Follow the Rules for Protested Amounts on Your Cost Reports or Lose Your Right to Appeal


For cost reporting periods ending on or after December 31, 2008, the new

regulations governing appeals before the Provider Reimbursement Review

Board (PRRB) require that, in order to appeal an issue to the PRRB, a provider

either (1) expressly claim a cost as an allowable cost on its cost report or (2) if

CMS policy indicates the cost is not allowable, include the cost on the cost

report as a protested amount. 42 C.F.R. § 405.1835(a)(1)(ii). The new PRRB

rules also state that for cost reporting periods ending on or after December 31,

2008, a provider must demonstrate how it followed the applicable procedures. Leslie Demaree Goldsmith of Ober|Kaler discusses.

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DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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