group therapy and catering expenses was proper.; 9. Whether the Intermediary's adjustment to rent expense was proper.; 10. Whether the Intermediary's adjustment to depreciation expense was proper.; 11. Whether the Intermediary's adjustment reclassifying telephone and wire service expenses to the Administrative and General (A&#x26;G) cost center was proper.; 12. Whether the Intermediary's adjustment reclassifying security and maintenance expenses to the Plant Operations cost center was proper.; 13. Whether the Intermediary's adjustment incorporating Medicare charges per the Provider Statistical and Reimbursement Report (PS&#x26;R) dated 2/29/00 was proper.; 14. Whether the Intermediary's adjustment to reflect gross salaries statistics on Worksheet B-1 was proper.; 15. Whether the Intermediary's adjustment to the square footage statistics was proper.; 16. Whether the Intermediary's adjustment to reflect the settlement data shown on the PS&#x26;R dated 2/29/00 was proper.; 17. Whether the Intermediary's adjustment to bad debts was proper.</p>]]></description></item><item><title>1999D19</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d19</guid><description><![CDATA[<p>case_name: Bradford Regional Medical Center, Bradford PA</p><p>case_numbers: 95-1242+, 95-1242C</p><p>decision_date: Thu, 07 Jan 1999 12:00:00 -0500</p><p>decision_number: 1999D19</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 39-0118</p><p>summary: Was the Intermediary's determination regarding the Provider's prospective payment system capital rate proper?</p>]]></description></item><item><title>1999D40</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d40</guid><description><![CDATA[<p>case_name: Doctor's Hospital Medical Center, Colorado Springs CO</p><p>case_numbers: 88-0373</p><p>decision_date: Wed, 28 Apr 1999 12:00:00 -0400</p><p>decision_number: 1999D40</p><p>fiscal_year_end: 12/31/1984; 12/31/1985</p><p>provider_number: 06-0098</p><p>summary: Was the DRG amount, other than outlier payments, calculated correctly under Medicare law and PPS regulations?</p>]]></description></item><item><title>1999D21</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d21</guid><description><![CDATA[<p>case_name: Boston City Hospital, Boston MA</p><p>case_numbers: 91-2474M</p><p>decision_date: Tue, 26 Jan 1999 12:00:00 -0500</p><p>decision_number: 1999D21</p><p>fiscal_year_end: 09/30/1984</p><p>provider_number: 22-0104</p><p>summary: I. Was the Intermediary's reclassification of compensation for payroll physicians proper?; 2. Was the Intermediary's reclassification of teaching compensation for contract physicians proper?; 3. Was the Intermediary's disallowance of teaching time spent by contract physicians proper?</p>]]></description></item><item><title>1999D66</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d66</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d66</guid><description><![CDATA[<p>case_name: Commonwealth of Kentucky 92-96 DSH Group</p><p>case_numbers: 98-0211GE</p><p>decision_date: Thu, 02 Sep 1999 12:00:00 -0400</p><p>decision_number: 1999D66</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Did the Intermediary properly determine that the Providers had less than 100 "beds" for the fiscal years in question?</p>]]></description></item><item><title>2006D34</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d34</guid><description><![CDATA[<p>case_name: St. David 89-92 Related Organization Purchased Services Group</p><p>case_numbers: 95-0315G</p><p>decision_date: Tue, 20 Jul 1999 12:00:00 -0400</p><p>decision_number: 2006D34</p><p>fiscal_year_end: 12/31/1889-12/31/1992</p><p>provider_number: 45-4069; 45-3038</p><p>summary: Whether the Intermediary's denial of the Providers' request for an exception to the related organization principle for calendar years 1989 through 1992 was proper.</p>]]></description></item><item><title>1999D26</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d26</guid><description><![CDATA[<p>case_name: Albert Einstein Medical Center, Philadelphia PA</p><p>case_numbers: 94-1159</p><p>decision_date: Fri, 26 Feb 1999 12:00:00 -0500</p><p>decision_number: 1999D26</p><p>fiscal_year_end: 06/30/1990</p><p>provider_number: 39-0142</p><p>summary: Was the Intermediary's use of reasonable compensation equivalent ("RCE") limits fromm 1984 to reduce the amount of compensation paid by the Provider to its hospital-based physicians for fiscal year 1990 proper?</p>]]></description></item><item><title>2006D21</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d21</guid><description><![CDATA[<p>case_name: HCT 94-95 Physical Therapy AHSEA Exception Group</p><p>case_numbers: 01-0546G</p><p>decision_date: Thu, 25 May 2006 12:00:00 -0400</p><p>decision_number: 2006D21</p><p>fiscal_year_end: 12/31/1994; 12/31/1995</p><p>provider_number: Various</p><p>summary: Whether the Intermediary appropriately denied the Provider's requests for an exception to the Medicare allowable hourly salary equivalency amount for physical therapy.</p>]]></description></item><item><title>1999D57</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d57</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d57</guid><description><![CDATA[<p>case_name: Saint Joseph Medical Center, Burbank CA</p><p>case_numbers: 95-1188R</p><p>decision_date: Thu, 19 Aug 1999 12:00:00 -0400</p><p>decision_number: 1999D57</p><p>fiscal_year_end: 12/31/1989</p><p>provider_number: 050235; 55-5046</p><p>summary: Was the Intermediary's denial of the Provider's Routine Cost Limits exception proper?</p>]]></description></item><item><title>2006D19</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d19</guid><description><![CDATA[<p>case_name: Western Arizona Regional Medical Center, Bullhead City, AZ</p><p>case_numbers: 04-0133</p><p>decision_date: Fri, 03 Mar 2006 12:00:00 -0500</p><p>decision_number: 2006D19</p><p>fiscal_year_end: 08/31/2001</p><p>provider_number: 03-0101</p><p>summary: Whether the Intermediary's adjustment of the Provider's disproportionate share (DSH) calculation was based upon a proper interpretation of the Medicare DSH statute as amended by the Benefits Improvement and Protection Act of 2000.</p>]]></description></item><item><title>2006D26</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d26</guid><description><![CDATA[<p>case_name: Mary Hitchcock Memorial Hospital, Lebanon NH</p><p>case_numbers: 02-0632</p><p>decision_date: Fri, 02 Jun 2006 12:00:00 -0400</p><p>decision_number: 2006D26</p><p>fiscal_year_end: 12/31/2001</p><p>provider_number: 30-0003</p><p>summary: Whether the denial of the Provider's request for an exception to the renal dialysis composite rate by the Centers for Medicare and Medicaid Services (CMS) was proper.</p>]]></description></item><item><title>2006D28</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d28</guid><description><![CDATA[<p>case_name: Provena St. Joseph Medical Center; Provena United Samaritans Medical Center</p><p>case_numbers: 04-0783; 04-0819</p><p>decision_date: Mon, 05 Jun 2006 12:00:00 -0400</p><p>decision_number: 2006D28</p><p>fiscal_year_end: 12/31/2001</p><p>provider_number: 14-0007; 04-0093</p><p>summary: Whether the Intermediary's adjustment to school of nursing costs was based upon a proper application of the effective date articulated in Section 6205(a)(2) of the Omnibus Budget Reconciliation Act of 1989.</p>]]></description></item><item><title>1999D29</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d29</guid><description><![CDATA[<p>case_name: Charlotte Memorial Hospital and Medical Center, Charlotte NC</p><p>case_numbers: 92-0668</p><p>decision_date: Thu, 18 Mar 1999 12:00:00 -0500</p><p>decision_number: 1999D29</p><p>fiscal_year_end: 09/30/1982</p><p>provider_number: 34-0113</p><p>summary: Did the Intermediary properly reopen the Provider's cost report and recoup an overpayment made to the Provider?</p>]]></description></item><item><title>2006D36</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d36</guid><description><![CDATA[<p>case_name: Extendicare 99 Uncollect Co-in Dual Elig Group</p><p>case_numbers: 02-2110G</p><p>decision_date: Fri, 21 Jul 2006 12:00:00 -0400</p><p>decision_number: 2006D36</p><p>fiscal_year_end: 12/31/1999</p><p>provider_number: Various</p><p>summary: Whether the Intermediary properly determined that bad debts claimed related to uncollectible deductibles and coinsurance for services rendered to patients that were dually eligible for Medicare and Medicaid, also known as qualified Medicare beneficiaries (QMB), that were paid under the Medicare Part B fee screen do not constitute bad debts under applicable Medicare law and regulations.</p>]]></description></item><item><title>2006D15</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d15</guid><description><![CDATA[<p>case_name: Acadian HomeCare, Inc., Lafayette LA</p><p>case_numbers: 02-1526</p><p>decision_date: Fri, 03 Feb 2006 12:00:00 -0500</p><p>decision_number: 2006D15</p><p>fiscal_year_end: 12/31/1999</p><p>provider_number: 19-7060</p><p>summary: Whether the Intermediary's disallowance of medical director fees was proper.</p>]]></description></item><item><title>1999D62</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d62</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d62</guid><description><![CDATA[<p>case_name: Elzora Manor, Freewater OR</p><p>case_numbers: 96-0122</p><p>decision_date: Fri, 20 Aug 1999 12:00:00 -0400</p><p>decision_number: 1999D62</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 38-5161</p><p>summary: Was the Intermediary's adjustment limiting contracted occupational therapy and speech therapy costs to $104 per hour proper?</p>]]></description></item><item><title>1999D53</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d53</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d53</guid><description><![CDATA[<p>case_name: Belmont Center for Comprehensive Treatment, Philadelphia PA</p><p>case_numbers: 94-1156</p><p>decision_date: Tue, 29 Jun 1999 12:00:00 -0400</p><p>decision_number: 1999D53</p><p>fiscal_year_end: 06/30/1990</p><p>provider_number: 39-4023</p><p>summary: Was the Intermediary's application of the 1984 Reasonable Compensation Equivalent (RCE) limits proper?</p>]]></description></item><item><title>1999D68</title><pubDate>Mon, 04 Nov 2019 02:23:54 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d68</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d68</guid><description><![CDATA[<p>case_name: VNA Health Care Services, Inc./ VNA of Brooklyn </p><p>case_numbers: 98-2042; 98-2046</p><p>decision_date: Mon, 27 Mar 2000 12:00:00 -0500</p><p>decision_number: 1999D68</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 33-7005; 33-7002</p><p>summary: This decision is a reissuance of the original PRRB Dec. No. 99-D68 issued on 9/17/1999. In the original decision, the Board modified the Intermediary's adjustment and specified a new utilization and apportionment statistic. The parties to the decision asked the Board to clarify how the adjustment should be implemented. This decision more clearly defines the adjustment methodology. ; 1. Was the Intermediary's adjustment to home health aide hours proper?; 2. Was the Intermediary's adjustment to public relations costs proper?; 3. Was the Intermediary's adjustment to medical supply costs proper?</p>]]></description></item><item><title>1999D03</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d03</guid><description><![CDATA[<p>case_name: High Tech Home Health, Inc., Palm Beach Gardens FL</p><p>case_numbers: 95-2373</p><p>decision_date: Thu, 29 Oct 1998 12:00:00 -0500</p><p>decision_number: 1999D03</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 10-7281</p><p>summary: 1. Was the Intermediary's adjustment to employee salary and benfits proper?; 2. Was the Intermediary's adjustment to Advertising proper?; 3. Was the Intermediary's adjustment to Deferred compensation proper?; 4. Was the Intermediary's adjustment topayroll benefits/ profit sharing proper; 5. Was the Intermediary's adjustment to dues and subscriptions proper?; 6. Was the Intermediary's adjustment to auto insurance and auto lease expense proper?; 7. Was the Intermediary's adjustment to liability insurance expense proper?; 8. Was the Intermediary's adjustment to professional accounting expense proper?; 9. Was the Intermediary's adjustment to salaries and benefits for intake coordinators proper?; 10. Was the Intermediary's adjustment to auto mileage/ allowance expense proper?; 11. Was the Intermediary's adjustment to staff travel/education expense proper?; 12. Was the Intermediary's adjustment to education/other expense proper?; 13. Was the Intermediary's adjustment to miscellaneous expense proper?; 14. Was the Intermediary's adjustment to bonus expense proper?; 15. Was the Intermediary's adjustment to owner's compensation expense proper?; 16. Was the Intermediary's adjustment to overhead expense proper?; 17. [withdrawn]</p>]]></description></item><item><title>1999D33</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d33</guid><description><![CDATA[<p>case_name: Edgrwood Hospital, Chicago IL</p><p>case_numbers: 91-2887</p><p>decision_date: Tue, 06 Apr 1999 12:00:00 -0400</p><p>decision_number: 1999D33</p><p>fiscal_year_end: 01/21/1989</p><p>provider_number: 14-0087</p><p>summary: Was the Intermediary's netting of the balance due to Edgewood Hospital of liabilities owed to the program by Edgewood Medical Center proper?</p>]]></description></item><item><title>2006D39</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d39</guid><description><![CDATA[<p>case_name: Loma Linda University Medical Center, Loma Linda CA</p><p>case_numbers: 01-2871</p><p>decision_date: Thu, 27 Jul 2006 12:00:00 -0400</p><p>decision_number: 2006D39</p><p>fiscal_year_end: 08/30/2000</p><p>provider_number: 05-0327</p><p>summary: Whether the denial of the Provider's request for an exception to the end stage renal disease (ESRD) composite rate by the Centers for Medicare and Medicaid Services (CMS) was proper.</p>]]></description></item><item><title>1999D04</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d04</guid><description><![CDATA[<p>case_name: Jersey Shore Medical Center, Neptune NJ</p><p>case_numbers: 95-0907</p><p>decision_date: Fri, 30 Oct 1998 12:00:00 -0500</p><p>decision_number: 1999D04</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 31-0073</p><p>summary: Was the Intermediary's calculation of the Provider's disproportionate share hospital adjustment proper?</p>]]></description></item><item><title>2006D22</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d22</guid><description><![CDATA[<p>case_name: Saint Anthony's Health Center, Alton IL</p><p>case_numbers: 01-0820</p><p>decision_date: Thu, 25 May 2006 12:00:00 -0400</p><p>decision_number: 2006D22</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: 14-0052</p><p>summary: Whether the Intermediary properly excluded patient days attributable to Medicare Health Maintenance Organization (HMO) encounters from the calcualtion of the Provider's disproportionate share adjustment.</p>]]></description></item><item><title>1999D06</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d06</guid><description><![CDATA[<p>case_name: St. Mary's Hospital, Huntington WV</p><p>case_numbers: 93-1518+/C</p><p>decision_date: Tue, 17 Nov 1998 12:00:00 -0500</p><p>decision_number: 1999D06</p><p>fiscal_year_end: 09/30/1990</p><p>provider_number: 51-0007</p><p>summary: 1. Was the Intermediary's treatment of equity income as investment income proper?; 2. Does 42 C. F. R. Section 412.106, as promulgated, violate the Medicare Act, the Administrative Procedure Act and/or the Constitution?</p>]]></description></item><item><title>2006D06</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d06</guid><description><![CDATA[<p>case_name: Professional Home Care, Inc.; Professional HC97 Access Infusion Group</p><p>case_numbers: 97-2444, 98-2580, 99-3445, 99-3383G, 00-1426</p><p>decision_date: Fri, 18 Nov 2005 12:00:00 -0500</p><p>decision_number: 2006D06</p><p>fiscal_year_end: 01/31/1995-01/31/1998</p><p>provider_number: 37-7120, 37-7417</p><p>summary: 1. Whether the adjustments to the Providers' physical therapy costs were proper - applies to Case Nos. 97-2444, 98-2580, 99-3445 and 00-1426.; 2. Whether the adjustments to the Providers' travel costs were proper - applies to Case Nos. 97-2444 and 98-2580.; 3.Whether the adjustments to the Providers' home infusion costs were proper - applies to Case Nos. 99-3383G and 00-1426.</p>]]></description></item><item><title>1999D15</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d15</guid><description><![CDATA[<p>case_name: Sterling Physical Therapy and Rehabilitation, P.C., Warren MI</p><p>case_numbers: 94-0030</p><p>decision_date: Tue, 08 Dec 1998 12:00:00 -0500</p><p>decision_number: 1999D15</p><p>fiscal_year_end: 12/31/1990</p><p>provider_number: 23-6563</p><p>summary: 1. Was the Intermediary's adjustment to Medicare charges relating to settlement data based on information contained in the PS&#x26;R report proper?; 2. Was the Intermediary's adjustment to Medicare payments proper?</p>]]></description></item><item><title>2006D23</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d23</guid><description><![CDATA[<p>case_name: UPMC- St. Margaret Hospital, Pittsburgh PA</p><p>case_numbers: 00-2689</p><p>decision_date: Fri, 26 May 2006 12:00:00 -0400</p><p>decision_number: 2006D23</p><p>fiscal_year_end: 02/28/1997</p><p>provider_number: 39-0102</p><p>summary: Whether the Intermediary's audit adjustments to the Medicare cost report that disallowed the loss on disposal of depreciable assets due to the facility's change of ownership (CHOW) were proper.</p>]]></description></item><item><title>1999D35</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d35</guid><description><![CDATA[<p>case_name: The Parkway Hospital, Inc., Forest Hill, NY</p><p>case_numbers: 89-1782R</p><p>decision_date: Wed, 07 Apr 1999 12:00:00 -0400</p><p>decision_number: 1999D35</p><p>fiscal_year_end: 12/31/86; 12/31/87</p><p>provider_number: 33-0041</p><p>summary: Were the Intermediary's adjustments reclassifying the lease rental costs reported as capital costs proper?</p>]]></description></item><item><title>1999D24</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d24</guid><description><![CDATA[<p>case_name: Sid Peterson Memorial Hospital , Kerrville TX</p><p>case_numbers: 93-0688, 94-0445, 94-2071</p><p>decision_date: Tue, 23 Feb 1999 12:00:00 -0500</p><p>decision_number: 1999D24</p><p>fiscal_year_end: 06/30/1990-06/30/1992</p><p>provider_number: 45-0007</p><p>summary: 1. Were the Intermediary's disallowances of interest expense resulting from the sale of the Provider to Sid Peterson Memorial Hospital ("SPMH") proper?; 2. Were the Intermediary's adjustments to disallow public relations expense and establish a non-reimbursable cost center for marketing proper?</p>]]></description></item><item><title>1999D51</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d51</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d51</guid><description><![CDATA[<p>case_name: Athens-Limestone Hospital, Athens AL</p><p>case_numbers: 94-0198</p><p>decision_date: Wed, 16 Jun 1999 12:00:00 -0400</p><p>decision_number: 1999D51</p><p>fiscal_year_end: 09/30/1989; 09/30/1990</p><p>provider_number: 01-0079</p><p>summary: Was the Intermediary's attempt to recover Disproportionate Share Hospital (DSH) payments from the Provider for FYs 89 and 90 proper?</p>]]></description></item><item><title>1999D22</title><pubDate>Mon, 04 Nov 2019 02:23:52 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d22</guid><description><![CDATA[<p>case_name: North Coast Rehabilitation Center, Santa Rosa CA</p><p>case_numbers: 93-1886</p><p>decision_date: Thu, 18 Feb 1999 12:00:00 -0500</p><p>decision_number: 1999D22</p><p>fiscal_year_end: 08/31/1989</p><p>provider_number: 05-5837</p><p>summary: Is the Provider entitled to the full exception request to the , which is sought from HCFA?</p>]]></description></item><item><title>1999D23</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d23</guid><description><![CDATA[<p>case_name: Sarasota Palms Hospital, Sarasota FL</p><p>case_numbers: 93-0178, 93-0518, 92-1084</p><p>decision_date: Thu, 18 Feb 1999 12:00:00 -0500</p><p>decision_number: 1999D23</p><p>fiscal_year_end: 05/31/1988-05/31/1990</p><p>provider_number: 10-4013</p><p>summary: Was the Provider entitled to an adjustment to the TEFRA rate of increase ceiling for the cost reoprt periods ended May 31, 1988, May 31 1989, and May 31, 1990?</p>]]></description></item><item><title>1999D20</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d20</guid><description><![CDATA[<p>case_name: Providence Medical Center, Seattle WA</p><p>case_numbers: 91-1734</p><p>decision_date: Fri, 22 Jan 1999 12:00:00 -0500</p><p>decision_number: 1999D20</p><p>fiscal_year_end: 12/31/1987</p><p>provider_number: 50-0025</p><p>summary: Was the Intermediary's adjustment to bad debts proper?</p>]]></description></item><item><title>2000D08</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d08</guid><description><![CDATA[<p>case_name: The Christ Hospital, Cincinnati, OH</p><p>case_numbers: 95-0527</p><p>decision_date: Wed, 08 Dec 1999 12:00:00 -0500</p><p>decision_number: 2000D08</p><p>fiscal_year_end: 04/27/1994</p><p>provider_number: 36-0163</p><p>summary: Was the denial of Provider's End Stage Renal Disease ("ESRD") composite rate exception request based on atypical service intensity/patient mix proper?</p>]]></description></item><item><title>1999D28</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d28</guid><description><![CDATA[<p>case_name: Butler Memorial Hospital, Butler PA</p><p>case_numbers: 94-0152</p><p>decision_date: Thu, 11 Mar 1999 12:00:00 -0500</p><p>decision_number: 1999D28</p><p>fiscal_year_end: 06/30/1988</p><p>provider_number: 39-0158</p><p>summary: Was HCFA's denial of the Provider's request for an exceptionfor its TEFRA target rate adjustment for its exempt psychiatric unit for the fiscal year June 30, 1988 due to untimely filing, proper?</p>]]></description></item><item><title>2000D09</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d09</guid><description><![CDATA[<p>case_name: AllCare Home Health, Inc., Denver, CO</p><p>case_numbers: 98-1081</p><p>decision_date: Thu, 09 Dec 1999 12:00:00 -0500</p><p>decision_number: 2000D09</p><p>fiscal_year_end: 05/31/1996</p><p>provider_number: 06-7201</p><p>summary: Were the Intermediary's adjustments to owners' compensation proper?</p>]]></description></item><item><title>2006D13</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d13</guid><description><![CDATA[<p>case_name: Community Hospital of the Monterey Peninsula</p><p>case_numbers: 01-2940</p><p>decision_date: Thu, 19 Jan 2006 12:00:00 -0500</p><p>decision_number: 2006D13</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 05-0145</p><p>summary: Whether for purposes of the Provider's disproportionate share (DSH) adjustment calculation, the Provider is entitled to an increased number of days of care rendered to eligible Medicaid beneficiaries.</p>]]></description></item><item><title>2006D30</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d30</guid><description><![CDATA[<p>case_name: Greenbriar Nursing and Convalescent Center; Guest House of Slidell; Riverland Healthcare Center</p><p>case_numbers: 00-3284; 00-3619; 01-0598</p><p>decision_date: Fri, 16 Jun 2006 12:00:00 -0400</p><p>decision_number: 2006D30</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 19-5301; 19-5302; 19-5304</p><p>summary: Whether the Intermediary's adjustments to reduce the Providers' outpatient therpay costs by 10 percent were proper?</p>]]></description></item><item><title>1999D16</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d16</guid><description><![CDATA[<p>case_name: Dallas-Ft. Worth Hospital Council Wage Index Group Appeal</p><p>case_numbers: 92-1962G</p><p>decision_date: Tue, 08 Dec 1998 12:00:00 -0500</p><p>decision_number: 1999D16</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Should the revised Dallas-Fort Worth wage indexes be effective October 1, 1991?</p>]]></description></item><item><title>2006D11</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d11</guid><description><![CDATA[<p>case_name: St. Joseph Hospital, Orange CA</p><p>case_numbers: 02-0812</p><p>decision_date: Fri, 23 Dec 2005 12:00:00 -0500</p><p>decision_number: 2006D11</p><p>fiscal_year_end: 01/01/2001</p><p>provider_number: 05-0069</p><p>summary: Whether the denial of the Provider's request for an exception to the renal dialysis composite rate by the Centers for Medicare and Medicaid Services (CMS) was proper.</p>]]></description></item><item><title>1999D17</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d17</guid><description><![CDATA[<p>case_name: Deaconess Medical Center, St. Louis MO</p><p>case_numbers: 91-2308, 94-2352, 94-1066</p><p>decision_date: Wed, 09 Dec 1998 12:00:00 -0500</p><p>decision_number: 1999D17</p><p>fiscal_year_end: 09/30/1989- 09/30/1991</p><p>provider_number: 26-0021</p><p>summary: Was the Intermediary's reclassification of the Provider's nursing school library costs from the nursing school cost center to the administrative and general cost center proper?