List of PRRB Decisions

The Provider Reimbursement Review Board is an independent panel to which a certified Medicare provider of services may appeal if it is dissatisfied with a final determination of its fiscal intermediary or the Centers for Medicaid & Medicare Services (CMS). A decision of the Board may be affirmed, modified, reversed or vacated and remanded by the CMS Administrator within 60 days of notification to the provider of that decision.

Decision #	Case #	Provider #	Issue
2004D11	99-3324	42-7025	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?
2004D14	98-1861	34-0115	Was the Intermediary's determination disallowing the loss incurred on change of ownership proper?
2004D15	97-2025	05-0373	Whether the Provider's budgeted beds are the most appropriate measure of available beds for proposes of computing the indirect medical education (IME) payment?
2004D17	00-2285	32-7125	Was the Intermediary's adjustment to the Provider's cost limits proper?
2005D20	02-1342	15-0021	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.
2005D21	02-0028	18-5175	Whether the Intermediary's adjustment removing the Skilled Nursing Facility (SNF) for purposes of evaluating the Routine Cost Limit (RCL) exception amount was appropriate?
2005D23	01-3385	53-7025	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?
2005D26	97-2174	38-0018	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?
2005D30	03-0901	19-4056	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.)
2004D31	99-3760	39-7628	Was the Intermediary's adjustment applying Medicare's Physical Therapy Compensation Guidelines to the Provider's employee physical therapists proper?
2004D32	98-2100	24-0063	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?
2004D33	99-3663G; 00-2170G	Various	Should the provider's Federal Insurance Contributions Act (FICA) payroll costs be classified to the administrative and general cost center?
2004D35	96-0059; 96-0060	15-5383	Was the Provider entitled to an exemption from the routine cost limit as a "new" provider?
2004D36	00-0386	39-0088	Was the Intermediary's denial of the Provider's loss on disposal of assets proper?
2004D37	96-0720	18-0092	Whether non-acute care swing-bed days should be included in the Medicare proxy for the disproportionate share calculation ("DSH")?
2004D38	02-1971	31-0067	Was the intermediary's determination of loss on consolidation proper?
2004D39	96-0591; 97-2042	05-7252	Should denied Medicare visits be included in the "total visits" count for purposes of apportioning costs to the Medicare program?
2004D40	02-0431; 02-0364	23-0075; 23-0004	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?
2004D41	98-3477G	Various	Was the Intermediary's determination of the disproportionate share hospital (DSH) computation relating to state-only General Assistance Days Proper?
2004D42	01-2416	05-4012	Did the Intermediary properly eliminate the Provider's Medicare bad debts due to the Provider allowing discounts to only non-Medicare patients?
2004D43	00-3936; 00-3937	19-2531; 19-2509	Whether the Intermediary correctly disallowed Medicare bad debts related to amounts not included in the End-Stage Renal Dialysis (ESRD) Composite rate?
2004D44	94-2187	23-0098	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?
2004D46	01-1540; 01-2860; 02-1247	23-7251	Was the Intermediary's adjustment to start-up costs proper?
2003D01	99-0299; 99-3610	26-0094	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?
2003D02	99-3300	45-0272	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?
2003D03	01-0710G	Various	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?
2003D04	01-0320	28-5149	Whether the provider's appeal of bad debts was derived from an intermediary determination or adverse finding?
2004D19	99-0729; 01-0036	39-5432	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?
2004D18	01-1017	10-5930	Whether the Intermediary's adjustment reducing the adjusted hourly salary equivalency amount allowed for services of Physical Therapy Aides was proper?
2004D22	03-0063; 03-0064	39-0026	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?
2004D24	98-0815	15-7046	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?
2004D25	96-1496; 98-0237	14-7135	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?
2004D27	95-2033R; 96-1979R; 97-1498R; 98-2049R	04-0036	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?
2004D29	96-2359; 01-0124	22-5681	Was the Intermediary's denial of the Provider's request for an exemption from Medicare's service cost limits proper?
2003D19	99-0646	03-5145	Whether the Intermediary properly calculated the Provider's Medicare bad debts?
2003D21	01-0153	06-7201	Was the Intermediary's adjustment to owner's compensation proper?
2003D22	96-1531, 97-1417; 98-1063	20-0024	Is the Provider entitled to a TEFRA exception?
2003D23	99-0160	45-0119	Was the Intermediary's determination of available beds for purposes of the disproportionate share payment calculation proper?
2003D06	97-0061 & 97-0062	22-0156; 22-0111	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?
2003D08	00-3980	49-5281	Was the Intermediary's adjustment disallowing the allocation of general service costs to the ancillary cost centers proper?
2003D09	00-3979	17-5185	Was the Intermediary's adjustment disallowing the allocation of general service costs to the ancillary cost centers proper?
