Provider Reimbursement Review Board

News & Analysis as of

The Bad Debt Moratorium Requires a Flexible Approach to Evaluating "Reasonable Collection Efforts"

On September 10, 2015, District Judge Randolph D. Moss of the U.S. District Court for the District of Columbia issued an opinion in Mountain States Health Alliance v. Burwell (Mountain States) involving Section 310 of the...more

D.C. District Court Holds that CMS’s Rigid Application of the “Similar Collection Efforts” Requirement Violates the Bad Debt...

In a case of first impression in the U.S. District Court for the District of Columbia, brought by King & Spalding on behalf of Mountain States Health Alliance, the court held that CMS’s disallowance of certain Medicare bad...more

Ministry Motivation Costs Hospital $59 Million

Sometimes doing the right thing for the right reason can be costly. Last week it cost nonprofit Via Christi Regional Medical Center $59 million....more

Provider Reimbursement Review Board Imposes New Requirements for Providers with Pending Medicaid Eligible Days Appeals

On May 23, 2014, the CMS Office of Hearings released Alert 10, notifying providers with pending appeals before the Provider Reimbursement Review Board (PRRB) of a new sixty-day submission requirement for the Medicaid eligible...more

Supreme Court: Providers' Appeal Period Not Extended by Doctrine of Equitable Tolling

Under the Medicare statute and implementing regulation, providers have 180 days from the issuance of a Notice of Program Reimbursement (NPR) in which to file an appeal to the Provider Reimbursement Review Board (PRRB). This...more

Supreme Court Rules Equitable Tolling Cannot Be Used To Extend Deadline For Filing Medicare Part A Reimbursement Appeals

On January 21, 2103, the U.S. Supreme Court unanimously held in Sebelius v. Auburn Regional Medical Center that the Medicare statute does not permit the time period for filing an appeal with the Provider Reimbursement Review...more

Supreme Court Upholds Regulatory Time Limitations on PRRB Appeals

On January 22, 2013, the United States Supreme Court unanimously upheld the Secretary of HHS’s regulation establishing an absolute three-year limit for taking an appeal from a Notice of Provider Reimbursement (“NPR”). In...more

Bolstered By Favorable District Court Decision, King & Spalding Now Forming Group Appeals Contesting Inclusion of Part C Days in...

In a recent decision for which King & Spalding organized the appealing group of hospitals and was co-counsel, the D.C. district court ruled that CMS’s regulation requiring the inclusion of Medicare Part C patient days in the...more

8 Results
View per page
Page: of 1

"My best business intelligence, in one easy email…"

Your first step to building a free, personalized, morning email brief covering pertinent authors and topics on JD Supra:

Sign up to create your digest using LinkedIn*

*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
*With LinkedIn, you don't need to create a separate login to manage your free JD Supra account, and we can make suggestions based on your needs and interests. We will not post anything on LinkedIn in your name. Or, sign up using your email address.