</p>]]></description></item><item><title>2006D14</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d14</guid><description><![CDATA[<p>case_name: Harborside Healthcare-Reservoir, West Harford CT</p><p>case_numbers: 03-0176</p><p>decision_date: Wed, 25 Jan 2006 12:00:00 -0500</p><p>decision_number: 2006D14</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 07-5407</p><p>summary: Whether the Intermediary properly denied the Provider's new provider exemption request.</p>]]></description></item><item><title>1999D05</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d05</guid><description><![CDATA[<p>case_name: Belmont Center for Comprehensive Treatment, Philadelphia PA</p><p>case_numbers: 94-2470</p><p>decision_date: Mon, 16 Nov 1998 12:00:00 -0500</p><p>decision_number: 1999D05</p><p>fiscal_year_end: 06/30/1991</p><p>provider_number: 39-4023</p><p>summary: Was the Intermediary's use of the reasonable compensation equivalent ("RCE") limits from 1984 to reduce the amount of reimbursable compensation paid to its hospital-based physicians ("HBPs") for fiscal year ended ("FYE") 1991 proper?</p>]]></description></item><item><title>1999D30</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d30</guid><description><![CDATA[<p>case_name: Columbia/ HCA Healthcare Corporation 90 Franchise Tax- Louisianna</p><p>case_numbers: 93-1376G</p><p>decision_date: Mon, 22 Mar 1999 12:00:00 -0500</p><p>decision_number: 1999D30</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Was the Intermediary's classification of the Louisianna franchise tax as an operating cost rather than a capital cost proper?</p>]]></description></item><item><title>2003D09</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d09</guid><description><![CDATA[<p>case_name: Smoky Hill Rehabilitation Center, Salina, KS</p><p>case_numbers: 00-3979</p><p>decision_date: Thu, 19 Dec 2002 12:00:00 -0500</p><p>decision_number: 2003D09</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 17-5185</p><p>summary: Was the Intermediary's adjustment disallowing the allocation of general service costs to the ancillary cost centers proper?</p>]]></description></item><item><title>1999D13</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d13</guid><description><![CDATA[<p>case_name: St. Mary's Hospital, Waterbury CT</p><p>case_numbers: 91-2935M</p><p>decision_date: Tue, 01 Dec 1998 12:00:00 -0500</p><p>decision_number: 1999D13</p><p>fiscal_year_end: 09/30/1984</p><p>provider_number: 07-0016</p><p>summary: Was the Intermediary's refusial to reclassify as graduate medical education ("GME") costs certain physician compensation costs and related secretarial compensation costs originally classified as non-GME operating costs on the Provider's GME base-year cost report proper?</p>]]></description></item><item><title>1999D12</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d12</guid><description><![CDATA[<p>case_name: Maximum Home Health Care, Inc., Watertown TN</p><p>case_numbers: 93-0451, 93-1941</p><p>decision_date: Wed, 25 Nov 1998 12:00:00 -0500</p><p>decision_number: 1999D12</p><p>fiscal_year_end: 06/30/1990, 06/30/1991</p><p>provider_number: 44-7425</p><p>summary: Was the Intermediary's adjustment of management fees proper?</p>]]></description></item><item><title>2006D12</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d12</guid><description><![CDATA[<p>case_name: Immanuel- St. Joseph Hospital, Mankanto MN</p><p>case_numbers: 99-3024</p><p>decision_date: Fri, 23 Dec 2005 12:00:00 -0500</p><p>decision_number: 2006D12</p><p>fiscal_year_end: 09/30/1996</p><p>provider_number: 24-0093</p><p>summary: Whether the Intermediary's adjustment to reduce the unweighted FTE resident count and related adjustment cap for time spent by residents providing services at the Mankato Clinic was proper.</p>]]></description></item><item><title>1999D14</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d14</guid><description><![CDATA[<p>case_name: University of Chicago Hospital, Chicago IL</p><p>case_numbers: 94-3074, 95-2199</p><p>decision_date: Fri, 04 Dec 1998 12:00:00 -0500</p><p>decision_number: 1999D14</p><p>fiscal_year_end: 06/30/1992, 06/30/1993</p><p>provider_number: 14-0088</p><p>summary: 1. Was the Intermediary's calculation of the Provider's number of beds for purposes of determining the Provider's IME adjustment proper?; 2. Was the Intermediary's payments for outlier cases proper pursuant to 42 U.S.C. Section 1395ww(d)(5)9A0(iv), insofar as total outlier payments by the Secretary in the fiscal years in question were less than five percent of the total payments made based on DRG prospective payments for the years in question?</p>]]></description></item><item><title>2006D32</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d32</guid><description><![CDATA[<p>case_name: Osteopathic Founders Foundation, Tulsa OK</p><p>case_numbers: 01-2850</p><p>decision_date: Thu, 22 Jun 2006 12:00:00 -0400</p><p>decision_number: 2006D32</p><p>fiscal_year_end: 06/10/1996</p><p>provider_number: 37-0078</p><p>summary: 1. Whether the closing costs of $943,089, incurred for the sale of the hospital are allowable as a deduction from the salles price to determine gain or loss on the sale.; 2. Whether a portion of the sales proceeds received by the Provider from the sale of its hospital should be allocated to medical records and assembled work force assets to determine the amount of gain or loss on the sale.</p>]]></description></item><item><title>1999D07</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d07</guid><description><![CDATA[<p>case_name: St. Charles General Hospital, New Orleans LA</p><p>case_numbers: 94-1896, 95-1021</p><p>decision_date: Tue, 24 Nov 1998 12:00:00 -0500</p><p>decision_number: 1999D07</p><p>fiscal_year_end: 05/31/1991, 05/31/1992</p><p>provider_number: 19-0158</p><p>summary: Was the Provider entitled to be reimbursed for the costs incured in connection with an abandoned hospital expansion project?</p>]]></description></item><item><title>2006D37</title><pubDate>Mon, 04 Nov 2019 02:23:51 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d37</guid><description><![CDATA[<p>case_name: Lawrence and Memorial Hospital, New London CT</p><p>case_numbers: 02-0140</p><p>decision_date: Wed, 26 Jul 2006 12:00:00 -0400</p><p>decision_number: 2006D37</p><p>fiscal_year_end: 09/30/1997</p><p>provider_number: 07-0007</p><p>summary: Whether the Intermediary's adjustment to disallow the Connecticut Sales Tax was proper.</p>]]></description></item><item><title>2000D10</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d10</guid><description><![CDATA[<p>case_name: Cannonburg General Hospital Skilled Nursing Facility, Cannonburg,PA</p><p>case_numbers: 94-3018, 94-3019, 94-3020, 94-3021, 95-2194</p><p>decision_date: Mon, 13 Dec 1999 12:00:00 -0500</p><p>decision_number: 2000D10</p><p>fiscal_year_end: 06/30/1987 thru 06/30/1993</p><p>provider_number: 39-5580</p><p>summary: 1. Was HCFA's decision limiting SNF routine cost limit exception relief for fiscal years 1987 through 1990 and 1993 proper?; 2. Was HCFA's denial of the Provider's request for an exception to its routine cost limits for fiscal years ended June 30, 1991 and 1992 due to untimely filing proper?</p>]]></description></item><item><title>2005D23</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d23</guid><description><![CDATA[<p>case_name: High Country Home Health Care, Inc., Laramie, WY</p><p>case_numbers: 01-3385</p><p>decision_date: Thu, 13 Jan 2005 12:00:00 -0500</p><p>decision_number: 2005D23</p><p>fiscal_year_end: 6/30/98</p><p>provider_number: 53-7025</p><p>summary: 1. Whether the Intermediary's disallowance of a portion of the fiscal year 1998 accrued compensation for the Provider's Administrator and Assistant Administrator was proper?; 2. Whether the Intermediary's disallowance of a portion of the fiscal year 1998 payroll taxes and other withholdings required by the government was proper?; 3. Whether the Intermediary's adjustment removing a portion of claimed consulting, accounting and legal fees was proper?</p>]]></description></item><item><title>1999D08</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d08</guid><description><![CDATA[<p>case_name: Larkin Chase Nursing and Restorative Center, Bowie MD</p><p>case_numbers: 96-0640</p><p>decision_date: Tue, 24 Nov 1998 12:00:00 -0500</p><p>decision_number: 1999D08</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 21-5264</p><p>summary: 1. Was HCFA's denial of the Provider's request for an exemption from the skilled nursing facility routine cost service limitation, as a new provider, Proper?; 2. Was the Intermediary's denial of the Provider's request for an exemption from the skilled nursing facility routine cost service limitations, based upon atypical services, without an occupancy adjustment, proper?</p>]]></description></item><item><title>1999D10</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d10</guid><description><![CDATA[<p>case_name: Tri-City Medical Center, Oceanside CA</p><p>case_numbers: 89-1103</p><p>decision_date: Tue, 24 Nov 1998 12:00:00 -0500</p><p>decision_number: 1999D10</p><p>fiscal_year_end: 06/30/1986</p><p>provider_number: 05-0128</p><p>summary: Was the Intermediary's adjustment to reclassify all identified purchased repairs and maintenance expences from the individual cost centers to the maintenance overhead cost center proper?</p>]]></description></item><item><title>1999D25</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d25</guid><description><![CDATA[<p>case_name: Central Georgia Rehabilitation Hospital, Macon GA</p><p>case_numbers: 94-2452</p><p>decision_date: Thu, 25 Feb 1999 12:00:00 -0500</p><p>decision_number: 1999D25</p><p>fiscal_year_end: 09/30/1991</p><p>provider_number: 11-3027</p><p>summary: Were the sale and lease of the Provider Transactions between related organations?</p>]]></description></item><item><title>2005D30</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d30</guid><description><![CDATA[<p>case_name: Community Care Hospital, New Orleans, LA</p><p>case_numbers: 03-0901</p><p>decision_date: Fri, 01 Apr 2005 12:00:00 -0500</p><p>decision_number: 2005D30</p><p>fiscal_year_end: 4/30/99</p><p>provider_number: 19-4056</p><p>summary: Whether the Intermediary erred when it adjusted the method of reimbursing the Provider's skilled nursing facility (SNF) from cost-based reimbursement to the prospective payment system (PPS.)</p>]]></description></item><item><title>2006D17</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d17</guid><description><![CDATA[<p>case_name: Alden Court Nursing Home, Fairhaven MA</p><p>case_numbers: 99-3635</p><p>decision_date: Fri, 17 Feb 2006 12:00:00 -0500</p><p>decision_number: 2006D17</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 22-5387</p><p>summary: Whether CMS' denial of the Provider's request for an exception to the routine cost limits for skilled nursing facilities as a provider of atypical services was proper?</p>]]></description></item><item><title>2004D32</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d32</guid><description><![CDATA[<p>case_name: St. Joseph's Hospital, St. Paul, MN</p><p>case_numbers: 98-2100</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D32</p><p>fiscal_year_end: 08/31/1995</p><p>provider_number: 24-0063</p><p>summary: 1. Was the Intermediary's adjustment to the provider's disproportionate share (DSH) payment proper? ; 2. Was the Intermediary's adjustment to the provider's capital DSH payment proper?</p>]]></description></item><item><title>1999D01</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d01</guid><description><![CDATA[<p>case_name: Greenview Hospital, Bowling Green KY</p><p>case_numbers: 93-0824+</p><p>decision_date: Mon, 05 Oct 1998 12:00:00 -0400</p><p>decision_number: 1999D01</p><p>fiscal_year_end: 09/30/1990</p><p>provider_number: 18-0124</p><p>summary: Was the Intermediary's adjustment toMedicare bad debts proper?</p>]]></description></item><item><title>2003D01</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d01</guid><description><![CDATA[<p>case_name: Skaggs Community Health Center, Branson, MO</p><p>case_numbers: 99-0299; 99-3610</p><p>decision_date: Wed, 16 Oct 2002 12:00:00 -0400</p><p>decision_number: 2003D01</p><p>fiscal_year_end: 04/30/96; 04/30/97</p><p>provider_number: 26-0094</p><p>summary: Were the Intermediary's adjustments reclassifying home health agency (HHA) building rent to the HHA cost center and the elimination of corresponding square footage allocation statistics proper?</p>]]></description></item><item><title>2001D09</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d09</guid><description><![CDATA[<p>case_name: Ohio Valley Medical Center, Wheeling, WV</p><p>case_numbers: 92-0111</p><p>decision_date: Wed, 17 Jan 2001 12:00:00 -0500</p><p>decision_number: 2001D09</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 51-0039</p><p>summary: Was the Intermediary's analysis and application of the Medicare "Spend down" ("S-D") procedure for curing $4 million dollars of unnecessary borring ("UB" proper?</p>]]></description></item><item><title>1999D02</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/1999d02</guid><description><![CDATA[<p>case_name: Sacred Heart Medical Center, Spokane WA</p><p>case_numbers: 92-1027</p><p>decision_date: Fri, 16 Oct 1998 12:00:00 -0400</p><p>decision_number: 1999D02</p><p>fiscal_year_end: 12/31/1987</p><p>provider_number: 50-0054</p><p>summary: Did the Intermediary properly include neonatal intensive care unit ("NICU") beds in the Provider's available bed count used for the indirect medical education ("IME") calculation?</p>]]></description></item><item><title>2001D08</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d08</guid><description><![CDATA[<p>case_name: Geneva General Hospital, Geneva, NY</p><p>case_numbers: 94-3107</p><p>decision_date: Thu, 11 Jan 2001 12:00:00 -0500</p><p>decision_number: 2001D08</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 33-0058</p><p>summary: Was HCFA's denial of the Provider's ESRD composite payment rate exception proper?</p>]]></description></item><item><title>2003D03</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d03</guid><description><![CDATA[<p>case_name: Kaleida Health 97 Ownership of Assets Group</p><p>case_numbers: 01-0710G</p><p>decision_date: Tue, 05 Nov 2002 12:00:00 -0500</p><p>decision_number: 2003D03</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: 1. Were the Intermediary's adjustments to the Providers' cost reports for FYE 12/31/97 to eliminate the Providers' claimed losses on disposition of assets proper?; 2. Did the Intermediary err in determining that the Providers disposed of their assets on or after December 1, 1997?; 3. Alternatively, is the regulation that eliminates recognition of gain or loss on asset sales on or after December 1, 1997 invalid, so that the Providers are entitled to losses on disposition of their assets regardless of the date on which that disposition occurred?</p>]]></description></item><item><title>2006D10</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d10</guid><description><![CDATA[<p>case_name: Highland Medical Center, Lubbock TX</p><p>case_numbers: 03-1555, 04-0387</p><p>decision_date: Thu, 22 Dec 2005 12:00:00 -0500</p><p>decision_number: 2006D10</p><p>fiscal_year_end: 09/30/1999, 09/30/2000</p><p>provider_number: 45-0162</p><p>summary: Whether or not Highland Medical Center has 100 or more available beds for Medicare disproportionate share adjustment qualification and payment purposes.</p>]]></description></item><item><title>2000D03</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d03</guid><description><![CDATA[<p>case_name: Sutter Memorial Hospital, Sacramento, CA</p><p>case_numbers: 97-2434</p><p>decision_date: Tue, 19 Oct 1999 12:00:00 -0400</p><p>decision_number: 2000D03</p><p>fiscal_year_end: 12/31/81, 12/31/82, 7/31/83</p><p>provider_number: 05-0109</p><p>summary: Did the Intermediary properly implement PRRB Decision No. 96-D35?</p>]]></description></item><item><title>2001D06</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d06</guid><description><![CDATA[<p>case_name: Bryn Mawr Terrace Convalescent Center, Bryn Mawr, PA</p><p>case_numbers: 97-0139R</p><p>decision_date: Wed, 10 Jan 2001 12:00:00 -0500</p><p>decision_number: 2001D06</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 39-5095</p><p>summary: Was the Intermediary's reclassification of employment taxes proper?</p>]]></description></item><item><title>2006D05</title><pubDate>Mon, 04 Nov 2019 02:23:50 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d05</guid><description><![CDATA[<p>case_name: Rush-Presbyterian-St. Luke's Medical Center, Chicago IL</p><p>case_numbers: 94-2729</p><p>decision_date: Fri, 18 Nov 2005 12:00:00 -0500</p><p>decision_number: 2006D05</p><p>fiscal_year_end: 06/30/1991</p><p>provider_number: 14-0119</p><p>summary: 1. Whether the Intermediary's adjustment to and calculation of the Provider's disproportionate share hospital payment (DSH) was proper, specifically relating to the inclusion of general assistance days.; 2. Whether the Intermediary's calculation of the number of interns and residents and the amount of allowable costs for fiscal year 1991 for purposes of the Provider's graduate medical education programs (GME) was proper.; 3. Should the Intermediary have reclassified expenses relating to the Inn at University Village as investment losses and offset such losses against investment income rather than disallowing them entirely?</p>]]></description></item><item><title>2001D17</title><pubDate>Mon, 04 Nov 2019 02:23:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d17</guid><description><![CDATA[<p>case_name: San Joaquin Community Hospital - SNF, Bakersfield, CA</p><p>case_numbers: 97-2425</p><p>decision_date: Tue, 17 Apr 2001 12:00:00 -0400</p><p>decision_number: 2001D17</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 05-0455</p><p>summary: 1. Was the Intermediary's adjustment reclassifying the Provider's costs from direct to indirect cost centers proper?; 2. Was the Health Care Financing Administration's ("HCFA's") refusal to grant an exception from that portion of the Provider's per diem cost which do not exceed 112 percent of the total peer group mean cost proper? (On the record.)</p>]]></description></item><item><title>2001D07</title><pubDate>Mon, 04 Nov 2019 02:23:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d07</guid><description><![CDATA[<p>case_name: Elmhurst Extended Care Center, Inc., Elmhurst, IL</p><p>case_numbers: 97-2509</p><p>decision_date: Thu, 11 Jan 2001 12:00:00 -0500</p><p>decision_number: 2001D07</p><p>fiscal_year_end: 07/31/1993</p><p>provider_number: 14-5111</p><p>summary: Was the Intermediary's adjustment to the routine cost limit proper?</p>]]></description></item><item><title>2005D72</title><pubDate>Mon, 04 Nov 2019 02:23:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d72</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d72</guid><description><![CDATA[<p>case_name: Saddleback Memorial Medical Center</p><p>case_numbers: 99-2472</p><p>decision_date: Thu, 29 Sep 2005 12:00:00 -0400</p><p>decision_number: 2005D72</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 05-0603</p><p>summary: Whether CMS' denial of the Provider's request for a new provider exemption based upon a finding of an untimely submission in response to a request for additional documentation was proper.</p>]]></description></item><item><title>2006D08</title><pubDate>Mon, 04 Nov 2019 02:23:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d08</guid><description><![CDATA[<p>case_name: Preferred Management Corporation Group</p><p>case_numbers: 03-0009G</p><p>decision_date: Thu, 22 Dec 2005 12:00:00 -0500</p><p>decision_number: 2006D08</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediary's adjustments reallocating key employee and owners' bonuses were proper.</p>]]></description></item><item><title>2000D04</title><pubDate>Mon, 04 Nov 2019 02:23:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d04</guid><description><![CDATA[<p>case_name: Good Samaritan Regional Medical Center, Phoenix, AZ</p><p>case_numbers: 94-0426, 94-0429</p><p>decision_date: Tue, 19 Oct 1999 12:00:00 -0400</p><p>decision_number: 2000D04</p><p>fiscal_year_end: 12/31/1989, 12/31/1990</p><p>provider_number: 03-0002</p><p>summary: Must the Provider have a written agreement with its related facilities in order to have the resident rotations included in its GME count?</p>]]></description></item><item><title>2001D16</title><pubDate>Mon, 04 Nov 2019 02:23:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d16</guid><description><![CDATA[<p>case_name: Marblehead Visiting Nurse Association, Inc., Marblehead, MA</p><p>case_numbers: 95-2234, 97-0068, 97-2678</p><p>decision_date: Fri, 06 Apr 2001 12:00:00 -0400</p><p>decision_number: 2001D16</p><p>fiscal_year_end: 12/31/1993 - 12/31/1995</p><p>provider_number: 22-7029</p><p>summary: 1. Was the Intermediary's adjustment reclassifying advertising costs to a non-reimbursable cost center proper? (1993, 1994, 1995) ; 2. Was the Intermediary's adjustment reclassifying fundraising costs to a non-reimbursable cost center proper? (1994)</p>]]></description></item><item><title>2001D02</title><pubDate>Mon, 04 Nov 2019 02:23:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d02</guid><description><![CDATA[<p>case_name: Moyle's Central Valley Health Care, Inc., Visalia, CA</p><p>case_numbers: 96-0423G, 99-0448G, 99-2082G</p><p>decision_date: Wed, 01 Nov 2000 12:00:00 -0500</p><p>decision_number: 2001D02</p><p>fiscal_year_end: 12/31/1993 - 12/31/1996</p><p>provider_number: 05-5916, 05-5053, 05-6261, 55-5658</p><p>summary: Were the Intermediary's adjustments to disallow costs related to the Provider's airplane proper</p>]]></description></item><item><title>2001D01</title><pubDate>Mon, 04 Nov 2019 02:23:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d01</guid><description><![CDATA[<p>case_name: Rush Presbyterian-St. Luke's Medical Center, Chicago, IL</p><p>case_numbers: 99-1249</p><p>decision_date: Tue, 31 Oct 2000 12:00:00 -0500</p><p>decision_number: 2001D01</p><p>fiscal_year_end: 06/30/1995</p><p>provider_number: 14-5335</p><p>summary: Is the Provider entitled to an exception to the skilled nursing facility routine service cost limits for fiscal year ending 1995?</p>]]></description></item><item><title>2005D71</title><pubDate>Mon, 04 Nov 2019 02:23:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d71</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d71</guid><description><![CDATA[<p>case_name: Saint Joseph Community Hospital, Mishawaka IN</p><p>case_numbers: 02-0399, 02-1946</p><p>decision_date: Thu, 29 Sep 2005 12:00:00 -0400</p><p>decision_number: 2005D71</p><p>fiscal_year_end: 12/31/1998, 12/31/1999</p><p>provider_number: 15-0029</p><p>summary: Were the Intermediary's adjustments to the count of full-time equivalent interns and residents proper?</p>]]></description></item><item><title>2001D04</title><pubDate>Mon, 04 Nov 2019 02:23:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d04</guid><description><![CDATA[<p>case_name: Otis Bowen Center For Human Services, Warsaw, IN</p><p>case_numbers: 98-0627</p><p>decision_date: Thu, 02 Nov 2000 12:00:00 -0500</p><p>decision_number: 2001D04</p><p>fiscal_year_end: 06/30/1995</p><p>provider_number: 15-4014</p><p>summary: 1. Was the Intermediary correct in its disallowance of Provider component hours for provider-based physicians?; 2. Was the Intermediary correct in its adjustments to total charges and Medicare charges for the clinic cost center?</p>]]></description></item><item><title>2000D06</title><pubDate>Mon, 04 Nov 2019 02:23:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d06</guid><description><![CDATA[<p>case_name: Rocky Mountain Care Time Study Group</p><p>case_numbers: 96-0053G</p><p>decision_date: Wed, 01 Dec 1999 12:00:00 -0500</p><p>decision_number: 2000D06</p><p>fiscal_year_end: 12/31/1992 - 12/31/1995</p><p>provider_number: 46-5067, 46-5068, 49-5049, 46-5075</p><p>summary: Did the Intermediary improperly disallow the time studies the Providers used for allocation of nursing administration, medical records and social services?</p>]]></description></item><item><title>2000D01</title><pubDate>Mon, 04 Nov 2019 02:23:49 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d01</guid><description><![CDATA[<p>case_name: Interim Health Care of New Haven, New Haven, CT</p><p>case_numbers: 97-0602</p><p>decision_date: Thu, 14 Oct 1999 12:00:00 -0400</p><p>decision_number: 2000D01</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 07-7133</p><p>summary: Was the Intermediary's adjustment to disallow franchise fees correct?</p>]]></description></item><item><title>2001D24</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d24</guid><description><![CDATA[<p>case_name: Memorial Hospital for Cancer and Allied Diseases, New York, NY</p><p>case_numbers: 97-1699</p><p>decision_date: Fri, 04 May 2001 12:00:00 -0400</p><p>decision_number: 2001D24</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 33-0154</p><p>summary: Was the Intermediary's adjustment disallowing certain expenses of compensating hospital based physicians pursuant to the 1984 Reasonable Compensation Equivalency limits proper?