2003D10	00-3413	39-5460	1. Was the Intermediary's reclassification of Staff Development Coordinator salaries proper?; 2. Was the Intermediary's reclassification of Social Services salaries proper?
2003D12	97-1686	39-7006	Was the Intermediary's adjustment to rent paid by the Provider to a related party proper?
2003D18	99-0321	06-3027	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?
2003D17	00-0544	05-0248	Was the Intermediary's adjustment to the residents count and Graduate Medical Education payments proper?
2003D16	02-0721G	50-0023, 44-0131; 45-0059	Were the Intermediaries adjustments to exclude observation bed days from the providers' bed count in determining disproportionate share hospital ("DSH") eligibility and payments proper?
2003D15	96-1651	33-5758	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?
2003D14	96-1951	23-0167	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?
2003D13	96-0618G, 96-0619G; 96-0620G	Various	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.]
2003D11	00-2451	39-7279	Were the Intermediary's adjustments to physical therapy costs proper?
2003D25	99-3866; 01-0764	39-5742	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?
2003D26	94-3266	05-0373	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.)
2003D27	00-2949	49-7259	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.
2003D41	00-0346; 01-0210	39-5789	Was the Intermediary's adjustment to remove nursing administration statistics from the ancillary cost centers on worksheet B-1 proper?
2003D24	98-0362G, 99-2356; 01-0053	Various	Was the Intermediary's adjustment to deny the allocation of social service costs based on departmental gross charges proper?
2003D42	02-1198	41-7001	Was the Intermediary's disallowance of the Provider's Spanish and Portuguese interpreter expenses proper?
2003D43	97-3008	10-0055	Was the Intermediary's determination of obligated capital proper?
2003D44	02-0901G	Various	Was the Intermediary's disallowance of liabilities not liquidated timely on the Medicare cost report proper?
2003D45	99-0722	05-7252	Whether the Intermediary's adjustment of Medicare visits to agree with Medicare's Provider Statistical and Reimbursement (PS&R)report were proper?
2003D28	00-3416	14-7614	Was the Intermediary's adjustment to disallow accrued bonuses for employees proper?
2003D29	01-1866	23-0205	Was the Intermediary's adjustment to DRG (Diagnostic Related Group) payments proper?
2003D30	01-1525	31-7060	Was the Intermediary's adjustment to the Per Beneficiary Limit (PBL) calculation proper?
2003D31	98-0507, 99-2398; 00-0946	36-0003	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)
2003D32	98-1282	67-7181	Was the Intermediary's Audit Adjustment #2 which disallowed $108,875 of Administrative and General Costs proper?
2003D33	01-1779; 02-0270	18-3026	Was the all inclusive rate allocation Methodology proper?
2003D34	99-2427G	Various	Were the Intermediary's adjustment disallowing the Providers' claimed losses on disposal of assets due to a change of ownership proper?
2003D35	99-2241G	Various	Were the Intermediary's adjustment disallowing the Providers' claimed losses on disposal of assets due to a change of ownership proper?
2003D36	98-1973	12-0006	Were the Intermediary's adjustment disproportionate share hospital payments proper?
2003D37	94-2728	34-0141; 34-S141	Whether the Intermediary and HCFA properly determined that the Provider's request for an adjustment to the TEFRA limits was untimely?
2003D38	01-1637	15-0102	Was the Intermediary's adjustment to limit reimbursement to the lower of cost or charges for the Provider's distinct part psychiatric unit proper?
2003D40	01-2787	10-5858	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?
2003D39	97-2608	55-5405	Was the Intermediary's denial of the Provider's SNF routine service cost limit exception request proper?
2003D46	00-1172	55-7008	Whether the Provider is entitled to an exception to the visit cost limits in accordance with Medicare regulations?
2003D47	98-2105, 98-2106;98-2107	33-0261	Was the Intermediary's treatment of the Provider's increase in bed size of its exempt rehabilitation unit proper?
2003D48	99-2780, 99-2781, 01-1334, 01-1335; 02-0450	39-7015	Was the Intermediary's adjustment to home office costs proper?
2003D49	02-1970	14-0167	Is the Provider entitled to status as a Medicare Dependent hospital ("MDH") for the period of October 1, 2001 through January 14, 2002?
2003D50	00-0961G	Various	Was the Intermediary's adjustment to restorative nurses aides proper?
2003D51	01-3608G	Various	Was the Intermediary's adjustment to restorative nurses aides proper?
2003D52	01-2455	N/A	Were the Intermediary's adjustments reclassifying the Medical Director cost proper?
2003D54	01-2453	05-6323	Was the Intermediary's adjustment reclassifying Medical Director cost proper?
2003D55	01-2262	55-5336	1. Was the Intermediary's adjustment to advertising costs proper?; 2. Was the Intermediary's adjustments reclassifying Medical Director cost proper?
