Southwest Consulting Associates Blog

PRRB Issues Decision in Massachusetts CCHIP Case

Posted by Michael Newell on Mar 22, 2017 1:36:03 PM

 

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Topics: DSH Litigation Environment, DSH Reimbursement, Medicare DSH Reimbursement, PRRB decisions

PRRB Published Jurisdictional Decisions:  A Year in Review - Part II

Posted by Kristin DeGroat on Mar 30, 2016 2:23:18 PM

 

The Provider Reimbursement Review Board (PRRB or Board) has published 177 jurisdictional decisions to date for 2015 and that is only through October of 2015.  We will summarize November and December decisions once available.  The published decisions can be found using the following link:

 

https://www.cms.gov/Regulations-and-Guidance/Review-Boards/PRRBReview/List-of-PRRB-Jurisdictional-Decisions.html

 

In a previous post, 124 negative jurisdictional decisions were summarized and some best practice tips were provided for hospitals and/or their counsel to be sure they are following.  That post can be found HERE.  Of the 177 total decisions posted, the remaining 53 were in favor of Providers; HOWEVER, in 21 of those, only some of the Providers within a group obtained a favorable jurisdictional decision or if multiple Notices of Program Reimbursement (NPRs) were appealed, jurisdiction was only taken over one of the NPRs but not the other.    

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Topics: Medicare DSH Reimbursement, DSH Litigation Environment, PRRB decisions

PRRB Published Jurisdictional Decisions:  A Year in Review - Part I

Posted by Kristin DeGroat on Mar 21, 2016 10:30:00 AM

AND...the negative jurisdictional decision trend continued for 2015...  


The Provider Reimbursement Review Board (PRRB or Board) has published 177 jurisdictional decisions to date for 2015 and that is only through October of 2015.  Of those 177, only 53 were in favor of Providers; and, in 21 of those, only some of the Providers within a group obtained a favorable jurisdictional decision or if multiple Notices of Program Reimbursement (NPRs) were appealed, jurisdiction was only taken over one of the NPRs but not the other.  The decisions can be found using the following link:

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Topics: Medicare DSH Reimbursement, DSH Litigation Environment, PRRB decisions

About This Blog

The climate of provider reimbursement is ever-changing and this blog is intended to keep you up-to-date on the latest information regarding:

  • DSH Reimbursement
  • 340B Pharmacy Drug Discount Program
  • Compliance Issues
  • Litigation Surrounding Provider Reimbursement

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