</p>]]></description></item><item><title>2001D28</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d28</guid><description><![CDATA[<p>case_name: Southwestern Nursing Home and Rehabilitation Center, Pittsburgh, PA</p><p>case_numbers: 97-2018; 99-0881</p><p>decision_date: Fri, 11 May 2001 12:00:00 -0400</p><p>decision_number: 2001D28</p><p>fiscal_year_end: 12/31/1995; 12/31/1996</p><p>provider_number: 39-5742</p><p>summary: 1. Were the Intermediary's adjustments reclassifying Director of Nursing and Assistant Director of Nursing costs from the Administrative and General Cost Center to the Nursing Administration Cost Center proper?; 2. Were the Intermediary's adjustments reclassifying Social Services costs proper?; 3. Were the Intermediary's adjustments reclassifying over-the-counter drug costs and incontinency costs proper?</p>]]></description></item><item><title>2001D13</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d13</guid><description><![CDATA[<p>case_name: Baptist Memorial Medical Center, Little Rock, AR</p><p>case_numbers: 95-2033, 96-1979, 97-1498, 98-2049</p><p>decision_date: Tue, 03 Apr 2001 12:00:00 -0400</p><p>decision_number: 2001D13</p><p>fiscal_year_end: 12/31/1991 - 12/31/1994</p><p>provider_number: 04-0036</p><p>summary: Were the Intermediary's adjustments disallowing pass-through cost reimbursement of nursing education costs proper?</p>]]></description></item><item><title>2001D19</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d19</guid><description><![CDATA[<p>case_name: St. Mary's Hospital and Medical Center, San Francisco, CA</p><p>case_numbers: 91-1844</p><p>decision_date: Wed, 25 Apr 2001 12:00:00 -0400</p><p>decision_number: 2001D19</p><p>fiscal_year_end: 06/26/1988</p><p>provider_number: 05-0457</p><p>summary: Did the Intermediary properly adjust outpatient surgery, anesthesia and supply charges?</p>]]></description></item><item><title>2006D07</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d07</guid><description><![CDATA[<p>case_name: Chicago 98-00 MSA Wage Index Group</p><p>case_numbers: 99-3690G</p><p>decision_date: Thu, 15 Dec 2005 12:00:00 -0500</p><p>decision_number: 2006D07</p><p>fiscal_year_end: 9/30/1999</p><p>provider_number: Various</p><p>summary: 1. Did Michael Reese Hospital (Reese) fail to exhaust its administrative remedies for a correction to its wage data during the February-March 1998 window for correcting wage data?; 2. Did Reese Hospital nevertheless meet the criteria for a correction in the mid-year correction process as a data entry or tabulation error?; 3. Can other hospitals in the same Metropolitan Statistical Area (MSA) seek a correction to the wage data for Reese Hospital?</p>]]></description></item><item><title>2006D02</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d02</guid><description><![CDATA[<p>case_name: Oakwood Hospital and Medical Center, Dearborn MI</p><p>case_numbers: 02-1686</p><p>decision_date: Wed, 16 Nov 2005 12:00:00 -0500</p><p>decision_number: 2006D02</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 23-0020</p><p>summary: Is expedited judicial review (EJR) appropriate for the question of whether the Centers for Medicare &#x26; Medicaid Services (CMS) undercounted the patient days for patients entitled to Supplemental Security Income (SSI) which is used to compute the disproportionate share (DSH) adjustment?</p>]]></description></item><item><title>2006D09</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d09</guid><description><![CDATA[<p>case_name: Washington County Memorial Hospital, Potosi MO</p><p>case_numbers: 04-0412</p><p>decision_date: Thu, 22 Dec 2005 12:00:00 -0500</p><p>decision_number: 2006D09</p><p>fiscal_year_end: 08/31/2000</p><p>provider_number: 26-0039</p><p>summary: Whether the Intermediary's computation of the adjustment due the Provider for a decrease in discharges experienced in FY 2000 was correct.</p>]]></description></item><item><title>2006D04</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d04</guid><description><![CDATA[<p>case_name: Omega Hills, Inc., Jasper IN</p><p>case_numbers: 99-1295</p><p>decision_date: Thu, 17 Nov 2005 12:00:00 -0500</p><p>decision_number: 2006D04</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 15-5478</p><p>summary: Was the Intermediary's adjustment to owners' compensation proper?</p>]]></description></item><item><title>2000D07</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d07</guid><description><![CDATA[<p>case_name: Good Shepherd Medical Center, Longview, TX</p><p>case_numbers: 94-2649</p><p>decision_date: Thu, 02 Dec 1999 12:00:00 -0500</p><p>decision_number: 2000D07</p><p>fiscal_year_end: 09/30/1991</p><p>provider_number: 45-0037</p><p>summary: 1. Was the HHA cafeteria allocation statistic proper?; 2. Were the HHA administrative costs proper?</p>]]></description></item><item><title>2000D05</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d05</guid><description><![CDATA[<p>case_name: St. Anthony's Memorial Hospital, Effingham, IL</p><p>case_numbers: 94-0327</p><p>decision_date: Wed, 20 Oct 1999 12:00:00 -0400</p><p>decision_number: 2000D05</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 14-0032</p><p>summary: Was the Health Care Financing Administration's ("HCFA") denial of the Provider's request for classification as a sole community hospital proper?</p>]]></description></item><item><title>2000D13</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d13</guid><description><![CDATA[<p>case_name: Hackensack Medical Center, Hackensack, NJ</p><p>case_numbers: 94-0718</p><p>decision_date: Thu, 16 Dec 1999 12:00:00 -0500</p><p>decision_number: 2000D13</p><p>fiscal_year_end: 12/31/1991</p><p>provider_number: 31-0001</p><p>summary: 1. Did the Intermediary err by including the Provider's fourteen neonatal intensive care unit ("NICU") beds when calculating the Medicare reimbursement for costs relating to indirect medical education ("IME")?; 2. Did the Intermediary err by including NICU days when calculating the Provider's Medicare reimbursement for graduate medical education ("GME") costs?</p>]]></description></item><item><title>2000D11</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d11</guid><description><![CDATA[<p>case_name: St. Luke's Methodist Hospital SNF, Cedar Rapids,IA</p><p>case_numbers: 96-0498</p><p>decision_date: Tue, 14 Dec 1999 12:00:00 -0500</p><p>decision_number: 2000D11</p><p>fiscal_year_end: 08/31/1992</p><p>provider_number: 16-0045</p><p>summary: Was HCFA's determination denying the Provider's request for an exception to its routine cost limits for its atypical skilled nursing facility costs proper?</p>]]></description></item><item><title>2001D03</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d03</guid><description><![CDATA[<p>case_name: The University of California, San Diego Medical Center, San Diego, CA</p><p>case_numbers: 92-1220; 93-0473</p><p>decision_date: Wed, 01 Nov 2000 12:00:00 -0500</p><p>decision_number: 2001D03</p><p>fiscal_year_end: 06/30/1989; 06/30/1990</p><p>provider_number: 05-0025</p><p>summary: Was the Intermediary's adjustment to the number of available beds for indirect medical education ad</p>]]></description></item><item><title>2001D05</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d05</guid><description><![CDATA[<p>case_name: Hemet Valley Medical Center, Hemet, CA</p><p>case_numbers: 97-0693</p><p>decision_date: Mon, 04 Dec 2000 12:00:00 -0500</p><p>decision_number: 2001D05</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 05-0390</p><p>summary: Was the Intermediary's determination of inpatient and outpatient Medicare bad debts proper?</p>]]></description></item><item><title>2001D22</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d22</guid><description><![CDATA[<p>case_name: Campbell's Personal Care, Inc, Chicago, IL</p><p>case_numbers: 98-0229</p><p>decision_date: Wed, 02 May 2001 12:00:00 -0400</p><p>decision_number: 2001D22</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 14-7483</p><p>summary: Was the Intermediary's adjustment to skilled nursing and HHA visits proper?</p>]]></description></item><item><title>2001D29</title><pubDate>Mon, 04 Nov 2019 02:23:48 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d29</guid><description><![CDATA[<p>case_name: Golden Years CORF, Boca Raton, FL</p><p>case_numbers: 97-0159</p><p>decision_date: Mon, 14 May 2001 12:00:00 -0400</p><p>decision_number: 2001D29</p><p>fiscal_year_end: 10/31/1993</p><p>provider_number: 10-4549</p><p>summary: Was the Intermediary's adjustments to the Provider's therapy costs proper?</p>]]></description></item><item><title>2001D49</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d49</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d49</guid><description><![CDATA[<p>case_name: Grant Medical Center, Columbus, OH</p><p>case_numbers: 95-1217</p><p>decision_date: Tue, 18 Sep 2001 12:00:00 -0400</p><p>decision_number: 2001D49</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 36-0017</p><p>summary: Was the Intermediary's adjustment disallowing portions of the Part A physician compensation paid by the Provider based on the application of the 1984 reasonable compensation equivalents proper?</p>]]></description></item><item><title>2001D40</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d40</guid><description><![CDATA[<p>case_name: Athens-Limestone Hospital; Athens, AL</p><p>case_numbers: 97-0843</p><p>decision_date: Wed, 08 Aug 2001 12:00:00 -0400</p><p>decision_number: 2001D40</p><p>fiscal_year_end: 09/30/1994</p><p>provider_number: 01-0079</p><p>summary: Was the Intermediary's disallowance of the Provider's Medicare Part B bad debts for deductibles and coinsurance proper?</p>]]></description></item><item><title>2001D47</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d47</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d47</guid><description><![CDATA[<p>case_name: Home Comp Care, Inc., Matteson, IL</p><p>case_numbers: 96-0225</p><p>decision_date: Fri, 14 Sep 2001 12:00:00 -0400</p><p>decision_number: 2001D47</p><p>fiscal_year_end: 04/30/1994</p><p>provider_number: 14-7525</p><p>summary: Was the compensation paid to HCC's owner reasonable?</p>]]></description></item><item><title>2001D45</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d45</guid><description><![CDATA[<p>case_name: ProCare Home Health, Oxnard, CA</p><p>case_numbers: 98-0095</p><p>decision_date: Thu, 13 Sep 2001 12:00:00 -0400</p><p>decision_number: 2001D45</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 05-7465</p><p>summary: Was the Intermediary's adjustment reclassifying the community liaison's compensation to a non-reimbursable cost center proper?</p>]]></description></item><item><title>2001D33</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d33</guid><description><![CDATA[<p>case_name: Alden Town Manor Nursing Center; Cicero, Illinois</p><p>case_numbers: 00-1745</p><p>decision_date: Tue, 26 Jun 2001 12:00:00 -0400</p><p>decision_number: 2001D33</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 14-5736</p><p>summary: Was the Intermediary's denial of the Provider's request for an exception to the cost limits relating to the provision of atypical services that were necessary for the efficient delivery of needed health care services proper?</p>]]></description></item><item><title>2001D38</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d38</guid><description><![CDATA[<p>case_name: Mercy Medical Center SNF-Daphne, Daphne, AL</p><p>case_numbers: 98-2619</p><p>decision_date: Fri, 27 Jul 2001 12:00:00 -0400</p><p>decision_number: 2001D38</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 01-5049</p><p>summary: 1. Was the Health Care Financing Administration's ("HCFA's") methodology as set forth in Transmittal No. 378 for determining the amount of the exception from the routine cost limits ("RCLs") for hospital-based skilled nursing facilities ("HB-SNFs") and as applied by the Intermediary to the Provider for fiscal year ended ("FYE") December 31, 1995, a proper interpretation of the Medicare statute and regulations?; 2. Did the Intermediary properly deny the Provider a rollover interim exception for FYE December 31, 1995?</p>]]></description></item><item><title>2001D32</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d32</guid><description><![CDATA[<p>case_name: Providence Yakima Medical Center, Yakima, WA</p><p>case_numbers: 97-2651, 97-2652, 97-2653, 97-2654</p><p>decision_date: Wed, 16 May 2001 12:00:00 -0400</p><p>decision_number: 2001D32</p><p>fiscal_year_end: 12/31/1993 - 12/31/1996</p><p>provider_number: 50-0012; 50-5481</p><p>summary: Did the Health Care Financing Administration ("HCFA") properly deny the Provider's request that its skilled nursing unit ("SNU") receive an exemption from the routine cost limits ("RCLs") as a new provider under 42 C.F.R. Section 413.30(e)?</p>]]></description></item><item><title>2001D37</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d37</guid><description><![CDATA[<p>case_name: District Memorial Hospital of Southwestern North Carolina, Inc., Andrews, NC</p><p>case_numbers: 94-2298, 95-1213, 96-0132, 96-2235, 98-0023, 99-0057, 98-2943</p><p>decision_date: Thu, 28 Jun 2001 12:00:00 -0400</p><p>decision_number: 2001D37</p><p>fiscal_year_end: 09/30/1991 - 06/30/1997</p><p>provider_number: 34-0054</p><p>summary: Was the Intermediary's adjustment to the disproportionate share amount proper?</p>]]></description></item><item><title>2001D20</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d20</guid><description><![CDATA[<p>case_name: Lifeline Home Health Services, Inc., Garland, TX</p><p>case_numbers: 96-1308</p><p>decision_date: Thu, 26 Apr 2001 12:00:00 -0400</p><p>decision_number: 2001D20</p><p>fiscal_year_end: 01/31/1994</p><p>provider_number: 45-7751</p><p>summary: 1. Was the Intermediary's disallowance of subscription and publication costs proper?; 2. Did the Intermediary properly disallow a portion of the owner's compensation?</p>]]></description></item><item><title>2001D36</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d36</guid><description><![CDATA[<p>case_name: University Hospital, Cincinnati, OH</p><p>case_numbers: 97-0475</p><p>decision_date: Wed, 27 Jun 2001 12:00:00 -0400</p><p>decision_number: 2001D36</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 36-0003</p><p>summary: 1. Was the Intermediary's reclassification of allocation of certain administrative salaries and fringe benefits proper?; 2. Was the Intermediary's adjustment to clinic dietitians' salary and fringe benefit costs proper?</p>]]></description></item><item><title>2001D30</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d30</guid><description><![CDATA[<p>case_name: Golden Years CORF, Boca Raton, FL</p><p>case_numbers: 97-0160</p><p>decision_date: Mon, 14 May 2001 12:00:00 -0400</p><p>decision_number: 2001D30</p><p>fiscal_year_end: 10/31/1994</p><p>provider_number: 10-4549</p><p>summary: Was the Intermediary's adjustments to the Provider's therapy costs proper?</p>]]></description></item><item><title>2001D25</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d25</guid><description><![CDATA[<p>case_name: CareMed of Chicago, Chicago, IL</p><p>case_numbers: 99-3163</p><p>decision_date: Fri, 04 May 2001 12:00:00 -0400</p><p>decision_number: 2001D25</p><p>fiscal_year_end: 06/30/1997</p><p>provider_number: 14-7017</p><p>summary: 1. Was the Intermediary's adjustment to the Provider's Administrative and General (A&#x26;G) cost center proper?; 2. Was the Intermediary's reclassification adjustment of delivery expenses claimed by the Provider proper?; 3. Was the Intermediary's reclassification adjustment of courier costs claimed by the Provider proper?; 4. Was the Intermediary's adjustment to home office Business Development and Managed Care salaries proper?</p>]]></description></item><item><title>2001D26</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d26</guid><description><![CDATA[<p>case_name: University Medical Center of Southern Nevada, Las Vegas, NV</p><p>case_numbers: 96-1477, 97-1703, 97-2763</p><p>decision_date: Thu, 10 May 2001 12:00:00 -0400</p><p>decision_number: 2001D26</p><p>fiscal_year_end: 06/30/1993 - 06/30/1995</p><p>provider_number: 29-0007</p><p>summary: Was the Intermediary's determination that the Provider was not eligible for Medicare reimbursement for the disproportionate share adjustment under Section 1886(d)(5)(F)(i)(II) of the Social Security Act proper?</p>]]></description></item><item><title>2001D39</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d39</guid><description><![CDATA[<p>case_name: VNA of Maryland, LLC; Baltimore, MD</p><p>case_numbers: 00-2472</p><p>decision_date: Wed, 08 Aug 2001 12:00:00 -0400</p><p>decision_number: 2001D39</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 21-7008</p><p>summary: Was the Intermediary's adjustment subjecting the compensation of employed physical therapists paid on a per visit basis to the contract physical therapy guidelines proper?</p>]]></description></item><item><title>2006D20</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2006d20</guid><description><![CDATA[<p>case_name: Baystate Medical Center, Springfield MA</p><p>case_numbers: 96-1822; 97-1579; 98-1827; 99-2061</p><p>decision_date: Fri, 17 Mar 2006 12:00:00 -0500</p><p>decision_number: 2006D20</p><p>fiscal_year_end: 9/30/93 - 9/30/96</p><p>provider_number: 22-0077</p><p>summary: a. Whether the Centers For Medicare and Medicaid Services' (CMS') determination of the Provider's Medicare Part A / Supplemental Security Income (SSI)percentage, commonly known as the Medicare fraction component of the disproportionate share (DSH)percentage, is incorrect; and, if so, b. Whether the Provider is entitled to (a) an order from the Board directing CMS to correct such determination and the Intermediary to implement and pay any additional amounts due the Provider as the result of such correction; or (b) an order from the Board granting other appropriate relief.</p>]]></description></item><item><title>2001D10</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d10</guid><description><![CDATA[<p>case_name: Southwest Texas Methodist Hospital, San Antonio, TX</p><p>case_numbers: 93-1355</p><p>decision_date: Thu, 25 Jan 2001 12:00:00 -0500</p><p>decision_number: 2001D10</p><p>fiscal_year_end: 09/30/1990</p><p>provider_number: 45-0388</p><p>summary: Whether the Intermediary erred in determining that there was no capital related interest with respect to interest expense incurred on that portion of the 1989 bonds used to repay the Provider for assets purchased six to twelve months prior to the bond issuance?</p>]]></description></item><item><title>2001D23</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d23</guid><description><![CDATA[<p>case_name: Francis A. Bell Memorial Hospital, Ishpeming, MI</p><p>case_numbers: 94-1039; 94-1040</p><p>decision_date: Thu, 03 May 2001 12:00:00 -0400</p><p>decision_number: 2001D23</p><p>fiscal_year_end: 06/30/1990; 06/30/1991</p><p>provider_number: 23-0001</p><p>summary: Whether the Provider is entitled to interest under 42 U.S.C. Section 1395g(d) for any amounts paid by the Intermediary relating to the Provider's 1990 and 1991 fiscal years, and if so, for what period of time?</p>]]></description></item><item><title>2001D44</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d44</guid><description><![CDATA[<p>case_name: Tulsa Home Health Services, Tulsa, OK</p><p>case_numbers: 97-1917</p><p>decision_date: Thu, 30 Aug 2001 12:00:00 -0400</p><p>decision_number: 2001D44</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 37-7093</p><p>summary: Was the Intermediary' adjustment to physical therapy labor costs proper?</p>]]></description></item><item><title>2001D42</title><pubDate>Mon, 04 Nov 2019 02:23:46 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d42</guid><description><![CDATA[<p>case_name: Strong Memorial Hospital; Rochester, NY</p><p>case_numbers: 95-1143</p><p>decision_date: Wed, 22 Aug 2001 12:00:00 -0400</p><p>decision_number: 2001D42</p><p>fiscal_year_end: 12/31/1991</p><p>provider_number: 33-0285</p><p>summary: Was the Intermediary's application of the reasonable compensation equivalent (RCE) limits to disallow a portion of the Provider's provider-based physician compensation proper?</p>]]></description></item><item><title>2001D54</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d54</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d54</guid><description><![CDATA[<p>case_name: Centennial Medical Center - SNF, Nashville, TN</p><p>case_numbers: 97-1736</p><p>decision_date: Fri, 28 Sep 2001 12:00:00 -0400</p><p>decision_number: 2001D54</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 44-0161</p><p>summary: Was the decision of the Health Care Financing Administration ('HCFA'), pursuant to its Provider Reimbursement Manual ('PRM') Section 2534.5, to deny an exception for that portion of the Provider's per diem costs which exceed the Routine Cost Limit, but which do not exceed 112% of the total peer group mean cost, arbitrary, caprious, an abuse of discretion or not in accordance with law?</p>]]></description></item><item><title>2002D14</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d14</guid><description><![CDATA[<p>case_name: Olive View Medical Center, Sylmar, CA</p><p>case_numbers: 94-3354; 95-1196</p><p>decision_date: Wed, 20 Mar 2002 12:00:00 -0500</p><p>decision_number: 2002D14</p><p>fiscal_year_end: 06/30/1992; 06/30/1993</p><p>provider_number: 05-0040</p><p>summary: Was the Intermediary and Center for Medicare and Medicaid Services ("CMS," formerly the Health Care Financing Administration) denial of the Provider's request for a change in its base period for purposes of the TEFRA rate of increase ceiling for its PPS-exempt psychiatric unit in the fiscal years ending ("FYE") June 30, 1992 and June 30, 1993 proper?</p>]]></description></item><item><title>2002D11</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d11</guid><description><![CDATA[<p>case_name: Augustana Lutheran Home, Brooklyn, NY</p><p>case_numbers: 98-1968</p><p>decision_date: Tue, 05 Mar 2002 12:00:00 -0500</p><p>decision_number: 2002D11</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 33-5521</p><p>summary: Was the Intermediary's adjustment to unpaid interest expense proper?</p>]]></description></item><item><title>2002D02</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d02</guid><description><![CDATA[<p>case_name: Summit Care Corporation 95 Pharmacy Costs Group</p><p>case_numbers: 97-1280G</p><p>decision_date: Wed, 12 Dec 2001 12:00:00 -0500</p><p>decision_number: 2002D02</p><p>fiscal_year_end: 06/30/1995</p><p>provider_number: Various</p><p>summary: Did the Intermediary properly reimburse the Provider for drugs and medical supplies purchased from a related party?</p>]]></description></item><item><title>2002D04</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d04</guid><description><![CDATA[<p>case_name: The Christ Hospital, Cincinnati, OH</p><p>case_numbers: 95-0620</p><p>decision_date: Tue, 08 Jan 2002 12:00:00 -0500</p><p>decision_number: 2002D04</p><p>fiscal_year_end: 12/31/1990</p><p>provider_number: 36-0163</p><p>summary: Was the Intermediary's adjustment with respect to parking garage revenues proper?</p>]]></description></item><item><title>2001D52</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d52</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d52</guid><description><![CDATA[<p>case_name: Rapid City Regional Hospital, Rapid City, SD</p><p>case_numbers: 97-2064R, 97-2148R, 98-0474 (On the Record)</p><p>decision_date: Fri, 24 Mar 2000 12:00:00 -0500</p><p>decision_number: 2001D52</p><p>fiscal_year_end: 06/30/1993 - 06/30/1995</p><p>provider_number: 43-0077</p><p>summary: Whether, with respect to the Joint Nursing Education Program, the provisions of Section 4004(b) of the Omnibus Reconciliation Act of 1990 ('OBRA 1990') are applicable to the cost years at issue, and if so, whether the Provider meets the criteria set forth in Section 4004(b)(2) of OBRA 1990 for payment of the claimed costs as reasonable costs?</p>]]></description></item><item><title>2001D41</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d41</guid><description><![CDATA[<p>case_name: Newman Memorial County Hospital, Emporia, KS</p><p>case_numbers: 96-0102</p><p>decision_date: Mon, 20 Aug 2001 12:00:00 -0400</p><p>decision_number: 2001D41</p><p>fiscal_year_end: 12/31/1989</p><p>provider_number: 17-0001</p><p>summary: Did HCFA properly determine that the SNF routine cost limits exception request was not timely filed?</p>]]></description></item><item><title>2001D31</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d31</guid><description><![CDATA[<p>case_name: Rennes 97 Reclass Routine Rest Ther Aide Group</p><p>case_numbers: 00-0573G</p><p>decision_date: Tue, 15 May 2001 12:00:00 -0400</p><p>decision_number: 2001D31</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: Various</p><p>summary: 1. Was the Intermediary's reclassification of routine restorative therapy aide salaries from the physical therapy cost center to the SNF participating and non-participating cost centers proper?; 2. Was the Intermediary's reclassification of the salary used for the employee health and welfare worksheet B-l overhead allocation basis proper?