2003D56	99-3820	40-0098	1. Was the Intermediary's adjustment to interest expense proper?; 2. Was the Intermediary's adjustment to deferred organizational cost proper?
2003D57	99-3821	40-0098	Was the Intermediary's adjustment to bad debts proper?
2003D58	95-0590	40-0016	Was the Center for Medicare & Medicaid Services' denial of the Provider's exception request proper?
2003D59	00-1344	40-0079	Was the Intermediary's adjustment to the disproportionate share, (DSH) computation proper?
2003D60	00-0064	46-7051	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?
2003D61	01-0627	23-3519	Was HCFA's (the Center for Medicare & Medicaid Services') determination concerning the exception request under the prospective payment system proper?
2003D62	99-0584	39-0080	Was the Intermediary's determination of loss on sale of assets proper?
2003D63	99-2054, 99-2307G; 01-0337	Various	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?
2003D64	98-2851	17-0087	Was the Intermediary's determination of loss on consolidation proper?
2003D65	95-2104G, 95-1244G; 96-2516G	Various	Whether the Intermediary correctly applied the Medicare lower of cost or charges limit in determining payments to the Providers?
2003D66	99-4073	49-5280	Was the Intermediary's adjustment disallowing Medicare Part A and Part B bad debts proper?
2005D18	98-2318	15-5400	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?
2004D02	99-3609; 00-3050; 01-2972	22-4022	Were the Intermediary's adjustments to physician stand-by costs in the routine area correct?
2004D03	99-3323	42-7010	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?
2004D04	00-2255; 01-2782	17-8012	Whether the Intermediary's adjustment to include private duty nursing costs on the Medicare cost report was correct?
2002D18	96-1254; 96-1443	06-7032	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)
2002D19	99-0233	13-0024	Was the Intermediary's adjustment to emergency room ("ER") physicians' availability costs proper?
2002D30	95-1515, 95-2428, 99-3520, 99-3125	05-0366	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?
2002D31	97-0135	01-5426	Was the Centers for Medicare & Medicaid Services' (Formerly the Health Care Financing Administration) denial of a new provider exemption proper?
2002D32	00-3418G	Various	Was the Intermediary's adjustment to the non-qualified deferred compensation plan proper?
2002D33	91-0550G	Various	Was the Intermediary's adjustment to Indirect Medical Education costs proper?
2002D34	89-1181R	05-0230	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.
2002D35	00-3147; 00-3150	23-6554	Did the Intermediary properly adjust the provider's bad debt expense?
2002D36	97-1761	14-7525	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?
2002D38	98-1171	06-7239	Was the Intermediary's determination of legal fees proper?
2002D39	97-0403	39-5066	Was the Intermediary's adjustment to Medicare patient days proper?
2002D40	96-2090R	39-5863	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?
2002D41	99-0286R	31-7062	Was the interest paid on working capital loans from the Friend Center Fund and commercial banks necessary and allowable?
2002D42	99-0417	37-5262	Was the Intermediary's methodology used in settling a low utilization cost report proper?
2002D43	98-2295; 99-2144	15-2009	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?
2002D44	97-3201	20-0009	Was it proper for the Intermediary to deny the Provider's TEFRA exception request for untimely filing?
2002D45	97-2659	21-5302	Did the Provider meet the regulatory requirements for approval of the new provider exemption?
2002D46	98-0460	05-0211	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.
2002D47	00-3139; 01-2861	23-0115	Was the Intermediary's denial of the Provider's request for additional payment for decreased discharges proper?
2002D48	96-2035, 96-2036, 96-2037; 96-2038	22-5673	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)?
2002D49	98-0489	22-0036	Was the Intermediary's adjustment (denial) of the transitional care unit new provider exemption proper?
2002D50	96-1033	50-5025	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?
2001D12	97-0744; 99-0318	10-7281	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.)
2001D55	91-2902M & 95-1677	39-0156	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?
2000D02	96-1218	44-0008	Was the Intermediary's reclassification of home health agency costs proper?
2000D15	94-1517	10-0129	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?
2000D16	97-0080	05-7299	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?
2000D17	92-1549	26-0104	Was the computation and allocation of the cashiering, accounts receivable, and collections cost center done correctly and done in accordance with the regulations?
2000D18	94-1750	45-0698	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?
2000D19	95-0072	38-0007	Was the Intermediary's or HCFA's determination regarding the Provider's TEFRA exception request proper?
2000D20	94-2879	33-3028	Was HCFA's partial denial of the Provider's request for a TEFRA target rate adjustment proper?
2000D21	95-0897	31-0002	Was the Intermediary's failure to apply updated reasonable compensation equivalent limits proper?
2005D02	96-2577G	Various	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?
2005D03	96-0211, 97-1061R, 98-2080R	26-0015	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?
