News & Analysis as of

Hospitals › Provider Reimbursement Review Board

Baker Donelson

Court Rejects CMS's "Predicate Facts" Position

Baker Donelson on

In a decision with implications that could go back 35 years, the United States Court of Appeals for the District of Columbia Circuit rejected a CMS interpretation of its reopening rules as that interpretation affects current...more

King & Spalding

CMS Acquiesces to Banner Self-Disallowance Decision

King & Spalding on

On April 23, 2018, CMS released CMS-1727-R (the Ruling), which announced that it will follow the United States District Court’s decision in Banner Heart Hospital v. Burwell, 201 F. Supp. 3d 131 (D.D.C. 2016). The Banner...more

King & Spalding

Federal District Court Rebukes CMS for Seeking to Remand Case in Which Providers Did Not Protest Unallowable Items on Their Cost...

King & Spalding on

Last week, the United States District Court for the District of Columbia denied CMS’s request to remand to the Provider Reimbursement Review Board (PRRB) the claims of several hospitals who sought expedited judicial review...more

King & Spalding

D.C. District Court Dismisses a Hospital’s Challenge of Another Hospital’s Failure to Provide Wage Documentation to CMS

King & Spalding on

On March 21, 2017, the U.S. District Court for the District of Columbia ruled that a hospital lacked standing to challenge a decision of the Provider Reimbursement Review Board (the “PRRB”), since the hospital failed to...more

Baker Donelson

Court Rules in Favor of Hospitals in Bad Debt Collection Effort

Baker Donelson on

On July 25, 2016, the United States District Court for the District of Columbia issued an opinion favoring provider flexibility in the reasonable collection of Medicare bad debt. Winder HMA, LLC, et al. v. Sylvia Burwell. The...more

Faegre Drinker Biddle & Reath LLP

Another Blow to Medicare “Self-Disallowance” Rule

Faegre Drinker Biddle & Reath LLP on

You can tell by its name that you won’t like the Medicare “self-disallowance” rule. The federal district court for D.C. didn’t like it, either, and gave a group of Banner Health hospitals summary judgment that the rule was...more

Baker Donelson

Court Allows 'Retroactive' Application of 2005 Wage Index Rule Limiting Reimbursement for Pension Plan Costs

Baker Donelson on

On February 22, 2016, in Regents of the University of California v. Burwell, the U.S. District Court for the District of Columbia granted summary judgment in favor of the Secretary of Health and Human Services (the Secretary)...more

Baker Donelson

Recent PRRB and CMS Administrator Decisions: A Summary for Providers

Baker Donelson on

In recently released decisions, the PRRB and the CMS Administrator addressed a number of issues of interest to many providers. Short summaries of those decisions are provided below. The PRRB and CMS Administrator post their...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 Log in
*By using the service, you signify your acceptance of JD Supra's Privacy Policy.
- hide
- hide