</p>]]></description></item><item><title>2005D68</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d68</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d68</guid><description><![CDATA[<p>case_name: The Manor House At Riverview, Noblesville IN</p><p>case_numbers: 99-2385</p><p>decision_date: Fri, 16 Sep 2005 12:00:00 -0400</p><p>decision_number: 2005D68</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 15-5281</p><p>summary: 1. Whether the Intermediary's adjustment of the square footage statistic for the Physical Therapy department was proper.; 2. Whether the Intermediary's adjustment disallowing owners' compensation was proper.; 3. Whether the Intermediary's denial of the Routine Cost Limit exception request due to the Provider's failure to respond to a documentation request timely was proper.</p>]]></description></item><item><title>2001D27</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d27</guid><description><![CDATA[<p>case_name: Great Rivers Home Care Inc., St. Peters, MO</p><p>case_numbers: 99-0095</p><p>decision_date: Fri, 11 May 2001 12:00:00 -0400</p><p>decision_number: 2001D27</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 26-7262</p><p>summary: Was the Intermediary's adjustment to remove excess key employee compensation proper?</p>]]></description></item><item><title>2001D46</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d46</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d46</guid><description><![CDATA[<p>case_name: HHS/AllCare 93-94, 96 PT Group Appeal, Denver, CO</p><p>case_numbers: 99-2365G</p><p>decision_date: Fri, 14 Sep 2001 12:00:00 -0400</p><p>decision_number: 2001D46</p><p>fiscal_year_end: Various</p><p>provider_number: 06-7032; 06-7201</p><p>summary: Were the Intermediary's adjustments to physical therapy costs proper?</p>]]></description></item><item><title>2005D70</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d70</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d70</guid><description><![CDATA[<p>case_name: Potomac Home Health Care, Rockville MD</p><p>case_numbers: 98-1725; 99-2325; 02-1682</p><p>decision_date: Tue, 27 Sep 2005 12:00:00 -0400</p><p>decision_number: 2005D70</p><p>fiscal_year_end: 06/30/95; 06/30/96; 06/30/99</p><p>provider_number: 21-7084</p><p>summary: 1. Whether the Intermediary's adjustment applying the Salary Equivalency Guidelines (SEGs) or "physical therapy compensation guidelines" to fee-for-service employee compensation was proper (Case Nos. 98-1725 (FYE 6/30/95) and 99-2325 (FYE 6/30/96)).; 2. Whether it was proper for the Intermediary to make an ajustment reclassifying interest expenses. (case No. 02-1682 (FYE 6/30/99)).</p>]]></description></item><item><title>2005D67</title><pubDate>Mon, 04 Nov 2019 02:23:45 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d67</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d67</guid><description><![CDATA[<p>case_name: Rhode Island Hospital, Providence RI</p><p>case_numbers: 98-2026</p><p>decision_date: Tue, 13 Sep 2005 12:00:00 -0400</p><p>decision_number: 2005D67</p><p>fiscal_year_end: 09/30/1996</p><p>provider_number: 41-0007</p><p>summary: Whether a resident's research time must be directly related to the disgnosis and usual care of an individual patient in order to include such time in the Full-Time Equivalent (FTE) count for Indirect Medical Education (IME) purposes, and, if so, can the Provider prove that the research time it seeks to include in its FTE count for IME purposes was spect in research directly related to the diagnosis and usual care of individual patients for the fiscal year ended (FYE) 9/30/96.</p>]]></description></item><item><title>2005D63</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d63</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d63</guid><description><![CDATA[<p>case_name: Colorado Home Care, Inc,. Broomfield CO</p><p>case_numbers: 98-1913</p><p>decision_date: Thu, 01 Sep 2005 12:00:00 -0400</p><p>decision_number: 2005D63</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 06-7188</p><p>summary: Whether the Intermediary's adjustment applying the Adjusted Hourly Salary Equivalency Amount, (commonly referred to as the Salary Equivalency Guidelines (SEGs) or 'physical therapy compensation guidelines') to fee-for-service employees compensation was proper.</p>]]></description></item><item><title>2002D06</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d06</guid><description><![CDATA[<p>case_name: Devon Gables Health Care Center, Tucson, AZ</p><p>case_numbers: 98-0511</p><p>decision_date: Thu, 10 Jan 2002 12:00:00 -0500</p><p>decision_number: 2002D06</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 03-5145</p><p>summary: Did the Intermediary calculate the provider's bad debts properly?</p>]]></description></item><item><title>2002D07</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d07</guid><description><![CDATA[<p>case_name: University of Virginia Medical Center, Charlottesville, VA</p><p>case_numbers: 98-0490</p><p>decision_date: Thu, 10 Jan 2002 12:00:00 -0500</p><p>decision_number: 2002D07</p><p>fiscal_year_end: 06/30/1995</p><p>provider_number: 49-0009</p><p>summary: Was the Intermediary's computation of the Provider's graduate medical education cost proper?</p>]]></description></item><item><title>2002D22</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d22</guid><description><![CDATA[<p>case_name: Summit Place, Inc., Simpsonville, SC</p><p>case_numbers: 01-0199</p><p>decision_date: Wed, 29 May 2002 12:00:00 -0400</p><p>decision_number: 2002D22</p><p>fiscal_year_end: 09/30/1997</p><p>provider_number: 42-5112</p><p>summary: 1. Was the Intermediary's adjustment combining all SNF and NF cost charges, days, and statistics into one cost center proper?; 2. Was the Intermediary's determination that payroll records were not adequate to support nursing service cost allocation to the SNF distinct part proper?; 3. Was the Intermediary's determination that the allocation of nursing time resulted in an inequitable allocation of cost to the SNF distinct part proper?; 4. Was the Intermediary's decision to disregard statistics and supporting documentation for the allocation of all other general service costs to the SNF distinct part proper?</p>]]></description></item><item><title>2002D10</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d10</guid><description><![CDATA[<p>case_name: Alexander's Home Health of Colorado, Inc, Denver, CO</p><p>case_numbers: 97-3094</p><p>decision_date: Tue, 05 Mar 2002 12:00:00 -0500</p><p>decision_number: 2002D10</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 06-7199</p><p>summary: Was the Intermediary's adjustment disallowing yellow page advertisement expense proper?</p>]]></description></item><item><title>2001D50</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d50</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d50</guid><description><![CDATA[<p>case_name: Riverside Methodist Hospital, Columbus, OH</p><p>case_numbers: 98-0787</p><p>decision_date: Wed, 26 Sep 2001 12:00:00 -0400</p><p>decision_number: 2001D50</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 36-0006</p><p>summary: 1. Was the Intermediary's adjustment relating to the determination and calculation of intern and resident FTEs for purposes of the indirect medical education payment proper?; 2. Was the Intermediary's adjustment relating to the determination and calculation of intern and resident FTEs for purposes of the direct medical education payment proper?</p>]]></description></item><item><title>2002D17</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d17</guid><description><![CDATA[<p>case_name: Sun Home Health Services, Inc., Northumberland, PA</p><p>case_numbers: 00-1736</p><p>decision_date: Wed, 17 Apr 2002 12:00:00 -0400</p><p>decision_number: 2002D17</p><p>fiscal_year_end: 03/31/1998</p><p>provider_number: 39-7095</p><p>summary: Was the Intermediary's reclassification of the salaries and benefits attributable to the unallowable activities from the administrative and general ("A &#x26; G") cost center to a non-reimbursable cost center proper?</p>]]></description></item><item><title>2002D01</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d01</guid><description><![CDATA[<p>case_name: Presbyterian Hospital of Greenville, Greenville, TX</p><p>case_numbers: 00-1056, 99-3600, 00-1057</p><p>decision_date: Wed, 21 Nov 2001 12:00:00 -0500</p><p>decision_number: 2002D01</p><p>fiscal_year_end: 09/30/1994 - 09/30/1996</p><p>provider_number: 45-0352</p><p>summary: Were the Intermediary's adjustments to the number of available beds for disproportionate share (DSH) qualification purposes proper?</p>]]></description></item><item><title>2002D05</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d05</guid><description><![CDATA[<p>case_name: Grace Nursing Home, Clinton, LA</p><p>case_numbers: 96-0550</p><p>decision_date: Wed, 09 Jan 2002 12:00:00 -0500</p><p>decision_number: 2002D05</p><p>fiscal_year_end: 03/31/1993</p><p>provider_number: 19-5258</p><p>summary: Was the Intermediary's denial of a routine cost limit exemption as a new provider proper?</p>]]></description></item><item><title>2005D58</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d58</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d58</guid><description><![CDATA[<p>case_name: Central Texas Medical Center, San Marcos TX</p><p>case_numbers: 99-0832</p><p>decision_date: Tue, 30 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D58</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 45-0272</p><p>summary: Whether observation days and swing bed days should reduce the number of available beds for the purpose of calculating the Provider's eligibility for disproportionate share (DSH) payments.</p>]]></description></item><item><title>2002D26</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d26</guid><description><![CDATA[<p>case_name: Mount Clemens General Hospital, Mount Clemens, MI</p><p>case_numbers: 96-0623</p><p>decision_date: Tue, 09 Jul 2002 12:00:00 -0400</p><p>decision_number: 2002D26</p><p>fiscal_year_end: 04/27/1994</p><p>provider_number: 23-0227</p><p>summary: Whether the Provider's renal dialysis exception request (the "Exception Request") should be deemed to have been approved, pursuant to 42 U.S.C. Section 1395rr(b)(7), where the Centers for Medicare &#x26; Medicaid Services ("CMS") rendered the determination within sixty days but neither the Intermediary nor the Provider received notice of the determination within sixty working days.</p>]]></description></item><item><title>2005D60</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d60</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d60</guid><description><![CDATA[<p>case_name: Mary Imogene Bassett Hospital- Oneonta Satellite Dialysis Facility, Oneonta NY</p><p>case_numbers: 02-1126</p><p>decision_date: Wed, 31 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D60</p><p>fiscal_year_end: 07/01/2001</p><p>provider_number: 33-3531</p><p>summary: Whether the denial of the Provider's request for an exception to the renal dialysis composite rate by the Centers for Medicare and Medicaid Services (CMS) was proper.</p>]]></description></item><item><title>2002D28</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d28</guid><description><![CDATA[<p>case_name: Hoag Memorial Hospital Presbyterian, Newport Beach, CA</p><p>case_numbers: 96-1240</p><p>decision_date: Fri, 02 Aug 2002 12:00:00 -0400</p><p>decision_number: 2002D28</p><p>fiscal_year_end: 09/11/1993</p><p>provider_number: 05-0224</p><p>summary: 1. Was the Intermediary's treatment of cell biology laboratory expense and revenue proper?; 2. Was the Intermediary's determination of reimbursable Medicare bad debts proper?; 3. Was the Intermediary's treatment of the rental expenses for the nursing administration and OB education departments proper?; 4. Was the Intermediary's determination of nonreimbursable costs for the unused space cost center proper?</p>]]></description></item><item><title>2002D24</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d24</guid><description><![CDATA[<p>case_name: Easley Nursing Center, Easley, SC</p><p>case_numbers: 01-0198</p><p>decision_date: Thu, 27 Jun 2002 12:00:00 -0400</p><p>decision_number: 2002D24</p><p>fiscal_year_end: 09/30/1997</p><p>provider_number: 42-5018</p><p>summary: 1. Was the Intermediary's adjustment combining all SNF and NF cost charges, days, and statistics into one cost center proper?; 2. Was the Intermediary's determination that payroll records were not adequate to support nursing service cost allocation to the SNF distinct part proper?; 3. Was the Intermediary's determination that the allocation of nursing time resulted in an inequitable allocation of cost to the SNF distinct part proper?; 4. Was the Intermediary's decision to disregard statistics and supporting documentation for the allocation of all other general service costs to the SNF distinct part proper?</p>]]></description></item><item><title>2002D08</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d08</guid><description><![CDATA[<p>case_name: Colleton Regional Hospital - Skilled Nursing Facility; Waterboro, SC</p><p>case_numbers: 97-1048</p><p>decision_date: Thu, 21 Feb 2002 12:00:00 -0500</p><p>decision_number: 2002D08</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 42-0030</p><p>summary: 1. Was the decision of the Health Care Financing Administration ('HCFA'), pursuant to its HCFA Pub. 15-1 Section 2534.5, to refuse to grant an exception for that portion of the Provider's per diem costs which exceed the Routine Cost Limit ('RCL'), but which do not exceed 112 percent of the total peer group mean cost, arbitrary, capricious, an abuse of discretion or not in accordance with law?; 2. Was the Intermediary's adjustment reclassifying the Provider's costs from direct to indirect cost centers arbitrary, capricious, an abuse of discretion or not in accordance with law?; 3. Was the Intermediary's application of the low occupancy adjustment in HCFA Transmittal No. 378, HCFA Pub. 15-1 Section 2534.5.A, arbitrary, capricious, an abuse of discretion or not in accordance with law?</p>]]></description></item><item><title>2002D03</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d03</guid><description><![CDATA[<p>case_name: Samaritan Health System, Phoenix, AZ</p><p>case_numbers: 98-3317G; 98-2888G</p><p>decision_date: Wed, 12 Dec 2001 12:00:00 -0500</p><p>decision_number: 2002D03</p><p>fiscal_year_end: 12/31/1993; 12/31/1994</p><p>provider_number: 03-0002, 03-0065, 03-0001, 03-0089</p><p>summary: Was the Intermediary's adjustment to home office interest expense proper?</p>]]></description></item><item><title>2002D23</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d23</guid><description><![CDATA[<p>case_name: United Hospital, St. Paul, MN</p><p>case_numbers: 96-1189; 97-0797R</p><p>decision_date: Thu, 27 Jun 2002 12:00:00 -0400</p><p>decision_number: 2002D23</p><p>fiscal_year_end: 12/31/1992; 12/31/1993</p><p>provider_number: 24-0038</p><p>summary: Whether state-funded days may qualify as Medicaid-eligible days for purposes of the Provider's disproportionate share calculation?</p>]]></description></item><item><title>2005D51</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d51</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d51</guid><description><![CDATA[<p>case_name: Sun Terrace Health Care Center, Sun City FL</p><p>case_numbers: 98-2210</p><p>decision_date: Thu, 11 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D51</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 10-5319A</p><p>summary: Whether the Intermediary properly reclassified the Provider's square footage costs for its common areas from the Administrative and General cost center to the Plant Operations, Maintenance and Repair cost center.</p>]]></description></item><item><title>2001D51</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d51</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d51</guid><description><![CDATA[<p>case_name: Leo N. Levi Memorial Hospital, Hot Springs, AR</p><p>case_numbers: 96-0166</p><p>decision_date: Wed, 26 Sep 2001 12:00:00 -0400</p><p>decision_number: 2001D51</p><p>fiscal_year_end: 12/31/1983</p><p>provider_number: 04-3001</p><p>summary: Is the Intermediary barred from recovering an overpayment resulting from the issuance of the September 30, 1995 corrected Notice of Program Reimbursement (NPR) for the Intermediary's Notice of Reopening dated January 14, 1987?</p>]]></description></item><item><title>2005D65</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d65</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d65</guid><description><![CDATA[<p>case_name: Hill Country Health Services, Inc., Killeen TX</p><p>case_numbers: 00-3600</p><p>decision_date: Fri, 02 Sep 2005 12:00:00 -0400</p><p>decision_number: 2005D65</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 45-7661</p><p>summary: Whether the Intermediary properly disallowed interest expense incurred in connection with the Provider's deferred compensation plan.</p>]]></description></item><item><title>2002D20</title><pubDate>Mon, 04 Nov 2019 02:23:44 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d20</guid><description><![CDATA[<p>case_name: Life Care Center of Aurora, Aurora, CO</p><p>case_numbers: 98-2883</p><p>decision_date: Thu, 16 May 2002 12:00:00 -0400</p><p>decision_number: 2002D20</p><p>fiscal_year_end: 08/31/1996</p><p>provider_number: 06-5332</p><p>summary: Were the Intermediary's adjustments to the Provider's depreciation expense related to the sale and leaseback of the facility proper?</p>]]></description></item><item><title>2005D48</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d48</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d48</guid><description><![CDATA[<p>case_name: Long Beach Memorial Hospital, Long Beach NY</p><p>case_numbers: 95-0777</p><p>decision_date: Fri, 29 Jul 2005 12:00:00 -0400</p><p>decision_number: 2005D48</p><p>fiscal_year_end: 12/31/1991</p><p>provider_number: 33-0225</p><p>summary: Whether the Intermediary's application of the reasonable compensation equivalent limits was proper.</p>]]></description></item><item><title>2005D59</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d59</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d59</guid><description><![CDATA[<p>case_name: Central Texas Medical Center, San Marcos TX</p><p>case_numbers: 01-0728</p><p>decision_date: Tue, 30 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D59</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: 45-0272</p><p>summary: Whether observation days and swing bed days should reduce the number of available beds for the purpose of calculating the Provider's eligibility for disproportionate share (DSH) payments.</p>]]></description></item><item><title>2005D64</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d64</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d64</guid><description><![CDATA[<p>case_name: Alamitos West Convalescent, Los Alamitos CA</p><p>case_numbers: 98-1922</p><p>decision_date: Thu, 01 Sep 2005 12:00:00 -0400</p><p>decision_number: 2005D64</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 05-6169</p><p>summary: Whether the Intermediary's adjustment to allow only a 15% increase in the therapy rate for physical therapy supervisors was proper.</p>]]></description></item><item><title>2005D66</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d66</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d66</guid><description><![CDATA[<p>case_name: Health Care Options, East Baton Rogue Parish LA</p><p>case_numbers: 00-3299</p><p>decision_date: Fri, 02 Sep 2005 12:00:00 -0400</p><p>decision_number: 2005D66</p><p>fiscal_year_end: 06/30/1997</p><p>provider_number: 19-7213</p><p>summary: 1. Whether the Intermediary's adjustments applying the physical therapy salary guidelines to fee-for-service employee compensation were proper.; 2. Whether the Intermediary's adjustment to reduce allowable related party rental expense was proper.</p>]]></description></item><item><title>2005D19</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d19</guid><description><![CDATA[<p>case_name: Family Home Care, Inc.</p><p>case_numbers: 01-0261</p><p>decision_date: Fri, 07 Jan 2005 12:00:00 -0500</p><p>decision_number: 2005D19</p><p>fiscal_year_end: 6/30/98</p><p>provider_number: 19-7558</p><p>summary: Was the Intermediary's adjustment to disallow accrued salaries proper?</p>]]></description></item><item><title>2005D47</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d47</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d47</guid><description><![CDATA[<p>case_name: Alhambra Hospital</p><p>case_numbers: 02-2129; 04-1734</p><p>decision_date: Fri, 29 Jul 2005 12:00:00 -0400</p><p>decision_number: 2005D47</p><p>fiscal_year_end: 06/30/2000; 06/30/1999</p><p>provider_number: 05-0281</p><p>summary: Whether the Provider is entitled to include in the Medicaid proxy of the DSH payment calculation patient days associated with patients who otherwise were entitled to benefits under both Medicare &#x26; Medicaid who were treated in the Provider's sub-acute unit on days when those patients were not entitled to Medicare Part A skilled nursing facility (SNF) benefits.</p>]]></description></item><item><title>2005D55</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d55</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d55</guid><description><![CDATA[<p>case_name: Muhlenberg Hospital Center, Bethlehem PA</p><p>case_numbers: 00-3322</p><p>decision_date: Fri, 12 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D55</p><p>fiscal_year_end: 11/20/1997</p><p>provider_number: 39-0263</p><p>summary: Whether the Intermediary's adjustment disallowing the Provider's loss on sale of assets is proper?</p>]]></description></item><item><title>2005D69</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d69</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d69</guid><description><![CDATA[<p>case_name: Columbia Montour Home Health Services, Bloomsburg PA</p><p>case_numbers: 01-3317</p><p>decision_date: Fri, 16 Sep 2005 12:00:00 -0400</p><p>decision_number: 2005D69</p><p>fiscal_year_end: 06/30/1998</p><p>provider_number: 39-7086</p><p>summary: Whether the Intermediary's adjustment of accounting fees was proper.</p>]]></description></item><item><title>2005D43</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d43</guid><description><![CDATA[<p>case_name: Pleasant Care 97/98 Payroll Tax Cost group</p><p>case_numbers: 00-0909G</p><p>decision_date: Fri, 10 Jun 2005 12:00:00 -0400</p><p>decision_number: 2005D43</p><p>fiscal_year_end: 07/31/1996-05/31/1998</p><p>provider_number: Various</p><p>summary: Should the Intermediary reclassify the Provider's Federal Insurance Contributions Act (FICA) tax expense from the Employee Benefits cost center to the Administrative and General cost center (A&#x26;G)?</p>]]></description></item><item><title>2005D56</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d56</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d56</guid><description><![CDATA[<p>case_name: Central Texas Medical Center, San Marcos TX</p><p>case_numbers: 99-3095</p><p>decision_date: Tue, 30 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D56</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 45-0272</p><p>summary: Whether observation days and swing bed days should reduce the number of available beds for the purpose of calculating the Provider's eligibility for disproportionate share (DSH) payments.</p>]]></description></item><item><title>2005D50</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d50</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d50</guid><description><![CDATA[<p>case_name: Hillcrest Baptist Medical Center, Waco TX</p><p>case_numbers: 89-1584</p><p>decision_date: Thu, 11 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D50</p><p>fiscal_year_end: 08/31/1986</p><p>provider_number: 45-0101</p><p>summary: 1.Whether capitalized interest that may have been amortized in future years can be expensed in the current year when future cost reports are no longer subject to reopening.; 2. Whether the Intermediary's determination of allowable interest expense which deducted Hillcrest Medical Tower [HMT] interest from allowable versus total expense is proper.</p>]]></description></item><item><title>2005D49</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d49</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d49</guid><description><![CDATA[<p>case_name: Ashtabula County Med Cen; Community Hos; Akron General Med Cent; Lima Memorial Hos; Toledo Hos</p><p>case_numbers: Various</p><p>decision_date: Wed, 10 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D49</p><p>fiscal_year_end: Various</p><p>provider_number: 36-0125; 36-0187; 36-0027; 36-0009; 36-0068</p><p>summary: Whether the Intermediary improperly excluded patient days related to Ohio's Hospital Care Assurance Program (HCAP) in the providers' disproportionate share calculations.