2005D04	01-1458	20-0033	Was CMS' denial of the Provider's end stage renal disease (ESRD) composite rate exception request correct?
2005D05	94-3085	05-0295	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?
2005D06	97-0592, 98-1495	23-0077	For purposes of allocation of Administrative & General ("A&G") costs, should Part B physicians' compensation and related fringe benefits be included in total expenses of private physician practices?
2005D07	00-0374	52-5478	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?
2005D08	00-1542, 01-1278, 03-0040	10-0070	Were the Intermediary's adjustments to interest expense relating to the acquisition of medical records and an assembled work force proper?
2005D09	99-1467	05-0420	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?
2005D10	02-0355	19-7210	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?
2005D11	00-3166, 00-3167, 00-3119	03-0023, 03-7047	Whether the Intermediary's denial of a request for exception to the Home Health Agency (HHA) per visit cost limits was proper?
2005D12	99-0452G	Various	Whether the Intermediary properly processed the Providers' TEFRA exception request?
2005D13	02-0078	19-7585	Whether the Intermediary denial of the Provider's request for exception to its per-visit cost limits was proper?
2005D14	00-0945	15-5258	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?
2005D15	02-0020	05-6092	Whether the Intermediary's denial of the Provider's Routine Cost Limit (RCL) exception request was proper?
2005D16	Various	Various	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?
2005D17	02-0013, 02-0319	04-3816	Was the Intermediary's adjustment to physician/owners compensation proper?
2004D05	01-0741	23-2557	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?
2004D06	01-0742	23-2553	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?
2004D08	03-0666	37-5109	Does the Board have jurisdiction over the recoupment of overpayments appealed from a letter from the Centers for Medicare and Medicaid Services?
2004D07	01-0743	23-2315	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?
2004D09	03-0665	37-5109	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?
2005D29	95-0468	05-0076	Was the Intermediary's partial denial of the Provider's End Stage Renal Disease (ESRD) exception request proper?
2004D01	01-1470; 01-1534G; 01-1539G	Various	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?
2003D07	00-3976	17-5218	Was the Intermediary's adjustment disallowing the allocation of general service costs to the ancillary cost centers proper?
2005D31	01-1679	48-0001	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.
2005D32	94-3299, 96-0845, 98-2163	31-0111	Whether the Intermediary failed to properly classify certain projects as old capital.
2005D01	02-0212, 02-0213,02-0214 et al	40-7019;40-7013;40-7017;et al	Whether the Providers' receivable financing was a loan or a sale of assets?
2004D13	01-0881GE	Various	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.
2003D05	00-3145	05-8017	Was the Intermediary's adjustment of start-up costs proper?
2003D20	99-4064	52-0089	Was the Intermediary's determination of the TEFRA exception request proper?
2004D16	00-0411; 00-2594	45-0061	Was the Intermediary's adjustment excluding observation bed days from the determination of the Provider's disproportionate share hospital adjustment proper?
2004D30	01-0937	23-7252	Was the Intermediary's adjustment to the single business tax proper?
2004D26	01-0883	20-0018	Was CMS' denial of end stage renal disease composite rate exception request correct based on applicable Medicare law?
2004D21	99-1424	04-0048	Was the Intermediary's determination of the loss on disposal of assets proper?
2004D10	00-2699; 00-2700	15-7193; 15-7318	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?
2004D28	04-1640; 04-1641	50-3300	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?
2005D22	01-0700	15-5228	Whether the Intermediary's adjustment to disallow a portion of the owner's compensation was proper?
2004D23	97-2439	19-0160	Was the Provider's routine cost limit determined in accordance with Medicare law, regulations, and program instructions?
2005D27	02-1008	25-0019	Was the Intermediary's disallowance of Medicare bad debts proper?
2005D19	01-0261	19-7558	Was the Intermediary's adjustment to disallow accrued salaries proper?
2004D20	98-1344; 99-1718; 00-2691	51-0001	Was the Intermediary's adjustment to bond interest proper?
2005D25	99-1213	67-7455	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?
2005D24	02-0183	19-7545	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?
2005D28	97-1566	04-0062	Was the Centers for Medicare and Medicaid Service's denial of the Provider's request for new provider exemption proper?
2005D34	98-1658	45-0124	Whether the Intermediary properly applied the "Pickle Amendment" in calculating the Provider's Disproportionate Share Hospital (DSH) adjustment.
2005D35	99-1345	55-7729	Whether the liabilities claimed by the Provider are reimbursable under the Medicare principles.
2005D36	02-0216; 02-0217	03-0064	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?
2005D37	01-2620	14-7112	Were the Intermediary adjustments applying Medicare's salary equivalency guidelines to services performed by Provider's employee physical and occupational therapists proper?
2005D38	02-2031	45-2049	Whether the Intermediary erred in denying the Provider a continuous improvement bonus ("CIB") for fiscal year ending August 31, 1999.
2003D53	99-2359	05-5039	1. Was the Intermediary's adjustment to advertising costs proper?; 2. Was the Intermediary's adjustment to tax penalties proper?
2005D40	00-2981	41-5122	Whether the Centers for Medicare & 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
2005D41	99-4038	36-0066	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.
2005D42	01-3257	33-0215	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.
2005D43	00-0909G	Various	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&G)?
2005D44	99-4061	50-5504	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.
2005D45	02-1213	22-0163	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?
2005D46	98-2583	50-0124; 50-5492	Was the Provider entitled to a "new provider" exemption from Medicare's routime cost limits for its hospital-based skilled nursing facility (SNF)?
2005D47	02-2129; 04-1734	05-0281	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 & 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.
2005D48	95-0777	33-0225	Whether the Intermediary's application of the reasonable compensation equivalent limits was proper.
2005D49	Various	36-0125; 36-0187; 36-0027; 36-0009; 36-0068	Whether the Intermediary improperly excluded patient days related to Ohio's Hospital Care Assurance Program (HCAP) in the providers' disproportionate share calculations.
2005D50	89-1584	45-0101	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.
2005D51	98-2210	10-5319A	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.
2005D52	99-1511G	Various	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.
2005D39	99-2779; 02-1243	36-0242	Whether the Intermediary's adjustment to disallow the interest paid to the Ohio State University Hospitals was proper.
2005D53	97-1198; 99-0246; 99-0247	05-0357	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)?
2005D54	03-0045; 03-0046	45-0130	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?
2005D55	00-3322	39-0263	Whether the Intermediary's adjustment disallowing the Provider's loss on sale of assets is proper?
2005D56	99-3095	45-0272	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.
2005D57	99-3096	45-0272	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.
2005D58	99-0832	45-0272	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.
2005D59	01-0728	45-0272	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.
2005D60	02-1126	33-3531	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.
2005D61	99-1543; 00-1001	39-7573	Whether the Intermediary's adjustments applying the physical therapy salary guidelines to fee-for-service employee compensation was proper.
2005D62	01-0077	25-5234	Whether the Intermediary's adjustment removing the Provider's 'grossing up' of costs and charges for drugs charged to patients was proper.
2005D63	98-1913	06-7188	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.
2005D64	98-1922	05-6169	Whether the Intermediary's adjustment to allow only a 15% increase in the therapy rate for physical therapy supervisors was proper.
2005D65	00-3600	45-7661	Whether the Intermediary properly disallowed interest expense incurred in connection with the Provider's deferred compensation plan.
2005D66	00-3299	19-7213	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.
2002D24	01-0198	42-5018	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?
2002D37	94-3225G, 94-1910G, 93-0483G, 93-0284G, 94-0209G, 95-1245G, 96-0976G, 98-0179	Various	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.
2002D25	01-0200	42-5102	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?
2002D27	99-3872	55-7633	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?
2002D21	96-1820	44-7442	Was the Intermediary's adjustment to the Provider's cost report to remove legal fees proper?
2002D22	01-0199	42-5112	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?
2002D26	96-0623	23-0227	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 & 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.
2002D20	98-2883	06-5332	Were the Intermediary's adjustments to the Provider's depreciation expense related to the sale and leaseback of the facility proper?
2002D23	96-1189; 97-0797R	24-0038	Whether state-funded days may qualify as Medicaid-eligible days for purposes of the Provider's disproportionate share calculation?
2002D29	98-0452	16-0026	Did the Provider qualify for a payment adjustment due to a decline in its discharges for fiscal year ending June 30, 1995?
2002D28	96-1240	05-0224	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?
2005D67	98-2026	41-0007	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.
2005D69	01-3317	39-7086	Whether the Intermediary's adjustment of accounting fees was proper.
2005D70	98-1725; 99-2325; 02-1682	21-7084	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)).
2002D17	00-1736	39-7095	Was the Intermediary's reclassification of the salaries and benefits attributable to the unallowable activities from the administrative and general ("A & G") cost center to a non-reimbursable cost center proper?
2002D14	94-3354; 95-1196	05-0040	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?
2002D10	97-3094	06-7199	Was the Intermediary's adjustment disallowing yellow page advertisement expense proper?
2002D11	98-1968	33-5521	Was the Intermediary's adjustment to unpaid interest expense proper?
2002D13	01-3205G	50-0023; 44-0131; 45-0059	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.
2002D16	98-2627	39-0073	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?
2002D15	97-1432	20-0066	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?
2002D12	00-0479	15-7425	Was the Intermediary's adjustment reclassifying a portion of the Hospice Director's salary proper?
2002D09	00-1180	06-7256	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?