</p>]]></description></item><item><title>2002D13</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d13</guid><description><![CDATA[<p>case_name: BBL 94-98 Observation Bed Days Group</p><p>case_numbers: 01-3205G</p><p>decision_date: Tue, 19 Mar 2002 12:00:00 -0500</p><p>decision_number: 2002D13</p><p>fiscal_year_end: Various</p><p>provider_number: 50-0023; 44-0131; 45-0059</p><p>summary: Whether the Intermediary improperly determined the Provider's DSH adjustments by excluding observation bed days from the DSH bed day calculation in violation of the applicable regulation and manual provisions.</p>]]></description></item><item><title>2002D09</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d09</guid><description><![CDATA[<p>case_name: Continue Care Home Health III, Inc.</p><p>case_numbers: 00-1180</p><p>decision_date: Thu, 21 Feb 2002 12:00:00 -0500</p><p>decision_number: 2002D09</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: 06-7256</p><p>summary: 1. Was the Intermediary's adjustment to reclassify cost to the Community Education cost center proper?; 2. Was the Intermediary's adjustment to reclassify travel expense to the Community Education cost center proper?</p>]]></description></item><item><title>2005D61</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d61</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d61</guid><description><![CDATA[<p>case_name: Erwine's Home Health Care, Inc., Kingston PA</p><p>case_numbers: 99-1543; 00-1001</p><p>decision_date: Wed, 31 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D61</p><p>fiscal_year_end: 12/31/1996; 12/31/1997</p><p>provider_number: 39-7573</p><p>summary: Whether the Intermediary's adjustments applying the physical therapy salary guidelines to fee-for-service employee compensation was proper.</p>]]></description></item><item><title>2005D41</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d41</guid><description><![CDATA[<p>case_name: St. Rita's Medical Center, Lima OH</p><p>case_numbers: 99-4038</p><p>decision_date: Wed, 25 May 2005 12:00:00 -0400</p><p>decision_number: 2005D41</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 36-0066</p><p>summary: Whether for purposes of the Provider's disproportionate share (DSH) calculation, the Provider is entitled to an increased number of days of care rendered to eligible Medicaid beneficiaries.</p>]]></description></item><item><title>2005D46</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d46</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d46</guid><description><![CDATA[<p>case_name: Evergreen Hospital Medical Center and SNF, Kirkland WA</p><p>case_numbers: 98-2583</p><p>decision_date: Fri, 29 Jul 2005 12:00:00 -0400</p><p>decision_number: 2005D46</p><p>fiscal_year_end: 12/31/1995- 12/31/1998</p><p>provider_number: 50-0124; 50-5492</p><p>summary: Was the Provider entitled to a "new provider" exemption from Medicare's routime cost limits for its hospital-based skilled nursing facility (SNF)?</p>]]></description></item><item><title>2005D57</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d57</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d57</guid><description><![CDATA[<p>case_name: Central Texas Medical Center, San Marcos TX</p><p>case_numbers: 99-3096</p><p>decision_date: Tue, 30 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D57</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 45-0272</p><p>summary: Whether observation days and swing bed days should reduce the number of available beds for the purpose of calculating the Provider's eligibility for disproportionate share (DSH) payments.</p>]]></description></item><item><title>2002D15</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d15</guid><description><![CDATA[<p>case_name: Mayo Regional Hospital, Dover-Foxcroft, ME</p><p>case_numbers: 97-1432</p><p>decision_date: Wed, 27 Mar 2002 12:00:00 -0500</p><p>decision_number: 2002D15</p><p>fiscal_year_end: 09/30/1994</p><p>provider_number: 20-0066</p><p>summary: 1. Was the Intermediary's denial of the Provider's request for a sole community hospital (SCH) decreased volume adjustment proper?; 2. Does the Board have jurisdictional authority to allow the Intermediary to adjust Provider's Medicare reimbursement for fiscal year (FY) 1994 to include an allowance for Medicare/Medicaid crossover bad debt?</p>]]></description></item><item><title>2005D62</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d62</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d62</guid><description><![CDATA[<p>case_name: Shady Lawn Nursing Home, Vicksburg MS</p><p>case_numbers: 01-0077</p><p>decision_date: Wed, 31 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D62</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 25-5234</p><p>summary: Whether the Intermediary's adjustment removing the Provider's 'grossing up' of costs and charges for drugs charged to patients was proper.</p>]]></description></item><item><title>2002D29</title><pubDate>Mon, 04 Nov 2019 02:23:43 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d29</guid><description><![CDATA[<p>case_name: Boone County Hospital, Boone, IA</p><p>case_numbers: 98-0452</p><p>decision_date: Fri, 02 Aug 2002 12:00:00 -0400</p><p>decision_number: 2002D29</p><p>fiscal_year_end: 06/30/1995</p><p>provider_number: 16-0026</p><p>summary: Did the Provider qualify for a payment adjustment due to a decline in its discharges for fiscal year ending June 30, 1995?</p>]]></description></item><item><title>2003D53</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d53</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d53</guid><description><![CDATA[<p>case_name: Pleasant Care- Good Samaritan, Stockton CA</p><p>case_numbers: 99-2359</p><p>decision_date: Thu, 28 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D53</p><p>fiscal_year_end: 09/30/1996</p><p>provider_number: 05-5039</p><p>summary: 1. Was the Intermediary's adjustment to advertising costs proper?; 2. Was the Intermediary's adjustment to tax penalties proper?</p>]]></description></item><item><title>2005D24</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d24</guid><description><![CDATA[<p>case_name: Nurses Registry Home Health Care, Inc., Harahan, LA</p><p>case_numbers: 02-0183</p><p>decision_date: Fri, 11 Feb 2005 12:00:00 -0500</p><p>decision_number: 2005D24</p><p>fiscal_year_end: 4/30/99</p><p>provider_number: 19-7545</p><p>summary: 1. Whether the Intermediary's adjustment to remove accrued salaries for owners due to payment not being properly liquidated within 75 days after the close of the cost reporting period was proper?; 2. Whether it was proper for the Intermediary to disallow the portion of the accrued owner's compensation expenses attributable to the employees' share of Federal and State withholding taxes?</p>]]></description></item><item><title>2004D20</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d20</guid><description><![CDATA[<p>case_name: West Virginia University Hospital, Morgantown, WV</p><p>case_numbers: 98-1344; 99-1718; 00-2691</p><p>decision_date: Fri, 30 Apr 2004 12:00:00 -0400</p><p>decision_number: 2004D20</p><p>fiscal_year_end: 12/31/94; 12/31/95; 12/31/96</p><p>provider_number: 51-0001</p><p>summary: Was the Intermediary's adjustment to bond interest proper?</p>]]></description></item><item><title>2005D45</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d45</guid><description><![CDATA[<p>case_name: UMass Memorial Medical Center, Worchester MA</p><p>case_numbers: 02-1213</p><p>decision_date: Tue, 14 Jun 2005 12:00:00 -0400</p><p>decision_number: 2005D45</p><p>fiscal_year_end: 07/30/2001</p><p>provider_number: 22-0163</p><p>summary: Was the Centers for Medicare and Medicaid Services' (CMS) denial of the Provider's request for an exemption to the end stage renal disease (ESRD) composite rate proper?</p>]]></description></item><item><title>2005D52</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d52</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d52</guid><description><![CDATA[<p>case_name: Sun City Center 96 Square Foot Allocations</p><p>case_numbers: 99-1511G</p><p>decision_date: Thu, 11 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D52</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: Various</p><p>summary: Whether the Intermediary properly reclassified the Providers' square footage costs for its common areas from the Administrative and General cost center to the Plant Operations, Maintenance and Repair cost center.</p>]]></description></item><item><title>2002D27</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d27</guid><description><![CDATA[<p>case_name: Total Quality Home Care, Inc., Alhambra, CA</p><p>case_numbers: 99-3872</p><p>decision_date: Tue, 09 Jul 2002 12:00:00 -0400</p><p>decision_number: 2002D27</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: 55-7633</p><p>summary: 1. Was the Intermediary's adjustment disallowing unsupported compensation paid to the Medical Director proper?; 2. Was the Intermediary's adjustment reducing compensation paid to the Director of Nursing to a reasonable amount proper?; 3. Was the Intermediary's adjustment to the Administrator's salary proper?</p>]]></description></item><item><title>2004D10</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d10</guid><description><![CDATA[<p>case_name: Preferred Home Health Care, Vincennes and Lafayette, IN</p><p>case_numbers: 00-2699; 00-2700</p><p>decision_date: Tue, 03 Feb 2004 12:00:00 -0500</p><p>decision_number: 2004D10</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 15-7193; 15-7318</p><p>summary: The case involves the propriety of reimbrusing home health agencies (HHA) under the Medicare program for expenses that the HHA incurs to provide pastoral care to its patients?</p>]]></description></item><item><title>2005D42</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d42</guid><description><![CDATA[<p>case_name: Rome Memorial Hospital, Rome NY</p><p>case_numbers: 01-3257</p><p>decision_date: Wed, 25 May 2005 12:00:00 -0400</p><p>decision_number: 2005D42</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 33-0215</p><p>summary: Whether for purposes of the Provider's disproportionate share calculation, the Provider is entitled to an increased number of days of care rendered to eligible Medicaid beneficiaries.</p>]]></description></item><item><title>2005D53</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d53</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d53</guid><description><![CDATA[<p>case_name: Goleta Valley Community Hospital a/k/a Goleta Valley Cottage Hospital, Goleta CA </p><p>case_numbers: 97-1198; 99-0246; 99-0247</p><p>decision_date: Fri, 12 Aug 2005 12:00:00 -0400</p><p>decision_number: 2005D53</p><p>fiscal_year_end: 09/30/95; 09/30/96; 12/31/96</p><p>provider_number: 05-0357</p><p>summary: Did the Provider supply sufficient information to enable the Centers for Medicare and Medicaid Services to make a decision regarding the Provider's request for an exemption to Medicare's routine service cost limits for skilled nursing facilities (SNF)? </p>]]></description></item><item><title>2004D21</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d21</guid><description><![CDATA[<p>case_name: Bates Medical Center, Bentonville, AR</p><p>case_numbers: 99-1424</p><p>decision_date: Thu, 06 May 2004 12:00:00 -0400</p><p>decision_number: 2004D21</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 04-0048</p><p>summary: Was the Intermediary's determination of the loss on disposal of assets proper?</p>]]></description></item><item><title>2005D44</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d44</guid><description><![CDATA[<p>case_name: Covenant Shores Health Center, Mercer Island WA</p><p>case_numbers: 99-4061</p><p>decision_date: Fri, 10 Jun 2005 12:00:00 -0400</p><p>decision_number: 2005D44</p><p>fiscal_year_end: 01/31/1998; 01/31/1999</p><p>provider_number: 50-5504</p><p>summary: Whether CMS' denial of the Provider's request for an exemption to the routine cost limits for skilled nursing facilities as a new provider was proper.</p>]]></description></item><item><title>2004D28</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d28</guid><description><![CDATA[<p>case_name: Children's Hospital &#x26; Regional Medical Center, Seattle, WA</p><p>case_numbers: 04-1640; 04-1641</p><p>decision_date: Wed, 14 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D28</p><p>fiscal_year_end: 09/30/2001; 09/30/2002</p><p>provider_number: 50-3300</p><p>summary: Were the Intermediary's adjustments to the provider's intern and resident full-time equivalents ("FTEs") counts used for calculating chidren's hospital graduate medical education ("CHGME") payments proper?</p>]]></description></item><item><title>2002D37</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d37</guid><description><![CDATA[<p>case_name: RCE Limits Group Appeals I &#x26; II, Tenet Health Systems, Nacogdoches Medical Center</p><p>case_numbers: 94-3225G, 94-1910G, 93-0483G, 93-0284G, 94-0209G, 95-1245G, 96-0976G, 98-0179</p><p>decision_date: Tue, 17 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D37</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Whether the Intermediaries' application of reasonable compensation equivalent ("RCE") limits issued by HCFA to limit hospitals' compensation to physicians for Medicare Part A services in cost reporting periods commencing in 1984 to the Providers' physician compensation for hospital services in cost reporting periods commencing in 1987 through 1994 was proper.</p>]]></description></item><item><title>2005D22</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d22</guid><description><![CDATA[<p>case_name: Heritage House of Richmond, Richmond, VA</p><p>case_numbers: 01-0700</p><p>decision_date: Thu, 13 Jan 2005 12:00:00 -0500</p><p>decision_number: 2005D22</p><p>fiscal_year_end: 7/31/98</p><p>provider_number: 15-5228</p><p>summary: Whether the Intermediary's adjustment to disallow a portion of the owner's compensation was proper?</p>]]></description></item><item><title>2005D34</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d34</guid><description><![CDATA[<p>case_name: Brackenridge Hospital, Austin TX</p><p>case_numbers: 98-1658</p><p>decision_date: Mon, 11 Apr 2005 12:00:00 -0400</p><p>decision_number: 2005D34</p><p>fiscal_year_end: 09/30/1994</p><p>provider_number: 45-0124</p><p>summary: Whether the Intermediary properly applied the "Pickle Amendment" in calculating the Provider's Disproportionate Share Hospital (DSH) adjustment.</p>]]></description></item><item><title>2005D40</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d40</guid><description><![CDATA[<p>case_name: St. Joseph's Health Services of Rhode Island, Providence RI</p><p>case_numbers: 00-2981</p><p>decision_date: Fri, 13 May 2005 12:00:00 -0400</p><p>decision_number: 2005D40</p><p>fiscal_year_end: 09/30/1997; 09/30/1998</p><p>provider_number: 41-5122</p><p>summary: Whether the Centers for Medicare &#x26; Medicaid Services' (CMS) denial of St. Joseph's Health Services of Rhode Island Transitional Care Center's request for exemption from the skilled nursing facility (SNF) routine cost limit (RCL) as a new provider was proper</p>]]></description></item><item><title>2005D25</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d25</guid><description><![CDATA[<p>case_name: Brady Home Health Care Services, Inc., Brady, TX</p><p>case_numbers: 99-1213</p><p>decision_date: Fri, 11 Feb 2005 12:00:00 -0500</p><p>decision_number: 2005D25</p><p>fiscal_year_end: 12/31/96</p><p>provider_number: 67-7455</p><p>summary: 1. Whether the Intermediary's adjustment to remove accrued salaries for owners due to payment not being properly liquidated within 75 days after the close of the cost reporting period was correct?; 2. Whether it was proper for the Intermediary to disallow the portion of the accrued owner's compensation expenses attributable to the employees' share of Federal and State withholding taxes?</p>]]></description></item><item><title>2005D28</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d28</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d28</guid><description><![CDATA[<p>case_name: St. Edward Mercy Medical Center, Fort Smith, AR</p><p>case_numbers: 97-1566</p><p>decision_date: Tue, 15 Mar 2005 12:00:00 -0500</p><p>decision_number: 2005D28</p><p>fiscal_year_end: 6/30/94</p><p>provider_number: 04-0062</p><p>summary: Was the Centers for Medicare and Medicaid Service's denial of the Provider's request for new provider exemption proper?</p>]]></description></item><item><title>2005D35</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d35</guid><description><![CDATA[<p>case_name: Mid-City Home Health, Los Angeles CA</p><p>case_numbers: 99-1345</p><p>decision_date: Tue, 12 Apr 2005 12:00:00 -0400</p><p>decision_number: 2005D35</p><p>fiscal_year_end: 09/02/1997</p><p>provider_number: 55-7729</p><p>summary: Whether the liabilities claimed by the Provider are reimbursable under the Medicare principles.</p>]]></description></item><item><title>2004D23</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d23</guid><description><![CDATA[<p>case_name: Glenwood Regional Medical Center, West Monroe, LA</p><p>case_numbers: 97-2439</p><p>decision_date: Mon, 07 Jun 2004 12:00:00 -0400</p><p>decision_number: 2004D23</p><p>fiscal_year_end: 08/31/1995</p><p>provider_number: 19-0160</p><p>summary: Was the Provider's routine cost limit determined in accordance with Medicare law, regulations, and program instructions?</p>]]></description></item><item><title>2005D27</title><pubDate>Mon, 04 Nov 2019 02:23:42 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d27</guid><description><![CDATA[<p>case_name: Memorial Hospital at Gulfport, Gulfport, MS</p><p>case_numbers: 02-1008</p><p>decision_date: Tue, 15 Mar 2005 12:00:00 -0500</p><p>decision_number: 2005D27</p><p>fiscal_year_end: 9/30/98</p><p>provider_number: 25-0019</p><p>summary: Was the Intermediary's disallowance of Medicare bad debts proper?</p>]]></description></item><item><title>2005D01</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d01</guid><description><![CDATA[<p>case_name: Fajardo Home Care, Guaynabo Home Care Program, Font Martelo Home Care Program, El Gigante Home Care</p><p>case_numbers: 02-0212, 02-0213,02-0214 et al</p><p>decision_date: Fri, 29 Oct 2004 12:00:00 -0400</p><p>decision_number: 2005D01</p><p>fiscal_year_end: 12/31/1999</p><p>provider_number: 40-7019;40-7013;40-7017;et al</p><p>summary: Whether the Providers' receivable financing was a loan or a sale of assets?</p>]]></description></item><item><title>2005D08</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d08</guid><description><![CDATA[<p>case_name: Bon Secours Venice Healthcare, Venice, FL</p><p>case_numbers: 00-1542, 01-1278, 03-0040</p><p>decision_date: Thu, 02 Dec 2004 12:00:00 -0500</p><p>decision_number: 2005D08</p><p>fiscal_year_end: 8/31/96, 8/31/97, 8/31/98</p><p>provider_number: 10-0070</p><p>summary: Were the Intermediary's adjustments to interest expense relating to the acquisition of medical records and an assembled work force proper?</p>]]></description></item><item><title>2005D09</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d09</guid><description><![CDATA[<p>case_name: Robert F. Kennedy Medical Center, Hawthorne, CA</p><p>case_numbers: 99-1467</p><p>decision_date: Fri, 10 Dec 2004 12:00:00 -0500</p><p>decision_number: 2005D09</p><p>fiscal_year_end: 3/30/96</p><p>provider_number: 05-0420</p><p>summary: Is a loss required to be recognized by Medicare as a result of the May 30, 1996 merger of the former corporate owner of the Provider into a new corporate owner?</p>]]></description></item><item><title>2004D09</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d09</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d09</guid><description><![CDATA[<p>case_name: Heritage Health Care, Inc. d/b/a/ Hertiage Villa Nursing Center</p><p>case_numbers: 03-0665</p><p>decision_date: Fri, 30 Jan 2004 12:00:00 -0500</p><p>decision_number: 2004D09</p><p>fiscal_year_end: 06/30/1998</p><p>provider_number: 37-5109</p><p>summary: Does the Board have jurisdiction over the recoupment of overpayments appealed from a letter from the Centers for Medicare and Medicaid Services, and the reimbursement effect is less than $10,000?</p>]]></description></item><item><title>2005D29</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d29</guid><description><![CDATA[<p>case_name: San Francisco Medical Center, San Francisco, CA</p><p>case_numbers: 95-0468</p><p>decision_date: Thu, 13 Jan 2005 12:00:00 -0500</p><p>decision_number: 2005D29</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 05-0076</p><p>summary: Was the Intermediary's partial denial of the Provider's End Stage Renal Disease (ESRD) exception request proper?</p>]]></description></item><item><title>2005D31</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d31</guid><description><![CDATA[<p>case_name: Roy L. Schneider Hospital, St. Thomas, VI</p><p>case_numbers: 01-1679</p><p>decision_date: Fri, 08 Apr 2005 12:00:00 -0400</p><p>decision_number: 2005D31</p><p>fiscal_year_end: 08/28/2000</p><p>provider_number: 48-0001</p><p>summary: Whether CMS' determination to deny a request for an exception to the end stage renal disease(ESRD) composite rate based on a lack of documentation supporting the criteria of the isolated essential facility (IEF) was proper.</p>]]></description></item><item><title>2005D05</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d05</guid><description><![CDATA[<p>case_name: Mercy Heathcare Bakersfield, Bakersfield, CA</p><p>case_numbers: 94-3085</p><p>decision_date: Fri, 19 Nov 2004 12:00:00 -0500</p><p>decision_number: 2005D05</p><p>fiscal_year_end: 06/30/94</p><p>provider_number: 05-0295</p><p>summary: Was the Center For Medicare and Medicaid Services (CMS)' parial denial of the Provider's End Stage Renal Disease (ESRD) atypical service exception request proper?</p>]]></description></item><item><title>2005D12</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d12</guid><description><![CDATA[<p>case_name: NYCHHC 94 TEFRA Target Amt. Per Case E/E Group</p><p>case_numbers: 99-0452G</p><p>decision_date: Fri, 17 Dec 2004 12:00:00 -0500</p><p>decision_number: 2005D12</p><p>fiscal_year_end: 6/30/94</p><p>provider_number: Various</p><p>summary: Whether the Intermediary properly processed the Providers' TEFRA exception request?</p>]]></description></item><item><title>2004D16</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d16</guid><description><![CDATA[<p>case_name: Odessa Regional Hospital, Odessa, TX</p><p>case_numbers: 00-0411; 00-2594</p><p>decision_date: Thu, 29 Apr 2004 12:00:00 -0400</p><p>decision_number: 2004D16</p><p>fiscal_year_end: 12/31/96; 12/31/97</p><p>provider_number: 45-0061</p><p>summary: Was the Intermediary's adjustment excluding observation bed days from the determination of the Provider's disproportionate share hospital adjustment proper?</p>]]></description></item><item><title>2004D26</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d26</guid><description><![CDATA[<p>case_name: Aroostook Medical Center, Presque Isle, ME</p><p>case_numbers: 01-0883</p><p>decision_date: Thu, 10 Jun 2004 12:00:00 -0400</p><p>decision_number: 2004D26</p><p>fiscal_year_end: 08/30/2000</p><p>provider_number: 20-0018</p><p>summary: Was CMS' denial of end stage renal disease composite rate exception request correct based on applicable Medicare law?</p>]]></description></item><item><title>2004D06</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d06</guid><description><![CDATA[<p>case_name: Alpena Dialysis Services, Alpena, MI</p><p>case_numbers: 01-0742</p><p>decision_date: Mon, 22 Dec 2003 12:00:00 -0500</p><p>decision_number: 2004D06</p><p>fiscal_year_end: N/A</p><p>provider_number: 23-2553</p><p>summary: Did the Centers for Medicare and Medicaid Services ("CMS") correctly deny Alpena Dialysis Services' request for an exception to the end stage renal disease ("ESRD") composite rate?</p>]]></description></item><item><title>2005D37</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d37</guid><description><![CDATA[<p>case_name: VNA Healthcare, Inc., Centralia IL</p><p>case_numbers: 01-2620</p><p>decision_date: Tue, 10 May 2005 12:00:00 -0400</p><p>decision_number: 2005D37</p><p>fiscal_year_end: 04/30/2005</p><p>provider_number: 14-7112</p><p>summary: Were the Intermediary adjustments applying Medicare's salary equivalency guidelines to services performed by Provider's employee physical and occupational therapists proper?</p>]]></description></item><item><title>2003D05</title><pubDate>Mon, 04 Nov 2019 02:23:40 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d05</guid><description><![CDATA[<p>case_name: Always Better Care Home Health Providers, Inc., Los Angeles, CA</p><p>case_numbers: 00-3145</p><p>decision_date: Thu, 21 Nov 2002 12:00:00 -0500</p><p>decision_number: 2003D05</p><p>fiscal_year_end: 07/31/1998</p><p>provider_number: 05-8017</p><p>summary: Was the Intermediary's adjustment of start-up costs proper?