2002D01	00-1056, 99-3600, 00-1057	45-0352	Were the Intermediary's adjustments to the number of available beds for disproportionate share (DSH) qualification purposes proper?
2002D06	98-0511	03-5145	Did the Intermediary calculate the provider's bad debts properly?
2002D05	96-0550	19-5258	Was the Intermediary's denial of a routine cost limit exemption as a new provider proper?
2002D03	98-3317G; 98-2888G	03-0002, 03-0065, 03-0001, 03-0089	Was the Intermediary's adjustment to home office interest expense proper?
2002D07	98-0490	49-0009	Was the Intermediary's computation of the Provider's graduate medical education cost proper?
2002D02	97-1280G	Various	Did the Intermediary properly reimburse the Provider for drugs and medical supplies purchased from a related party?
2002D04	95-0620	36-0163	Was the Intermediary's adjustment with respect to parking garage revenues proper?
2002D08	97-1048	42-0030	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?
2001D50	98-0787	36-0006	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?
2001D51	96-0166	04-3001	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?
2001D54	97-1736	44-0161	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?
2001D53	96-0180	33-0285	Did the Intermediary use the correct reasonable compensation equivalent ('RCE') limits to disallow a portion of the Provider's hospital-based physicians' compensation?
2001D52	97-2064R, 97-2148R, 98-0474 (On the Record)	43-0077	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?
2001D48	00-1179	25-7305	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?
2001D41	96-0102	17-0001	Did HCFA properly determine that the SNF routine cost limits exception request was not timely filed?
2001D43	89-1522R	05-0327	Was the Provider's computation of the self-disallowance amount of investment income offset against interest expense proper?
2001D47	96-0225	14-7525	Was the compensation paid to HCC's owner reasonable?
2001D42	95-1143	33-0285	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?
2001D44	97-1917	37-7093	Was the Intermediary' adjustment to physical therapy labor costs proper?
2001D49	95-1217	36-0017	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?
2001D40	97-0843	01-0079	Was the Intermediary's disallowance of the Provider's Medicare Part B bad debts for deductibles and coinsurance proper?
2001D46	99-2365G	06-7032; 06-7201	Were the Intermediary's adjustments to physical therapy costs proper?
2001D45	98-0095	05-7465	Was the Intermediary's adjustment reclassifying the community liaison's compensation to a non-reimbursable cost center proper?
2001D32	97-2651, 97-2652, 97-2653, 97-2654	50-0012; 50-5481	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)?
2001D33	00-1745	14-5736	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?
2001D38	98-2619	01-5049	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?
2001D30	97-0160	10-4549	Was the Intermediary's adjustments to the Provider's therapy costs proper?
2001D37	94-2298, 95-1213, 96-0132, 96-2235, 98-0023, 99-0057, 98-2943	34-0054	Was the Intermediary's adjustment to the disproportionate share amount proper?
2001D35	96-0343	36-0003	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&G costs proper?; 2. Was the Intermediary's emergency room physician billing revenue against emergency room expense rather than A&G expenses proper?
2001D31	00-0573G	Various	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?
2001D34	95-1001G	01-0055, 01-7013, 01-7020, 01-7048, 01-7072	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?
2001D39	00-2472	21-7008	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?
2001D36	97-0475	36-0003	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?
2005D68	99-2385	15-5281	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.
2006D20	96-1822; 97-1579; 98-1827; 99-2061	22-0077	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.
2001D27	99-0095	26-7262	Was the Intermediary's adjustment to remove excess key employee compensation proper?
2001D20	96-1308	45-7751	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?
2001D26	96-1477, 97-1703, 97-2763	29-0007	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?
2001D28	97-2018; 99-0881	39-5742	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?
2001D29	97-0159	10-4549	Was the Intermediary's adjustments to the Provider's therapy costs proper?
2001D24	97-1699	33-0154	Was the Intermediary's adjustment disallowing certain expenses of compensating hospital based physicians pursuant to the 1984 Reasonable Compensation Equivalency limits proper?
2001D22	98-0229	14-7483	Was the Intermediary's adjustment to skilled nursing and HHA visits proper?
2001D25	99-3163	14-7017	1. Was the Intermediary's adjustment to the Provider's Administrative and General (A&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?
2001D23	94-1039; 94-1040	23-0001	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?
2001D10	93-1355	45-0388	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?
2001D11	95-2183; 97-3095	36-0051	Did the Intermediary use the correct reasonable compensation equivalent ("RCE") limits to disallow a portion of the Provider's hospital-based physicians' compensation?
2001D13	95-2033, 96-1979, 97-1498, 98-2049	04-0036	Were the Intermediary's adjustments disallowing pass-through cost reimbursement of nursing education costs proper?
2001D14	95-1296	33-0106	Did the Intermediary use the correct reasonable compensation equivalent ("RCE") limits to disallow a portion of the Provider's hospital-based only physicians' compensation?