</p>]]></description></item><item><title>2005D10</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d10</guid><description><![CDATA[<p>case_name: Haven Home Health, Inc., Columbia, LA</p><p>case_numbers: 02-0355</p><p>decision_date: Fri, 10 Dec 2004 12:00:00 -0500</p><p>decision_number: 2005D10</p><p>fiscal_year_end: 2/29/00</p><p>provider_number: 19-7210</p><p>summary: 1. Whether the Intermediary's disallowance of owner's accrued salary expense for untimely liquidation was proper?; 2. Whether the Intermediary's adjustment to the related party portion of the office supplies and revision of the related party medical supply expense was proper?</p>]]></description></item><item><title>2005D15</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d15</guid><description><![CDATA[<p>case_name: Topanga Terrace, Canoga Park, CA</p><p>case_numbers: 02-0020</p><p>decision_date: Fri, 17 Dec 2004 12:00:00 -0500</p><p>decision_number: 2005D15</p><p>fiscal_year_end: 12/31/98</p><p>provider_number: 05-6092</p><p>summary: Whether the Intermediary's denial of the Provider's Routine Cost Limit (RCL) exception request was proper?</p>]]></description></item><item><title>2004D07</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d07</guid><description><![CDATA[<p>case_name: Northern Michigan Hospital, Petoskey, MI</p><p>case_numbers: 01-0743</p><p>decision_date: Mon, 22 Dec 2003 12:00:00 -0500</p><p>decision_number: 2004D07</p><p>fiscal_year_end: N/A</p><p>provider_number: 23-2315</p><p>summary: Did the Centers for Medicare and Medicaid Services ("CMS") correctly deny Northern Michigan Hospital's request for an exception to the end stage renal disease ("ESRD") composite rate?</p>]]></description></item><item><title>2005D17</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d17</guid><description><![CDATA[<p>case_name: Hamburg Health Clinic</p><p>case_numbers: 02-0013, 02-0319</p><p>decision_date: Thu, 06 Jan 2005 12:00:00 -0500</p><p>decision_number: 2005D17</p><p>fiscal_year_end: 12/31/98, 12/31/99</p><p>provider_number: 04-3816</p><p>summary: Was the Intermediary's adjustment to physician/owners compensation proper?</p>]]></description></item><item><title>2005D02</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d02</guid><description><![CDATA[<p>case_name: Dialysis Clinic 94 Bad Debt Expense Group</p><p>case_numbers: 96-2577G</p><p>decision_date: Thu, 18 Nov 2004 12:00:00 -0500</p><p>decision_number: 2005D02</p><p>fiscal_year_end: 9/30/1994, 9/30/95. 9/30/96</p><p>provider_number: Various</p><p>summary: Were the Intermediary's adjustments disallowing bad debts claimed by the Provider on uncollectable deductable and coinsurance amounts pertaining to items and services reimbursed outside of Medicare's composite rate for End Stage Renal Disease facilities proper?</p>]]></description></item><item><title>2005D04</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d04</guid><description><![CDATA[<p>case_name: Eastern Maine Medical Center, Bangor, ME</p><p>case_numbers: 01-1458</p><p>decision_date: Thu, 18 Nov 2004 12:00:00 -0500</p><p>decision_number: 2005D04</p><p>fiscal_year_end: 08/30/2000</p><p>provider_number: 20-0033</p><p>summary: Was CMS' denial of the Provider's end stage renal disease (ESRD) composite rate exception request correct?</p>]]></description></item><item><title>2005D11</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d11</guid><description><![CDATA[<p>case_name: Flagstaff Medical Center and Northern Arizona Homecare-Flagstaff, Flagstaff, AZ</p><p>case_numbers: 00-3166, 00-3167, 00-3119</p><p>decision_date: Fri, 17 Dec 2004 12:00:00 -0500</p><p>decision_number: 2005D11</p><p>fiscal_year_end: 12/31/94, 6/30/95, 6/30/97</p><p>provider_number: 03-0023, 03-7047</p><p>summary: Whether the Intermediary's denial of a request for exception to the Home Health Agency (HHA) per visit cost limits was proper?</p>]]></description></item><item><title>2005D13</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d13</guid><description><![CDATA[<p>case_name: Terrebonne Home Care, Inc.</p><p>case_numbers: 02-0078</p><p>decision_date: Fri, 17 Dec 2004 12:00:00 -0500</p><p>decision_number: 2005D13</p><p>fiscal_year_end: 7/31/00</p><p>provider_number: 19-7585</p><p>summary: Whether the Intermediary denial of the Provider's request for exception to its per-visit cost limits was proper?</p>]]></description></item><item><title>2005D06</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d06</guid><description><![CDATA[<p>case_name: Saint Mary's Medical Center, Saginaw, MI</p><p>case_numbers: 97-0592, 98-1495</p><p>decision_date: Tue, 23 Nov 2004 12:00:00 -0500</p><p>decision_number: 2005D06</p><p>fiscal_year_end: 6/30/94, 6/30/1995</p><p>provider_number: 23-0077</p><p>summary: For purposes of allocation of Administrative &#x26; General ("A&#x26;G") costs, should Part B physicians' compensation and related fringe benefits be included in total expenses of private physician practices?</p>]]></description></item><item><title>2005D07</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d07</guid><description><![CDATA[<p>case_name: Capeside Cove Good Samaritan Center, Siren, WI</p><p>case_numbers: 00-0374</p><p>decision_date: Tue, 23 Nov 2004 12:00:00 -0500</p><p>decision_number: 2005D07</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 52-5478</p><p>summary: Was the Intermediary correct in determining that Provider's request for an exception to the Skilled Nursing Facility (SNF) Routine Cost Limit was untimely filed?</p>]]></description></item><item><title>2004D01</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d01</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d01</guid><description><![CDATA[<p>case_name: Home Care PRN; Home Care PRN 96 Allow. Home Ofc. Exps.; Home Care PRN 96 Int. Exp. Grp.</p><p>case_numbers: 01-1470; 01-1534G; 01-1539G</p><p>decision_date: Tue, 14 Oct 2003 12:00:00 -0400</p><p>decision_number: 2004D01</p><p>fiscal_year_end: 12/31/95; 12/31/96</p><p>provider_number: Various</p><p>summary: Whether the Board has jurisdiction to determine which entity is the proper payee under the terms of a settlement agreement between the Providers and the Intermediary?</p>]]></description></item><item><title>2003D07</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d07</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d07</guid><description><![CDATA[<p>case_name: Westview Manor, Derby, KS</p><p>case_numbers: 00-3976</p><p>decision_date: Thu, 19 Dec 2002 12:00:00 -0500</p><p>decision_number: 2003D07</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 17-5218</p><p>summary: Was the Intermediary's adjustment disallowing the allocation of general service costs to the ancillary cost centers proper?</p>]]></description></item><item><title>2005D03</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d03</guid><description><![CDATA[<p>case_name: Twin Rivers Regional Medical Center</p><p>case_numbers: 96-0211, 97-1061R, 98-2080R</p><p>decision_date: Thu, 18 Nov 2004 12:00:00 -0500</p><p>decision_number: 2005D03</p><p>fiscal_year_end: 12/31/92,12/1/93, 12/31/94</p><p>provider_number: 26-0015</p><p>summary: Was the Provider entitled to an exemption from the skilled nursing facility routine cost limits for the years ended December 31, 1992, December 31, 1993, and December 31, 1994?</p>]]></description></item><item><title>2004D05</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d05</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d05</guid><description><![CDATA[<p>case_name: Chippewa Dialysis Services, Sault St. Marie, MI</p><p>case_numbers: 01-0741</p><p>decision_date: Mon, 22 Dec 2003 12:00:00 -0500</p><p>decision_number: 2004D05</p><p>fiscal_year_end: N/A</p><p>provider_number: 23-2557</p><p>summary: Did the Centers for Medicare and Medicaid Services ("CMS") correctly deny Chippewa Dialysis Services' request for an exception to the end stage renal disease ("ESRD") composite rate?</p>]]></description></item><item><title>2004D08</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d08</guid><description><![CDATA[<p>case_name: Heritage Health Care, Inc. d/b/a/ Hertiage Villa Nursing Center</p><p>case_numbers: 03-0666</p><p>decision_date: Fri, 30 Jan 2004 12:00:00 -0500</p><p>decision_number: 2004D08</p><p>fiscal_year_end: 06/30/1999</p><p>provider_number: 37-5109</p><p>summary: Does the Board have jurisdiction over the recoupment of overpayments appealed from a letter from the Centers for Medicare and Medicaid Services?</p>]]></description></item><item><title>2005D32</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d32</guid><description><![CDATA[<p>case_name: CentraState Medical Center</p><p>case_numbers: 94-3299, 96-0845, 98-2163</p><p>decision_date: Mon, 11 Apr 2005 12:00:00 -0400</p><p>decision_number: 2005D32</p><p>fiscal_year_end: 12/31/92, 12/31/93, 12/31/95</p><p>provider_number: 31-0111</p><p>summary: Whether the Intermediary failed to properly classify certain projects as old capital.</p>]]></description></item><item><title>2004D13</title><pubDate>Mon, 04 Nov 2019 02:23:39 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d13</guid><description><![CDATA[<p>case_name: Hunterdon/Somerset 2001 Wage Index Group</p><p>case_numbers: 01-0881GE</p><p>decision_date: Wed, 14 Apr 2004 12:00:00 -0400</p><p>decision_number: 2004D13</p><p>fiscal_year_end: 2001</p><p>provider_number: Various</p><p>summary: This case arises from Hunterdon Medical Center's and Somerset Medical Center's (Providers') dissatisfaction with having a closed hospital's wage data included in the Providers' Metropolitan Statistical Area (MSA) wage index and the exclusion from the wage index data of providers that have been reclassified by the Medicare Geographic Classification Review Board (MGCRB). The question addressed by the decision is whether expedited judicial review (EJR) is appropriate because the Board cannot grant the remedy sought by the Providers: a change to the Secretary's policies used to calculate wage indices.</p>]]></description></item><item><title>2000D20</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d20</guid><description><![CDATA[<p>case_name: Burke Rehabilitation Hospital, Inc., White Plains, NY</p><p>case_numbers: 94-2879</p><p>decision_date: Wed, 23 Feb 2000 12:00:00 -0500</p><p>decision_number: 2000D20</p><p>fiscal_year_end: 12/31/1991</p><p>provider_number: 33-3028</p><p>summary: Was HCFA's partial denial of the Provider's request for a TEFRA target rate adjustment proper?</p>]]></description></item><item><title>2002D48</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d48</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d48</guid><description><![CDATA[<p>case_name: Milton Hospital Transitional Care Unit, Milton, MA</p><p>case_numbers: 96-2035, 96-2036, 96-2037; 96-2038</p><p>decision_date: Mon, 30 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D48</p><p>fiscal_year_end: 09/30/1995 - 09/30/1998</p><p>provider_number: 22-5673</p><p>summary: Did the Centers for Medicare and Medicaid Services ("CMS") properly deny Milton Hospital Transitional Care Unit's request for an exemption from the Medicare skilled nursing facility routine service cost limits ("SNF RCLs") as a new provider under 42 C.F.R. Section 413.30(e)?</p>]]></description></item><item><title>2000D16</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d16</guid><description><![CDATA[<p>case_name: California Health Professionals, Inc., Chico, CA</p><p>case_numbers: 97-0080</p><p>decision_date: Mon, 07 Feb 2000 12:00:00 -0500</p><p>decision_number: 2000D16</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 05-7299</p><p>summary: 1. Was the Intermediary's adjustment to reclassify supplies' salaries to the administrative and general cost center proper?; 2. Was the Intermediary's adjustment to disallow costs paid to a related organization proper?; 3. Was the Intermediary's adjustment to allocate cost shared with the related company using the pooled cost method proper?</p>]]></description></item><item><title>2002D38</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d38</guid><description><![CDATA[<p>case_name: Select Home Health, Denver, CO</p><p>case_numbers: 98-1171</p><p>decision_date: Tue, 17 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D38</p><p>fiscal_year_end: 11/30/1995</p><p>provider_number: 06-7239</p><p>summary: Was the Intermediary's determination of legal fees proper?</p>]]></description></item><item><title>2002D34</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d34</guid><description><![CDATA[<p>case_name: Medical Center of Garden Grove, Garden Grove, CA</p><p>case_numbers: 89-1181R</p><p>decision_date: Wed, 21 Aug 2002 12:00:00 -0400</p><p>decision_number: 2002D34</p><p>fiscal_year_end: 02/28/1981 thru 2/28/1983</p><p>provider_number: 05-0230</p><p>summary: 1. Did CMS invalidly apply pre-composite rate ESRD Screens to limit the Provider's reimbursement for the reasonable costs it incurred for the treatment of ESRD patients?; 2. Whether and to what extent the Provider is entitled to an exception from the $138 per treatment ESRD screens for fiscal years 2/28/81, 2/28/82, and 2/28/83.</p>]]></description></item><item><title>2001D12</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d12</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d12</guid><description><![CDATA[<p>case_name: High Tech Home Health, Inc., Palm Beach Gardens, FL</p><p>case_numbers: 97-0744; 99-0318</p><p>decision_date: Wed, 21 Feb 2001 12:00:00 -0500</p><p>decision_number: 2001D12</p><p>fiscal_year_end: 12/31/1994; 12/31/1995</p><p>provider_number: 10-7281</p><p>summary: FY 1994 - 1. Was the Intermediary's adjustment to administrative and general for the intake coordinator's salaries proper?; 2. Was the Intermediary's adjustment to administrative and general staff expenses proper?; 3. Administratively resolved and withdrawn at hearing.; FY 1995 - 1. Same as No. 1 for FY 1994.; 2. Issue administratively resolved and withdrawn at hearing.; 3. Was the Intermediary's adjustment removing expenses from the cost report that were not actually incurred proper? (Parties relied upon materials in the record.)</p>]]></description></item><item><title>2002D49</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d49</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d49</guid><description><![CDATA[<p>case_name: St. Elizabeth's Medical Center, Boston, MA</p><p>case_numbers: 98-0489</p><p>decision_date: Mon, 30 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D49</p><p>fiscal_year_end: 09/30/1997</p><p>provider_number: 22-0036</p><p>summary: Was the Intermediary's adjustment (denial) of the transitional care unit new provider exemption proper?</p>]]></description></item><item><title>2002D50</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d50</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d50</guid><description><![CDATA[<p>case_name: Providence Hospital-Centralia SNF, Centralia, WA</p><p>case_numbers: 96-1033</p><p>decision_date: Mon, 30 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D50</p><p>fiscal_year_end: 12/31/1991</p><p>provider_number: 50-5025</p><p>summary: Was the decision of the Health Care Financing Administration ("HCFA"), pursuant to its Provider Reimbursement Manual ("PRM") Section 2534.5, to refuse to grant an exception for that portion of the Provider's per diem costs which exceed the Routine Cost Limit, but which do not exceed 112% of the total peer group mean cost, arbitrary, capricious, an abuse of discretion or not in accordance with law?</p>]]></description></item><item><title>2002D39</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d39</guid><description><![CDATA[<p>case_name: Jefferson Hills Manor, Pittsburgh, PA</p><p>case_numbers: 97-0403</p><p>decision_date: Wed, 18 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D39</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 39-5066</p><p>summary: Was the Intermediary's adjustment to Medicare patient days proper?</p>]]></description></item><item><title>2002D46</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d46</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d46</guid><description><![CDATA[<p>case_name: Alameda Hospital - SNF, Alameda, CA</p><p>case_numbers: 98-0460</p><p>decision_date: Fri, 27 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D46</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 05-0211</p><p>summary: 1.(A) - Did the Intermediary properly apply the low occupancy adjustment in Centers for Medicare and Medicaid Services ("CMS" formerly called the Health Care Financing Administration ("HCFA")) Transmittal No. 378, Section 2534.5.A?; 1.(B) - Was CMS' refusal to grant an exception for that portion of the Provider's per diem costs which do not exceed 112 percent of the total peer group mean cost proper? - on the record; 2. - Was the Intermediary's adjustment eliminating the community education director's salary proper? - on the record.</p>]]></description></item><item><title>2002D47</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d47</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d47</guid><description><![CDATA[<p>case_name: Schoolcraft Memorial Hospital, Manistique, MI</p><p>case_numbers: 00-3139; 01-2861</p><p>decision_date: Fri, 27 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D47</p><p>fiscal_year_end: 12/31/1992; 12/31/1994</p><p>provider_number: 23-0115</p><p>summary: Was the Intermediary's denial of the Provider's request for additional payment for decreased discharges proper?</p>]]></description></item><item><title>2001D55</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d55</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2001d55</guid><description><![CDATA[<p>case_name: Mercy Catholic Medical Center, Philadelphia, PA</p><p>case_numbers: 91-2902M &#x26; 95-1677</p><p>decision_date: Fri, 28 Sep 2001 12:00:00 -0400</p><p>decision_number: 2001D55</p><p>fiscal_year_end: Various</p><p>provider_number: 39-0156</p><p>summary: 1. Was the Intermediary's failure to recognize and reclassify certain operating costs as graduate medical education ("GME") proper?; 2. Was the Intermediary's failure to add misclassified operating costs to the Provider's Prospective Payment System ("PPS") hospital specific rate ("HSR") and TEFRA target amount ("TA") proper?</p>]]></description></item><item><title>2000D02</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d02</guid><description><![CDATA[<p>case_name: Methodist Hospital of Lexington, Lexington, TN</p><p>case_numbers: 96-1218</p><p>decision_date: Thu, 14 Oct 1999 12:00:00 -0400</p><p>decision_number: 2000D02</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 44-0008</p><p>summary: Was the Intermediary's reclassification of home health agency costs proper?</p>]]></description></item><item><title>2000D15</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d15</guid><description><![CDATA[<p>case_name: Medical Center of Orlando, Orlando, FL</p><p>case_numbers: 94-1517</p><p>decision_date: Mon, 07 Feb 2000 12:00:00 -0500</p><p>decision_number: 2000D15</p><p>fiscal_year_end: 09/10/1991</p><p>provider_number: 10-0129</p><p>summary: Does the recapture of depreciation due to the gain on the sale of depreciable assets have any effect on the Provider's equity capital for prior years?</p>]]></description></item><item><title>2000D18</title><pubDate>Mon, 04 Nov 2019 02:23:38 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2000d18</guid><description><![CDATA[<p>case_name: Lamb Healthcare Center, Littlefield, TX</p><p>case_numbers: 94-1750</p><p>decision_date: Thu, 10 Feb 2000 12:00:00 -0500</p><p>decision_number: 2000D18</p><p>fiscal_year_end: 07/31/1991</p><p>provider_number: 45-0698</p><p>summary: Did the Intermediary properly disallow the Provider's claim of an allowable loss on the sale of assets through a transaction that transferred ownership of all hospital assets and liabilities from Lamb County Hospital Authority to Lamb County, Texas?</p>]]></description></item><item><title>2002D35</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d35</guid><description><![CDATA[<p>case_name: Metro Physical Therapy and Rehabilitation, Inc., Taylor, MI</p><p>case_numbers: 00-3147; 00-3150</p><p>decision_date: Wed, 28 Aug 2002 12:00:00 -0400</p><p>decision_number: 2002D35</p><p>fiscal_year_end: 12/31/1996; 12/31/1997</p><p>provider_number: 23-6554</p><p>summary: Did the Intermediary properly adjust the provider's bad debt expense?</p>]]></description></item><item><title>2004D04</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d04</guid><description><![CDATA[<p>case_name: ProActive Home Care, Inc., Wichita, KS</p><p>case_numbers: 00-2255; 01-2782</p><p>decision_date: Tue, 25 Nov 2003 12:00:00 -0500</p><p>decision_number: 2004D04</p><p>fiscal_year_end: 12/31/97; 12/31/98</p><p>provider_number: 17-8012</p><p>summary: Whether the Intermediary's adjustment to include private duty nursing costs on the Medicare cost report was correct?</p>]]></description></item><item><title>2002D42</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d42</guid><description><![CDATA[<p>case_name: Healdton Nursing Home, Healdton, OK</p><p>case_numbers: 99-0417</p><p>decision_date: Thu, 19 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D42</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 37-5262</p><p>summary: Was the Intermediary's methodology used in settling a low utilization cost report proper?</p>]]></description></item><item><title>2003D56</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d56</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d56</guid><description><![CDATA[<p>case_name: Hospital San Francisco, Inc., Rio Piedras, PR</p><p>case_numbers: 99-3820</p><p>decision_date: Fri, 12 Sep 2003 12:00:00 -0400</p><p>decision_number: 2003D56</p><p>fiscal_year_end: 12/31/1989</p><p>provider_number: 40-0098</p><p>summary: 1. Was the Intermediary's adjustment to interest expense proper?; 2. Was the Intermediary's adjustment to deferred organizational cost proper?</p>]]></description></item><item><title>2002D19</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d19</guid><description><![CDATA[<p>case_name: Bonner General Hospital, Sandpoint, Idaho</p><p>case_numbers: 99-0233</p><p>decision_date: Thu, 16 May 2002 12:00:00 -0400</p><p>decision_number: 2002D19</p><p>fiscal_year_end: 08/31/1996</p><p>provider_number: 13-0024</p><p>summary: Was the Intermediary's adjustment to emergency room ("ER") physicians' availability costs proper?</p>]]></description></item><item><title>2003D64</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d64</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d64</guid><description><![CDATA[<p>case_name: St.Joseph Medical Center, Wichita, KS</p><p>case_numbers: 98-2851</p><p>decision_date: Mon, 29 Sep 2003 12:00:00 -0400</p><p>decision_number: 2003D64</p><p>fiscal_year_end: 09/30/1995</p><p>provider_number: 17-0087</p><p>summary: Was the Intermediary's determination of loss on consolidation proper?</p>]]></description></item><item><title>2002D18</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d18</guid><description><![CDATA[<p>case_name: Home Health Services of Metro Denver, Inc., Denver, CO</p><p>case_numbers: 96-1254; 96-1443</p><p>decision_date: Wed, 17 Apr 2002 12:00:00 -0400</p><p>decision_number: 2002D18</p><p>fiscal_year_end: 09/30/1993; 05/09/1994</p><p>provider_number: 06-7032</p><p>summary: 1. Was the Intermediary's disallowance of administrative salaries proper? (For Cost Reporting Period Ended September 30, 1993 - Case No. 96-1254); 2. Was the Intermediary's disallowance of legal fees proper? (For Cost Reporting Period Ended May 9, 1994 - Case No. 96-1443)</p>]]></description></item><item><title>2002D36</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d36</guid><description><![CDATA[<p>case_name: Home Comp Care, Inc., Matteson, IL</p><p>case_numbers: 97-1761</p><p>decision_date: Wed, 28 Aug 2002 12:00:00 -0400</p><p>decision_number: 2002D36</p><p>fiscal_year_end: 04/30/1995</p><p>provider_number: 14-7525</p><p>summary: 1. Were the Intermediary's adjustments to disallow patient advocate/community relations costs proper?; 2. Was the Intermediary's elimination of accrued expenses proper?; 3. Was the Intermediary's disallowance of pension costs proper?; 4. Was the Intermediary's treatment of executive compensation reasonable?</p>]]></description></item><item><title>2002D33</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d33</guid><description><![CDATA[<p>case_name: Mayo Clinic Indirect Medical Ed. Cost 86 Group</p><p>case_numbers: 91-0550G</p><p>decision_date: Fri, 09 Aug 2002 12:00:00 -0400</p><p>decision_number: 2002D33</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Was the Intermediary's adjustment to Indirect Medical Education costs proper?</p>]]></description></item><item><title>2002D45</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d45</guid><description><![CDATA[<p>case_name: Peninsula Regional Medical Center, Salisbury, MD;</p><p>case_numbers: 97-2659</p><p>decision_date: Fri, 27 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D45</p><p>fiscal_year_end: 06/30/1997</p><p>provider_number: 21-5302</p><p>summary: Did the Provider meet the regulatory requirements for approval of the new provider exemption?</p>]]></description></item><item><title>2003D63</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d63</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d63</guid><description><![CDATA[<p>case_name: Forestville Health &#x26; Rehabilitaion Center; CT Subacute 96 Diallowance of Rental Expense Group; Subac</p><p>case_numbers: 99-2054, 99-2307G; 01-0337</p><p>decision_date: Mon, 29 Sep 2003 12:00:00 -0400</p><p>decision_number: 2003D63</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Case No. 99-2054- 1. Was the Intermediary's adjustment disallowing capital related expenditures proper?; 2. Was the Intermediary's adjustment disallowing interest expense proper?; Case No. 99-2307G- 1. Was the Intermediary's adjustment disallowing rental expense proper?; Case No. 01-0337- 1.Was the Intermediary's adjustment disallowing rent expense proper?; 2. Was the Intermediary's adjustment disallowing capital related expenditures proper?; 3. Was the Intermediary's adjustment disallowing interest expense proper?</p>]]></description></item><item><title>2002D31</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d31</guid><description><![CDATA[<p>case_name: Mercy Medical Skilled Nursing Facility, Mobile, AL</p><p>case_numbers: 97-0135</p><p>decision_date: Wed, 07 Aug 2002 12:00:00 -0400</p><p>decision_number: 2002D31</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 01-5426</p><p>summary: Was the Centers for Medicare &#x26; Medicaid Services' (Formerly the Health Care Financing Administration) denial of a new provider exemption proper?</p>]]></description></item><item><title>2002D44</title><pubDate>Mon, 04 Nov 2019 02:23:37 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d44</guid><description><![CDATA[<p>case_name: Maine Medical Center, Portland, ME</p><p>case_numbers: 97-3201</p><p>decision_date: Thu, 26 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D44</p><p>fiscal_year_end: 09/30/1992</p><p>provider_number: 20-0009</p><p>summary: Was it proper for the Intermediary to deny the Provider's TEFRA exception request for untimely filing?</p>]]></description></item><item><title>2003D51</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d51</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d51</guid><description><![CDATA[<p>case_name: Pleasant Care Corporation- Restorative Nursing Aid Group</p><p>case_numbers: 01-3608G</p><p>decision_date: Wed, 27 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D51</p><p>fiscal_year_end: N/A</p><p>provider_number: Various</p><p>summary: Was the Intermediary's adjustment to restorative nurses aides proper?</p>]]></description></item><item><title>2002D40</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d40</guid><description><![CDATA[<p>case_name: Northwood Nursing &#x26; Convalescent Home, Inc., Philadelphia, PA</p><p>case_numbers: 96-2090R</p><p>decision_date: Wed, 18 Sep 2002 12:00:00 -0400</p><p>decision_number: 2002D40</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 39-5863</p><p>summary: Whether the Provider is entitled to reimbursement as ancillary services, certain nursing service costs for monitoring the functional operation of air-fluidized beds (AFBs) for the care of Medicare patients with stage IV pressure ulcers/decubitus ulcers?</p>]]></description></item><item><title>2002D30</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d30</guid><description><![CDATA[<p>case_name: Mark Twain St. Joseph's Hospital, San Andreas, CA</p><p>case_numbers: 95-1515, 95-2428, 99-3520, 99-3125</p><p>decision_date: Fri, 02 Aug 2002 12:00:00 -0400</p><p>decision_number: 2002D30</p><p>fiscal_year_end: 12/31/1992 thru 12/31/1995</p><p>provider_number: 05-0366</p><p>summary: Was the Intermediary's reopening in accordance with Medicare regulations, and did the Intermediary use the proper hospital-specific rate in determining the Provider's reimbursement?</p>]]></description></item><item><title>2003D61</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d61</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d61</guid><description><![CDATA[<p>case_name: Iron County Community Hospital</p><p>case_numbers: 01-0627</p><p>decision_date: Thu, 25 Sep 2003 12:00:00 -0400</p><p>decision_number: 2003D61</p><p>fiscal_year_end: 08/28/2000</p><p>provider_number: 23-3519</p><p>summary: Was HCFA's (the Center for Medicare &#x26; Medicaid Services') determination concerning the exception request under the prospective payment system proper?</p>]]></description></item><item><title>2002D32</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2002d32</guid><description><![CDATA[<p>case_name: VNA Gregoria Auffant 94-97 Deferred Comp Group</p><p>case_numbers: 00-3418G</p><p>decision_date: Fri, 09 Aug 2002 12:00:00 -0400</p><p>decision_number: 2002D32</p><p>fiscal_year_end: 06/30/1994 thru 06/30/1997</p><p>provider_number: Various</p><p>summary: Was the Intermediary's adjustment to the non-qualified deferred compensation plan proper?</p>]]></description></item><item><title>2003D57</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d57</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d57</guid><description><![CDATA[<p>case_name: Hospital San Francisco, Inc., Rio Piedras, PR</p><p>case_numbers: 99-3821</p><p>decision_date: Fri, 12 Sep 2003 12:00:00 -0400</p><p>decision_number: 2003D57</p><p>fiscal_year_end: 09/30/1996</p><p>provider_number: 40-0098</p><p>summary: Was the Intermediary's adjustment to bad debts proper?</p>]]></description></item><item><title>2004D03</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d03</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d03</guid><description><![CDATA[<p>case_name: Tri-County Home Health Care and Services, Inc.; Columbia, SC</p><p>case_numbers: 99-3323</p><p>decision_date: Fri, 21 Nov 2003 12:00:00 -0500</p><p>decision_number: 2004D03</p><p>fiscal_year_end: 09/30/1996</p><p>provider_number: 42-7010</p><p>summary: 1. Was the Intermediary's adjustment to Board of Directors fees proper?; 2. Was the Intermediary's adjustment to legal and professional fees proper?; 3. Was the Intermediary's adjustment to key employee compensation proper?; 4. Was the Intermediary's adjustment to routine and non-routine supply costs proper?</p>]]></description></item><item><title>2003D58</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d58</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d58</guid><description><![CDATA[<p>case_name: Hospital Auxilio Mutuo, Hato Rey, PR</p><p>case_numbers: 95-0590</p><p>decision_date: Wed, 24 Sep 2003 12:00:00 -0400</p><p>decision_number: 2003D58</p><p>fiscal_year_end: N/A</p><p>provider_number: 40-0016</p><p>summary: Was the Center for Medicare &#x26; Medicaid Services' denial of the Provider's exception request proper?</p>]]></description></item><item><title>2003D54</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d54</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d54</guid><description><![CDATA[<p>case_name: Pleasant Care- San Joaquin, Bakersfield, CA</p><p>case_numbers: 01-2453</p><p>decision_date: Thu, 28 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D54</p><p>fiscal_year_end: 03/31/1999</p><p>provider_number: 05-6323</p><p>summary: Was the Intermediary's adjustment reclassifying Medical Director cost proper?</p>]]></description></item><item><title>2003D65</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d65</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d65</guid><description><![CDATA[<p>case_name: Tenet Healthcare Corporation Group Appeals/ Application of the Lower of Cost or Charges Limit</p><p>case_numbers: 95-2104G, 95-1244G; 96-2516G</p><p>decision_date: Tue, 30 Sep 2003 12:00:00 -0400</p><p>decision_number: 2003D65</p><p>fiscal_year_end: 05/31/1992-05/31/1994</p><p>provider_number: Various</p><p>summary: Whether the Intermediary correctly applied the Medicare lower of cost or charges limit in determining payments to the Providers?</p>]]></description></item><item><title>2003D52</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d52</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d52</guid><description><![CDATA[<p>summary: Were the Intermediary's adjustments reclassifying the Medical Director cost proper?</p>]]></description></item><item><title>2003D55</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d55</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d55</guid><description><![CDATA[<p>case_name: Pleasant Care- Parkview, Bakersfield, CA</p><p>case_numbers: 01-2262</p><p>decision_date: Thu, 28 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D55</p><p>fiscal_year_end: 03/31/1999</p><p>provider_number: 55-5336</p><p>summary: 1. Was the Intermediary's adjustment to advertising costs proper?; 2. Was the Intermediary's adjustments reclassifying Medical Director cost proper?</p>]]></description></item><item><title>2005D18</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d18</guid><description><![CDATA[<p>case_name: Liberty Village, Muncie, IN</p><p>case_numbers: 98-2318</p><p>decision_date: Thu, 06 Jan 2005 12:00:00 -0500</p><p>decision_number: 2005D18</p><p>fiscal_year_end: 12/31/95</p><p>provider_number: 15-5400</p><p>summary: 1. Was the Intermediary's adjustment to National Premier Financial Services, Inc., and NPF VI, Inc. Costs/Program Fees was proper?; 2. Was the Intermediary's failure to allow $18,215 of related party depreciation was proper?; 3. Was the Intermediary's adjustment to decrease total respiratory therapy hours worked, unduplicated days, the cost of respiratory therapy services from outside providers, and $5,661 of related respiratory therapy expense was proper?</p>]]></description></item><item><title>2003D62</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d62</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d62</guid><description><![CDATA[<p>case_name: Jeanes Hospital, Philadelphia, PA</p><p>case_numbers: 99-0584</p><p>decision_date: Fri, 26 Sep 2003 12:00:00 -0400</p><p>decision_number: 2003D62</p><p>fiscal_year_end: 06/30/1996</p><p>provider_number: 39-0080</p><p>summary: Was the Intermediary's determination of loss on sale of assets proper?</p>]]></description></item><item><title>2003D59</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d59</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d59</guid><description><![CDATA[<p>case_name: Hospital Dr. Pedro J. Zamora, PR</p><p>case_numbers: 00-1344</p><p>decision_date: Wed, 24 Sep 2003 12:00:00 -0400</p><p>decision_number: 2003D59</p><p>fiscal_year_end: 06/30/1997</p><p>provider_number: 40-0079</p><p>summary: Was the Intermediary's adjustment to the disproportionate share, (DSH) computation proper?</p>]]></description></item><item><title>2003D60</title><pubDate>Mon, 04 Nov 2019 02:23:36 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d60</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d60</guid><description><![CDATA[<p>case_name: West Valley Home Health, Inc., West Valley, UT</p><p>case_numbers: 00-0064</p><p>decision_date: Wed, 24 Sep 2003 12:00:00 -0400</p><p>decision_number: 2003D60</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: 46-7051</p><p>summary: 1. Was the Intermediary's adjustment to home office costs proper?; 2. Was the Intermediary's adjustment disallowing a portion of the auto allowance proper?; 3. Was the Intermediary's adjustment to travel and lodging costs proper?</p>]]></description></item><item><title>2003D35</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d35</guid><description><![CDATA[<p>case_name: Meridian Hospitals Corporation- Group Appeal</p><p>case_numbers: 99-2241G</p><p>decision_date: Wed, 02 Jul 2003 12:00:00 -0400</p><p>decision_number: 2003D35</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: Various</p><p>summary: Were the Intermediary's adjustment disallowing the Providers' claimed losses on disposal of assets due to a change of ownership proper?</p>]]></description></item><item><title>2003D36</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d36</guid><description><![CDATA[<p>case_name: Castle Medical Center, Kailua, HI</p><p>case_numbers: 98-1973</p><p>decision_date: Wed, 16 Jul 2003 12:00:00 -0400</p><p>decision_number: 2003D36</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 12-0006</p><p>summary: Were the Intermediary's adjustment disproportionate share hospital payments proper?</p>]]></description></item><item><title>2003D43</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d43</guid><description><![CDATA[<p>case_name: Helen Ellis Memorial Hospital, Tarpon Springs, FL</p><p>case_numbers: 97-3008</p><p>decision_date: Thu, 07 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D43</p><p>fiscal_year_end: 09/30/1995</p><p>provider_number: 10-0055</p><p>summary: Was the Intermediary's determination of obligated capital proper?</p>]]></description></item><item><title>2003D32</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d32</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d32</guid><description><![CDATA[<p>case_name: Texacare,Inc., Duncanville, TX</p><p>case_numbers: 98-1282</p><p>decision_date: Thu, 12 Jun 2003 12:00:00 -0400</p><p>decision_number: 2003D32</p><p>fiscal_year_end: 09/30/1995</p><p>provider_number: 67-7181</p><p>summary: Was the Intermediary's Audit Adjustment #2 which disallowed $108,875 of Administrative and General Costs proper?</p>]]></description></item><item><title>2003D30</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d30</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d30</guid><description><![CDATA[<p>case_name: Patient Care Medical Services, Inc., Essex County, NJ</p><p>case_numbers: 01-1525</p><p>decision_date: Wed, 14 May 2003 12:00:00 -0400</p><p>decision_number: 2003D30</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 31-7060</p><p>summary: Was the Intermediary's adjustment to the Per Beneficiary Limit (PBL) calculation proper?</p>]]></description></item><item><title>2003D40</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d40</guid><description><![CDATA[<p>case_name: Citrus Health and Rehabilitation Center, Inverness, FL</p><p>case_numbers: 01-2787</p><p>decision_date: Tue, 29 Jul 2003 12:00:00 -0400</p><p>decision_number: 2003D40</p><p>fiscal_year_end: 05/31/1996-05/31/1998</p><p>provider_number: 10-5858</p><p>summary: Did the Centers for Medicare and Medicaid Services ("CMS") properly deny the Provider's request for an exemption from the Medicare skilled nursing facility routine service cost limits ("SNF RCLs") as a new provider under 42 C.F.R. Section 413.30(e) based on CMS' determination that the exemption request was not timely filed for cost reporting periods ended May 31, 1996, 1997 and 1998?</p>]]></description></item><item><title>2003D46</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d46</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d46</guid><description><![CDATA[<p>case_name: Pioneer Home Health, Bishop, CA</p><p>case_numbers: 00-1172</p><p>decision_date: Thu, 21 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D46</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 55-7008</p><p>summary: Whether the Provider is entitled to an exception to the visit cost limits in accordance with Medicare regulations?</p>]]></description></item><item><title>2003D19</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d19</guid><description><![CDATA[<p>case_name: Devon Gables Health Care Center, Tucson, AZ</p><p>case_numbers: 99-0646</p><p>decision_date: Wed, 19 Mar 2003 12:00:00 -0500</p><p>decision_number: 2003D19</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 03-5145</p><p>summary: Whether the Intermediary properly calculated the Provider's Medicare bad debts?</p>]]></description></item><item><title>2003D37</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d37</guid><description><![CDATA[<p>case_name: New Hanover Regional Medical Center &#x26; Psychiatric Unit, Wilmington, NC</p><p>case_numbers: 94-2728</p><p>decision_date: Thu, 17 Jul 2003 12:00:00 -0400</p><p>decision_number: 2003D37</p><p>fiscal_year_end: 09/30/1991</p><p>provider_number: 34-0141; 34-S141</p><p>summary: Whether the Intermediary and HCFA properly determined that the Provider's request for an adjustment to the TEFRA limits was untimely?</p>]]></description></item><item><title>2003D27</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d27</guid><description><![CDATA[<p>case_name: Home Town Health Care, Colonial Heights, VA</p><p>case_numbers: 00-2949</p><p>decision_date: Fri, 02 May 2003 12:00:00 -0400</p><p>decision_number: 2003D27</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: 49-7259</p><p>summary: 1. Whether the Intermediary's adjustment to disallow advertising cost was proper.; 2. Whether the Intermediary's adjustment to include Heaven Sent Nursing Services as a non-reimbursable cost center was proper.; 3. Whether the Intermediary's adjustment to reclassify the Community Education Coordinator's salary to a non-reimbursable cost center was proper.; 4. Whether the Intermediary's adjustment to remove the Administrator's excess compensation was proper.</p>]]></description></item><item><title>2003D21</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d21</guid><description><![CDATA[<p>case_name: AllCare Home Health, Denver, CO</p><p>case_numbers: 01-0153</p><p>decision_date: Fri, 21 Mar 2003 12:00:00 -0500</p><p>decision_number: 2003D21</p><p>fiscal_year_end: 05/31/1998</p><p>provider_number: 06-7201</p><p>summary: Was the Intermediary's adjustment to owner's compensation proper?</p>]]></description></item><item><title>2003D13</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d13</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d13</guid><description><![CDATA[<p>case_name: Extendicare Health Services</p><p>case_numbers: 96-0618G, 96-0619G; 96-0620G</p><p>decision_date: Tue, 28 Jan 2003 12:00:00 -0500</p><p>decision_number: 2003D13</p><p>fiscal_year_end: 12/31/1992-12/31/1994</p><p>provider_number: Various</p><p>summary: Whether the intermediary's refusal to accept the Provider's amended cost reports constituted a final determination appealable to the Board? [This Decision was Vacated.]</p>]]></description></item><item><title>2003D11</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d11</guid><description><![CDATA[<p>case_name: SNI Home Care, Inc., Langhorne, PA</p><p>case_numbers: 00-2451</p><p>decision_date: Fri, 20 Dec 2002 12:00:00 -0500</p><p>decision_number: 2003D11</p><p>fiscal_year_end: 10/31/1997</p><p>provider_number: 39-7279</p><p>summary: Were the Intermediary's adjustments to physical therapy costs proper?</p>]]></description></item><item><title>2003D17</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d17</guid><description><![CDATA[<p>case_name: Natividad Medical Center, Salinas, CA</p><p>case_numbers: 00-0544</p><p>decision_date: Thu, 06 Mar 2003 12:00:00 -0500</p><p>decision_number: 2003D17</p><p>fiscal_year_end: 06/30/1997</p><p>provider_number: 05-0248</p><p>summary: Was the Intermediary's adjustment to the residents count and Graduate Medical Education payments proper?</p>]]></description></item><item><title>2003D15</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d15</guid><description><![CDATA[<p>case_name: Long Island State Veterans Home, Stony Brook, NY</p><p>case_numbers: 96-1651</p><p>decision_date: Wed, 26 Feb 2003 12:00:00 -0500</p><p>decision_number: 2003D15</p><p>fiscal_year_end: 12/31/1993</p><p>provider_number: 33-5758</p><p>summary: Is it proper for the Intermediary to apply the lower of cost or charges (LCC) principle in calculating the Provider's reimbursement on the Medicare cost report Worksheet E, Part I?</p>]]></description></item><item><title>2003D41</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d41</guid><description><![CDATA[<p>case_name: Collins Health Center, Pittsburg, PA</p><p>case_numbers: 00-0346; 01-0210</p><p>decision_date: Fri, 01 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D41</p><p>fiscal_year_end: 12/31/1997; 12/31/1998</p><p>provider_number: 39-5789</p><p>summary: Was the Intermediary's adjustment to remove nursing administration statistics from the ancillary cost centers on worksheet B-1 proper?</p>]]></description></item><item><title>2003D42</title><pubDate>Mon, 04 Nov 2019 02:23:34 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d42</guid><description><![CDATA[<p>case_name: VNA of Rhode Island, Inc., Providence, RI</p><p>case_numbers: 02-1198</p><p>decision_date: Tue, 05 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D42</p><p>fiscal_year_end: 09/30/1997</p><p>provider_number: 41-7001</p><p>summary: Was the Intermediary's disallowance of the Provider's Spanish and Portuguese interpreter expenses proper?</p>]]></description></item><item><title>2003D22</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d22</guid><description><![CDATA[<p>case_name: Central Maine Medical Center, Lewiston, ME</p><p>case_numbers: 96-1531, 97-1417; 98-1063</p><p>decision_date: Thu, 24 Apr 2003 12:00:00 -0400</p><p>decision_number: 2003D22</p><p>fiscal_year_end: 06/30/93 thru 6/30/95</p><p>provider_number: 20-0024</p><p>summary: Is the Provider entitled to a TEFRA exception?</p>]]></description></item><item><title>2003D39</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d39</guid><description><![CDATA[<p>case_name: Hemet Valley Convalescent Hospital, Hemet, CA</p><p>case_numbers: 97-2608</p><p>decision_date: Fri, 18 Jul 2003 12:00:00 -0400</p><p>decision_number: 2003D39</p><p>fiscal_year_end: 12/31/1994</p><p>provider_number: 55-5405</p><p>summary: Was the Intermediary's denial of the Provider's SNF routine service cost limit exception request proper?</p>]]></description></item><item><title>2003D25</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d25</guid><description><![CDATA[<p>case_name: Southwestern Nursing Home and Rehabilitation Center, Pittsburgh, PA</p><p>case_numbers: 99-3866; 01-0764</p><p>decision_date: Thu, 01 May 2003 12:00:00 -0400</p><p>decision_number: 2003D25</p><p>fiscal_year_end: 12/31/1997; 12/31/1998</p><p>provider_number: 39-5742</p><p>summary: 1. Was the Intermediary's reclassification of Staff Development/ Quality Assurance Coordinator salaries proper?; 2. Was the Intermediary's adjustment allocating social service costs proper?</p>]]></description></item><item><title>2004D44</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d44</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d44</guid><description><![CDATA[<p>case_name: Wayne County General Hospital</p><p>case_numbers: 94-2187</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D44</p><p>fiscal_year_end: 08/13/1984</p><p>provider_number: 23-0098</p><p>summary: Whether the cost of terminating Provider's retirement benefits and retirees' health and life insurance benefits, which were allowed and approved by the Intermediary, should be allocated to prior cost reporting periods and reimbursed to the Provider as a below-the-line adjustment in its final cost report?</p>]]></description></item><item><title>2003D08</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d08</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d08</guid><description><![CDATA[<p>case_name: Blue Ridge Rehabilitation Center, Martinsville, VA</p><p>case_numbers: 00-3980</p><p>decision_date: Thu, 19 Dec 2002 12:00:00 -0500</p><p>decision_number: 2003D08</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 49-5281</p><p>summary: Was the Intermediary's adjustment disallowing the allocation of general service costs to the ancillary cost centers proper?</p>]]></description></item><item><title>2003D14</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d14</guid><description><![CDATA[<p>case_name: Ingham Regional Medical Center</p><p>case_numbers: 96-1951</p><p>decision_date: Thu, 30 Jan 2003 12:00:00 -0500</p><p>decision_number: 2003D14</p><p>fiscal_year_end: 12/31/1992</p><p>provider_number: 23-0167</p><p>summary: Whether the Board has jurisdiction over the calculation of the disproportionate share adjustment where the issue is added to the appeal of an original Notice of Program Reimbursement?</p>]]></description></item><item><title>2004D43</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d43</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d43</guid><description><![CDATA[<p>case_name: Ochsner Clinic-New Orleans Renal Dialysis Facility &#x26; Houma/Bayou Renal Dialysis Facility</p><p>case_numbers: 00-3936; 00-3937</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D43</p><p>fiscal_year_end: 12/31/1996</p><p>provider_number: 19-2531; 19-2509</p><p>summary: Whether the Intermediary correctly disallowed Medicare bad debts related to amounts not included in the End-Stage Renal Dialysis (ESRD) Composite rate?</p>]]></description></item><item><title>2003D24</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d24</guid><description><![CDATA[<p>case_name: Pleasant Care Corporation- California</p><p>case_numbers: 98-0362G, 99-2356; 01-0053</p><p>decision_date: Tue, 29 Apr 2003 12:00:00 -0400</p><p>decision_number: 2003D24</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Was the Intermediary's adjustment to deny the allocation of social service costs based on departmental gross charges proper?