2001D19	91-1844	05-0457	Did the Intermediary properly adjust outpatient surgery, anesthesia and supply charges?
2001D16	95-2234, 97-0068, 97-2678	22-7029	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)
2001D17	97-2425	05-0455	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.)
2001D02	96-0423G, 99-0448G, 99-2082G	05-5916, 05-5053, 05-6261, 55-5658	Were the Intermediary's adjustments to disallow costs related to the Provider's airplane proper
2001D09	92-0111	51-0039	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?
2001D03	92-1220; 93-0473	05-0025	Was the Intermediary's adjustment to the number of available beds for indirect medical education ad
2001D05	97-0693	05-0390	Was the Intermediary's determination of inpatient and outpatient Medicare bad debts proper?
2001D04	98-0627	15-4014	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?
2001D08	94-3107	33-0058	Was HCFA's denial of the Provider's ESRD composite payment rate exception proper?
2001D07	97-2509	14-5111	Was the Intermediary's adjustment to the routine cost limit proper?
2001D01	99-1249	14-5335	Is the Provider entitled to an exception to the skilled nursing facility routine service cost limits for fiscal year ending 1995?
2001D06	97-0139R	39-5095	Was the Intermediary's reclassification of employment taxes proper?
2005D71	02-0399, 02-1946	15-0029	Were the Intermediary's adjustments to the count of full-time equivalent interns and residents proper?
2005D72	99-2472	05-0603	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.
2006D01	98-0502	24-0010	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?
2006D02	02-1686	23-0020	Is expedited judicial review (EJR) appropriate for the question of whether the Centers for Medicare & 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?
2006D03	02-1765, 02-1766, 02-1767, 03-0825	31-4013	Whether the Intermediary's adjustments to disallow reimbursement for physicians' professioanl services on a reasonable cost basis was proper.
2006D04	99-1295	15-5478	Was the Intermediary's adjustment to owners' compensation proper?
2006D05	94-2729	14-0119	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?
2006D07	99-3690G	Various	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?
2006D08	03-0009G	Various	Whether the Intermediary's adjustments reallocating key employee and owners' bonuses were proper.
2006D09	04-0412	26-0039	Whether the Intermediary's computation of the adjustment due the Provider for a decrease in discharges experienced in FY 2000 was correct.
2006D10	03-1555, 04-0387	45-0162	Whether or not Highland Medical Center has 100 or more available beds for Medicare disproportionate share adjustment qualification and payment purposes.
2000D06	96-0053G	46-5067, 46-5068, 49-5049, 46-5075	Did the Intermediary improperly disallow the time studies the Providers used for allocation of nursing administration, medical records and social services?
2000D01	97-0602	07-7133	Was the Intermediary's adjustment to disallow franchise fees correct?
2000D03	97-2434	05-0109	Did the Intermediary properly implement PRRB Decision No. 96-D35?
2000D07	94-2649	45-0037	1. Was the HHA cafeteria allocation statistic proper?; 2. Were the HHA administrative costs proper?
2000D04	94-0426, 94-0429	03-0002	Must the Provider have a written agreement with its related facilities in order to have the resident rotations included in its GME count?
2000D05	94-0327	14-0032	Was the Health Care Financing Administration's ("HCFA") denial of the Provider's request for classification as a sole community hospital proper?
2000D10	94-3018, 94-3019, 94-3020, 94-3021, 95-2194	39-5580	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?
2000D13	94-0718	31-0001	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?
2000D14	95-1201	03-0024	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?
2000D11	96-0498	16-0045	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?
2000D12	95-0068	38-0024	Was the Intermediary's or HCFA's determination regarding the Provider's TEFRA exception request proper?
2000D08	95-0527	36-0163	Was the denial of Provider's End Stage Renal Disease ("ESRD") composite rate exception request based on atypical service intensity/patient mix proper?
2000D09	98-1081	06-7201	Were the Intermediary's adjustments to owners' compensation proper?
2006D14	03-0176	07-5407	Whether the Intermediary properly denied the Provider's new provider exemption request.
2006D11	02-0812	05-0069	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.
2006D13	01-2940	05-0145	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.
2006D12	99-3024	24-0093	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.
2006D15	02-1526	19-7060	Whether the Intermediary's disallowance of medical director fees was proper.
1999D001	93-0824+	18-0124	Was the Intermediary's adjustment toMedicare bad debts proper?
1999D002	92-1027	50-0054	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?
1999D003	95-2373	10-7281	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]
1999D004	95-0907	31-0073	Was the Intermediary's calculation of the Provider's disproportionate share hospital adjustment proper?
1999D005	94-2470	39-4023	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?
1999D006	93-1518+/C	51-0007	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?
1999D008	96-0640	21-5264	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?