</p>]]></description></item><item><title>2003D31</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d31</guid><description><![CDATA[<p>case_name: University Hospital, Cincinnati, OH</p><p>case_numbers: 98-0507, 99-2398; 00-0946</p><p>decision_date: Thu, 15 May 2003 12:00:00 -0400</p><p>decision_number: 2003D31</p><p>fiscal_year_end: 06/30/1994-6/30/1996</p><p>provider_number: 36-0003</p><p>summary: 1. Was the Intermediary's reclassification of certain administrative costs from ambulatory serices area to the Administrative and General Cost Center proper? (Fiscal years 1994, 1995 and 1996); 2. Was the Intermediary's reclassification of clinic dieticians' salary costs to the Dietary Cost Center proper? (Fiscal years 1994 and 1995)</p>]]></description></item><item><title>2003D47</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d47</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d47</guid><description><![CDATA[<p>case_name: Phelps Memorial Hospital, Sleepy Hollow, NY</p><p>case_numbers: 98-2105, 98-2106;98-2107</p><p>decision_date: Fri, 22 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D47</p><p>fiscal_year_end: 12/31/1993-12/31/1995</p><p>provider_number: 33-0261</p><p>summary: Was the Intermediary's treatment of the Provider's increase in bed size of its exempt rehabilitation unit proper?</p>]]></description></item><item><title>2003D49</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d49</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d49</guid><description><![CDATA[<p>case_name: Iroquois Memorial Hospital, Watseka, IL</p><p>case_numbers: 02-1970</p><p>decision_date: Wed, 27 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D49</p><p>fiscal_year_end: N/A</p><p>provider_number: 14-0167</p><p>summary: Is the Provider entitled to status as a Medicare Dependent hospital ("MDH") for the period of October 1, 2001 through January 14, 2002?</p>]]></description></item><item><title>2003D33</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d33</guid><description><![CDATA[<p>case_name: Cardinal Hill Rehabilitation Hospital, Lexington, KY</p><p>case_numbers: 01-1779; 02-0270</p><p>decision_date: Thu, 12 Jun 2003 12:00:00 -0400</p><p>decision_number: 2003D33</p><p>fiscal_year_end: 08/31/1997; 08/31/1998</p><p>provider_number: 18-3026</p><p>summary: Was the all inclusive rate allocation Methodology proper?</p>]]></description></item><item><title>2004D37</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d37</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d37</guid><description><![CDATA[<p>case_name: Clark Regional Medical Center</p><p>case_numbers: 96-0720</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D37</p><p>fiscal_year_end: 06/30/1993</p><p>provider_number: 18-0092</p><p>summary: Whether non-acute care swing-bed days should be included in the Medicare proxy for the disproportionate share calculation ("DSH")?</p>]]></description></item><item><title>2004D19</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d19</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d19</guid><description><![CDATA[<p>case_name: Twining Village, Holland, PA</p><p>case_numbers: 99-0729; 01-0036</p><p>decision_date: Fri, 30 Apr 2004 12:00:00 -0400</p><p>decision_number: 2004D19</p><p>fiscal_year_end: 12/31/96; 12/31/98</p><p>provider_number: 39-5432</p><p>summary: Was it proper for the Intermediary to make an adjustment to remove the hours in the ancillary areas used to allocate nursing administration on Worksheet B-1 of the Medicare cost report?</p>]]></description></item><item><title>2003D26</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d26</guid><description><![CDATA[<p>case_name: LAC &#x26; USC Medical Center, Los Angeles, CA</p><p>case_numbers: 94-3266</p><p>decision_date: Fri, 02 May 2003 12:00:00 -0400</p><p>decision_number: 2003D26</p><p>fiscal_year_end: 06/30/1987</p><p>provider_number: 05-0373</p><p>summary: Did the Intermediary correctly reduce the number of full-time equivalent interns and residents in approved training programs for the purpose of calculating the Provider's graduate medical education adjustment? (Whether the Intermediary may change the bases for excluding residents from the count more than three years after the issuance of the revised Notice of Program Reimbursement.)</p>]]></description></item><item><title>2003D38</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d38</guid><description><![CDATA[<p>case_name: Starke Memorial Hospital, Knox, IN</p><p>case_numbers: 01-1637</p><p>decision_date: Thu, 17 Jul 2003 12:00:00 -0400</p><p>decision_number: 2003D38</p><p>fiscal_year_end: 03/31/1998</p><p>provider_number: 15-0102</p><p>summary: Was the Intermediary's adjustment to limit reimbursement to the lower of cost or charges for the Provider's distinct part psychiatric unit proper?</p>]]></description></item><item><title>2004D42</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d42</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d42</guid><description><![CDATA[<p>case_name: Mesa Vista Hospital, San Diego, CA</p><p>case_numbers: 01-2416</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D42</p><p>fiscal_year_end: 02/28/1998</p><p>provider_number: 05-4012</p><p>summary: Did the Intermediary properly eliminate the Provider's Medicare bad debts due to the Provider allowing discounts to only non-Medicare patients?</p>]]></description></item><item><title>2003D06</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d06</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d06</guid><description><![CDATA[<p>case_name: Cardinal Cushing Hospital &#x26; Goddard Memorial Hospital, Brockton, MA</p><p>case_numbers: 97-0061 &#x26; 97-0062</p><p>decision_date: Wed, 27 Nov 2002 12:00:00 -0500</p><p>decision_number: 2003D06</p><p>fiscal_year_end: 09/30/1994</p><p>provider_number: 22-0156; 22-0111</p><p>summary: Was there a recognizable loss upon the transfer of assets to Good Samaritan Medical Center ("Good Samaritan") from Goddard Memorial Hospital ("Goddard") and Cardinal Cushing Hospital ("Cushing") that occurred in connection with the consolidation of the two hospitals and the resulting creation of Good Samaritan Medical Center?</p>]]></description></item><item><title>2003D16</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d16</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d16</guid><description><![CDATA[<p>case_name: BBL 95-99 Observation Bed Days Grou</p><p>case_numbers: 02-0721G</p><p>decision_date: Thu, 06 Mar 2003 12:00:00 -0500</p><p>decision_number: 2003D16</p><p>fiscal_year_end: Various</p><p>provider_number: 50-0023, 44-0131; 45-0059</p><p>summary: Were the Intermediaries adjustments to exclude observation bed days from the providers' bed count in determining disproportionate share hospital ("DSH") eligibility and payments proper?</p>]]></description></item><item><title>2003D34</title><pubDate>Mon, 04 Nov 2019 02:23:33 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d34</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d34</guid><description><![CDATA[<p>case_name: AHS 96 Related Organization Costs- Group Appeal</p><p>case_numbers: 99-2427G</p><p>decision_date: Fri, 27 Jun 2003 12:00:00 -0400</p><p>decision_number: 2003D34</p><p>fiscal_year_end: 04/30/1996</p><p>provider_number: Various</p><p>summary: Were the Intermediary's adjustment disallowing the Providers' claimed losses on disposal of assets due to a change of ownership proper?</p>]]></description></item><item><title>2004D24</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d24</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d24</guid><description><![CDATA[<p>case_name: Visiting Nurses Association of North Central Indiana, Inc.</p><p>case_numbers: 98-0815</p><p>decision_date: Mon, 07 Jun 2004 12:00:00 -0400</p><p>decision_number: 2004D24</p><p>fiscal_year_end: 12/31/1995</p><p>provider_number: 15-7046</p><p>summary: Was the Intermediary's decision to deny the Provider's request for an exception to Medicare's salary equivalency guidelines for physical therapy services furnished under arrangement proper?</p>]]></description></item><item><title>2004D41</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d41</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d41</guid><description><![CDATA[<p>case_name: Empire 91-94 Medicaid Eligible Days Group, Spokane, WA</p><p>case_numbers: 98-3477G</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D41</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Was the Intermediary's determination of the disproportionate share hospital (DSH) computation relating to state-only General Assistance Days Proper?</p>]]></description></item><item><title>2003D18</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d18</guid><description><![CDATA[<p>case_name: Spalding Rehabilitation Hospital, Aurora, CO</p><p>case_numbers: 99-0321</p><p>decision_date: Fri, 07 Mar 2003 12:00:00 -0500</p><p>decision_number: 2003D18</p><p>fiscal_year_end: 10/31/1995</p><p>provider_number: 06-3027</p><p>summary: Did the Intermediary incorrectly determine that the Provider was not entitled to a new provider exemption from the application of the skilled nursing facility for its provider-based skilled nursing facility?</p>]]></description></item><item><title>2003D45</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d45</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d45</guid><description><![CDATA[<p>case_name: Angeles Home Health Care, Inc., Los Angeles, CA</p><p>case_numbers: 99-0722</p><p>decision_date: Thu, 21 Aug 2003 12:00:00 -0400</p><p>decision_number: 2003D45</p><p>fiscal_year_end: 07/31/1996</p><p>provider_number: 05-7252</p><p>summary: Whether the Intermediary's adjustment of Medicare visits to agree with Medicare's Provider Statistical and Reimbursement (PS&#x26;R)report were proper?</p>]]></description></item><item><title>2004D22</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d22</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d22</guid><description><![CDATA[<p>case_name: Chesnut Hill Hospital, Philadelphia, PA</p><p>case_numbers: 03-0063; 03-0064</p><p>decision_date: Thu, 06 May 2004 12:00:00 -0400</p><p>decision_number: 2004D22</p><p>fiscal_year_end: 06/30/1999; 06/30/2000</p><p>provider_number: 39-0026</p><p>summary: Were the Intermediary's adjustments disallowing direct graduate medical education (GME) and indirect medical education (IME) costs of the interns and residents full-time equivalent counts proper?</p>]]></description></item><item><title>2003D23</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d23</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d23</guid><description><![CDATA[<p>case_name: Edinburg Hospital, Edinburg, TX</p><p>case_numbers: 99-0160</p><p>decision_date: Tue, 29 Apr 2003 12:00:00 -0400</p><p>decision_number: 2003D23</p><p>fiscal_year_end: 09/30/1992</p><p>provider_number: 45-0119</p><p>summary: Was the Intermediary's determination of available beds for purposes of the disproportionate share payment calculation proper?</p>]]></description></item><item><title>2004D27</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d27</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d27</guid><description><![CDATA[<p>case_name: Baptist Memorial Medical Center</p><p>case_numbers: 95-2033R; 96-1979R; 97-1498R; 98-2049R</p><p>decision_date: Wed, 07 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D27</p><p>fiscal_year_end: 12/31/91-12/31/94</p><p>provider_number: 04-0036</p><p>summary: 1. Does the Provider meet the criteria set forth at Section 4004(b) of Omnibus Budget Reconciliation Act (OBRA) 1990?; 2. Do the costs at issue meet the definition of clinical training costs?</p>]]></description></item><item><title>2004D15</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d15</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d15</guid><description><![CDATA[<p>case_name: LAC &#x26; USC Medical Center, Los Angeles, CA</p><p>case_numbers: 97-2025</p><p>decision_date: Thu, 15 Apr 2004 12:00:00 -0400</p><p>decision_number: 2004D15</p><p>fiscal_year_end: 06/30/1994</p><p>provider_number: 05-0373</p><p>summary: Whether the Provider's budgeted beds are the most appropriate measure of available beds for proposes of computing the indirect medical education (IME) payment?</p>]]></description></item><item><title>2004D36</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d36</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d36</guid><description><![CDATA[<p>case_name: Germantown Hospital and Medical Center</p><p>case_numbers: 00-0386</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D36</p><p>fiscal_year_end: 08/31/1997</p><p>provider_number: 39-0088</p><p>summary: Was the Intermediary's denial of the Provider's loss on disposal of assets proper?</p>]]></description></item><item><title>2004D39</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d39</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d39</guid><description><![CDATA[<p>case_name: Angeles Home Health Care, Inc., Los Angeles, CA</p><p>case_numbers: 96-0591; 97-2042</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D39</p><p>fiscal_year_end: 07/31/94; 07/31/95</p><p>provider_number: 05-7252</p><p>summary: Should denied Medicare visits be included in the "total visits" count for purposes of apportioning costs to the Medicare program?</p>]]></description></item><item><title>2004D35</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d35</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d35</guid><description><![CDATA[<p>case_name: Harborside Healthcare- Indianapolis (formerly Stone Manor Convalescent Center), Indianapolis, IN</p><p>case_numbers: 96-0059; 96-0060</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D35</p><p>fiscal_year_end: 12/31/92; 12/31/93</p><p>provider_number: 15-5383</p><p>summary: Was the Provider entitled to an exemption from the routine cost limit as a "new" provider?</p>]]></description></item><item><title>2003D29</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d29</guid><description><![CDATA[<p>case_name: Standish Community Hospital, Standish, MI</p><p>case_numbers: 01-1866</p><p>decision_date: Wed, 14 May 2003 12:00:00 -0400</p><p>decision_number: 2003D29</p><p>fiscal_year_end: 09/30/1993</p><p>provider_number: 23-0205</p><p>summary: Was the Intermediary's adjustment to DRG (Diagnostic Related Group) payments proper?</p>]]></description></item><item><title>2004D29</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d29</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d29</guid><description><![CDATA[<p>case_name: Carney Hospital (Transitional Care Unit)</p><p>case_numbers: 96-2359; 01-0124</p><p>decision_date: Fri, 16 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D29</p><p>fiscal_year_end: 09/30/96; 09/30/97</p><p>provider_number: 22-5681</p><p>summary: Was the Intermediary's denial of the Provider's request for an exemption from Medicare's service cost limits proper?</p>]]></description></item><item><title>2004D40</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d40</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d40</guid><description><![CDATA[<p>case_name: Battle Creek Health System/ Mercy General Health partners</p><p>case_numbers: 02-0431; 02-0364</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D40</p><p>fiscal_year_end: 06/30/1999</p><p>provider_number: 23-0075; 23-0004</p><p>summary: 1. Was the Intermediary's adjustment to the Provider's TEFRA rate Proper?; 2. Did the Intermediary properly conclude that the Provider failed to make reasonable collection efforts and document such efforts with respect to certain bad debts claimed by the Provider?</p>]]></description></item><item><title>2004D25</title><pubDate>Mon, 04 Nov 2019 02:23:32 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d25</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d25</guid><description><![CDATA[<p>case_name: Tip of Illinois Health Services, Carterville, IL</p><p>case_numbers: 96-1496; 98-0237</p><p>decision_date: Thu, 10 Jun 2004 12:00:00 -0400</p><p>decision_number: 2004D25</p><p>fiscal_year_end: 12/31/1993; 12/31/1994</p><p>provider_number: 14-7135</p><p>summary: Was the Intermediary's adjustment disallowing Medicare reimbursement for a portion of the Provider's physical therapy costs due to its application of physical therapy compensation guidelines proper?</p>]]></description></item><item><title>2003D10</title><pubDate>Mon, 04 Nov 2019 02:23:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d10</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d10</guid><description><![CDATA[<p>case_name: Christ the King Manor, DuBois, PA</p><p>case_numbers: 00-3413</p><p>decision_date: Fri, 20 Dec 2002 12:00:00 -0500</p><p>decision_number: 2003D10</p><p>fiscal_year_end: 06/30/1998</p><p>provider_number: 39-5460</p><p>summary: 1. Was the Intermediary's reclassification of Staff Development Coordinator salaries proper?; 2. Was the Intermediary's reclassification of Social Services salaries proper?</p>]]></description></item><item><title>2005D26</title><pubDate>Mon, 04 Nov 2019 02:23:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d26</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d26</guid><description><![CDATA[<p>case_name: Rogue Valley Medical Center, Medford, OR</p><p>case_numbers: 97-2174</p><p>decision_date: Tue, 15 Mar 2005 12:00:00 -0500</p><p>decision_number: 2005D26</p><p>fiscal_year_end: 9/30/95, 9/30/96, 9/30/97...</p><p>provider_number: 38-0018</p><p>summary: 1. Does the Board have jurisdiction over a new provider exemption appeal filed within 180 days of exemption determination?; 2. Does the Board have jurisdiction over multiple fiscal years in a new provider exemption or must the Provider file an exemption request for each cost reporting period?; 3. Was the Health Care Financing Administration's (HCFA's)denial of the Provider's request for exemption as a new provider proper?</p>]]></description></item><item><title>2004D31</title><pubDate>Mon, 04 Nov 2019 02:23:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d31</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d31</guid><description><![CDATA[<p>case_name: Pocono Medical Home Care, Inc., East Stroudsburg, PA</p><p>case_numbers: 99-3760</p><p>decision_date: Fri, 16 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D31</p><p>fiscal_year_end: 12/31/1997</p><p>provider_number: 39-7628</p><p>summary: Was the Intermediary's adjustment applying Medicare's Physical Therapy Compensation Guidelines to the Provider's employee physical therapists proper?</p>]]></description></item><item><title>2003D02</title><pubDate>Mon, 04 Nov 2019 02:23:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d02</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d02</guid><description><![CDATA[<p>case_name: Central Texas Medical Center, San Marcos, TX</p><p>case_numbers: 99-3300</p><p>decision_date: Wed, 16 Oct 2002 12:00:00 -0400</p><p>decision_number: 2003D02</p><p>fiscal_year_end: 12/31/1991</p><p>provider_number: 45-0272</p><p>summary: Whether the Intermediary's disallowance of disproportionate share (DSH) payments to the Provider on the grounds that it did not have 100 or more available beds was proper?</p>]]></description></item><item><title>2004D33</title><pubDate>Mon, 04 Nov 2019 02:23:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d33</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d33</guid><description><![CDATA[<p>case_name: Genesis 96, 97 Proper Cost Category Group/ Genesis 98 Payroll tax/ Workers compensation Cost Group</p><p>case_numbers: 99-3663G; 00-2170G</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D33</p><p>fiscal_year_end: Various</p><p>provider_number: Various</p><p>summary: Should the provider's Federal Insurance Contributions Act (FICA) payroll costs be classified to the administrative and general cost center?</p>]]></description></item><item><title>2004D38</title><pubDate>Mon, 04 Nov 2019 02:23:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d38</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d38</guid><description><![CDATA[<p>case_name: Saint Clare's Hospital- Dover</p><p>case_numbers: 02-1971</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D38</p><p>fiscal_year_end: 09/30/1994</p><p>provider_number: 31-0067</p><p>summary: Was the intermediary's determination of loss on consolidation proper?</p>]]></description></item><item><title>2004D18</title><pubDate>Mon, 04 Nov 2019 02:23:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d18</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d18</guid><description><![CDATA[<p>case_name: Woodland Terrace Extended Care Center, Deland, FL</p><p>case_numbers: 01-1017</p><p>decision_date: Thu, 29 Apr 2004 12:00:00 -0400</p><p>decision_number: 2004D18</p><p>fiscal_year_end: 12/31/1998</p><p>provider_number: 10-5930</p><p>summary: Whether the Intermediary's adjustment reducing the adjusted hourly salary equivalency amount allowed for services of Physical Therapy Aides was proper?</p>]]></description></item><item><title>2003D04</title><pubDate>Mon, 04 Nov 2019 02:23:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d04</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2003d04</guid><description><![CDATA[<p>case_name: Maple Crest Care Center</p><p>case_numbers: 01-0320</p><p>decision_date: Thu, 07 Nov 2002 12:00:00 -0500</p><p>decision_number: 2003D04</p><p>fiscal_year_end: 08/31/1998</p><p>provider_number: 28-5149</p><p>summary: Whether the provider's appeal of bad debts was derived from an intermediary determination or adverse finding?</p>]]></description></item><item><title>2004D46</title><pubDate>Mon, 04 Nov 2019 02:23:31 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d46</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d46</guid><description><![CDATA[<p>case_name: Spectrum Home Care, Inc.</p><p>case_numbers: 01-1540; 01-2860; 02-1247</p><p>decision_date: Fri, 30 Jul 2004 12:00:00 -0400</p><p>decision_number: 2004D46</p><p>fiscal_year_end: 12/31/96; 12/31/98; 12/31/99</p><p>provider_number: 23-7251</p><p>summary: Was the Intermediary's adjustment to start-up costs proper?</p>]]></description></item><item><title>2004D11</title><pubDate>Mon, 04 Nov 2019 02:23:30 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d11</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d11</guid><description><![CDATA[<p>case_name: Incare Home Health, Inc., Myrtle Beach, SC</p><p>case_numbers: 99-3324</p><p>decision_date: Thu, 05 Feb 2004 12:00:00 -0500</p><p>decision_number: 2004D11</p><p>fiscal_year_end: 09/30/1996</p><p>provider_number: 42-7025</p><p>summary: 1. Was the intermediary's adjustment to Board of Directors fees proper?; 2. Was the intermediary's adjustment to routine and non-routine supply costs proper?</p>]]></description></item><item><title>2004D17</title><pubDate>Mon, 04 Nov 2019 02:23:30 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d17</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d17</guid><description><![CDATA[<p>case_name: Hatch Valley Home Health Agency, Salem, NM</p><p>case_numbers: 00-2285</p><p>decision_date: Thu, 29 Apr 2004 12:00:00 -0400</p><p>decision_number: 2004D17</p><p>fiscal_year_end: 04/30/1997</p><p>provider_number: 32-7125</p><p>summary: Was the Intermediary's adjustment to the Provider's cost limits proper?</p>]]></description></item><item><title>2004D14</title><pubDate>Mon, 04 Nov 2019 02:23:30 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d14</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2004d14</guid><description><![CDATA[<p>case_name: Moore Regional Hospital, Inc., Pineherst, NC</p><p>case_numbers: 98-1861</p><p>decision_date: Thu, 15 Apr 2004 12:00:00 -0400</p><p>decision_number: 2004D14</p><p>fiscal_year_end: 10/31/1995</p><p>provider_number: 34-0115</p><p>summary: Was the Intermediary's determination disallowing the loss incurred on change of ownership proper?</p>]]></description></item><item><title>2005D21</title><pubDate>Mon, 04 Nov 2019 02:23:30 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d21</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d21</guid><description><![CDATA[<p>case_name: Treyton Oak Towers</p><p>case_numbers: 02-0028</p><p>decision_date: Fri, 07 Jan 2005 12:00:00 -0500</p><p>decision_number: 2005D21</p><p>fiscal_year_end: 6/30/98</p><p>provider_number: 18-5175</p><p>summary: Whether the Intermediary's adjustment removing the Skilled Nursing Facility (SNF) for purposes of evaluating the Routine Cost Limit (RCL) exception amount was appropriate?</p>]]></description></item><item><title>2005D20</title><pubDate>Mon, 04 Nov 2019 02:23:30 -0500</pubDate><link>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d20</link><guid>https://www.cms.gov//regulations-and-guidance/review-boards/prrbreview/list-of-prrb-decisions-items/2005d20</guid><description><![CDATA[<p>case_name: Parkview Memorial Hospital, Fort Wayne, IN</p><p>case_numbers: 02-1342</p><p>decision_date: Fri, 07 Jan 2005 12:00:00 -0500</p><p>decision_number: 2005D20</p><p>fiscal_year_end: 12/31/98</p><p>provider_number: 15-0021</p><p>summary: 1. Whether for purposes of evaluating the Routine Cost Limit (RCL) exception request, the base year per diem amounts should be adjusted to reflect reclassifications made by the Provider.; 2. Whether the Intermediary properly offset the costs for the "private room differential" from the direct cost centers only.</p>]]></description></item></channel></rss>
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