1999D009	94-2203	11-6571	Was the Intermediary's adjustment to bad debt proper?
1999D010	89-1103	05-0128	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?
1999D011	97-0831	40-7014	Was the Intermediary's audit adjustment to durable medidcal equipment ("DME") bad debts proper?
1999D012	93-0451, 93-1941	44-7425	Was the Intermediary's adjustment of management fees proper?
1999D013	91-2935M	07-0016	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?
1999D014	94-3074, 95-2199	14-0088	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?
1999D015	94-0030	23-6563	1. Was the Intermediary's adjustment to Medicare charges relating to settlement data based on information contained in the PS&R report proper?; 2. Was the Intermediary's adjustment to Medicare payments proper?
1999D016	92-1962G	Various	Should the revised Dallas-Fort Worth wage indexes be effective October 1, 1991?
1999D017	91-2308, 94-2352, 94-1066	26-0021	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?
1999D018	94-2471	39-0142	Was the Intermediary's methodology for determining physicians'Part A costs (reasonable compensation equivalents) proper?
1999D019	95-1242+, 95-1242C	39-0118	Was the Intermediary's determination regarding the Provider's prospective payment system capital rate proper?
1999D020	91-1734	50-0025	Was the Intermediary's adjustment to bad debts proper?
1999D007	94-1896, 95-1021	19-0158	Was the Provider entitled to be reimbursed for the costs incured in connection with an abandoned hospital expansion project?
1999D022	93-1886	05-5837	Is the Provider entitled to the full exception request to the , which is sought from HCFA?
1999D023	93-0178, 93-0518, 92-1084	10-4013	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?
1999D024	93-0688, 94-0445, 94-2071	45-0007	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?
1999D025	94-2452	11-3027	Were the sale and lease of the Provider Transactions between related organations?
2006D16	04-0426	05-0122	Whether the Intermediary's disallowance of the Provider's inpatient and outpatient Medicare bad debts was proper?
2006D17	99-3635	22-5387	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?
2006D18	00-0548, 00-0609	49-7033	Was the Intermediary's adjustment applying Medicare's Physical Therapy Compensation Guidelines to the Provider's employee physical therapists proper?
2006D19	04-0133	03-0101	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.
2006D06	97-2444, 98-2580, 99-3445, 99-3383G, 00-1426	37-7120, 37-7417	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.
1999D021	91-2474M	22-0104	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?
1999D026	94-1159	39-0142	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?
2006D21	01-0546G	Various	Whether the Intermediary appropriately denied the Provider's requests for an exception to the Medicare allowable hourly salary equivalency amount for physical therapy.
2006D22	01-0820	14-0052	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.
2006D23	00-2689	39-0102	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.
2006D24	03-0259; 03-0260	31-6597; 31-6625	Whether the Intermediary's adjustments were proper that disallowed the Providers' claimed Medicare Bad Debts, disallowed in a prior year period.
2006D25	01-1397; 01-1398	21-7118	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.)
2006D26	02-0632	30-0003	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.
2006D27	00-1020	03-0030	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.
2006D28	04-0783; 04-0819	14-0007; 04-0093	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.
2006D29	97-1202; 99-2900	33-0059	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 & Medicaid Services' methodology for determining the Provider's exceptions to the hospital-based skilled nursing facility cost limits proper?
2006D30	00-3284; 00-3619; 01-0598	19-5301; 19-5302; 19-5304	Whether the Intermediary's adjustments to reduce the Providers' outpatient therpay costs by 10 percent were proper?
2006D31	93-1227+; 93-1227C	05-0040	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.
2006D32	01-2850	37-0078	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.
1999D27	94-2772	45-0035	Was the denial of the Provider's request for an adjustment to the TEFRA limits because of untimely filing, proper?
1999D28	94-0152	39-0158	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?
1999D29	92-0668	34-0113	Did the Intermediary properly reopen the Provider's cost report and recoup an overpayment made to the Provider?
1999D30	93-1376G	Various	Was the Intermediary's classification of the Louisianna franchise tax as an operating cost rather than a capital cost proper?
1999D31	93-1475	05-0329	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?
1999D32	97-1195; 97-1192; 95-1564; 97-1191	23-7201	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)
2006D33	00-2873; 00-2874; 01-1931	09-7000	Whether the Intermediary's adjustment applying Medicare's Physical Therapy Compensation Guidelines to the Provider's employee physical therapists was proper.
2006D34	95-0315G	45-4069; 45-3038	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.
2006D35	01-0991	14-4646	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&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&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&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&R dated 2/29/00 was proper.; 17. Whether the Intermediary's adjustment to bad debts was proper.
2006D36	02-2110G	Various	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.
2006D37	02-0140	07-0007	Whether the Intermediary's adjustment to disallow the Connecticut Sales Tax was proper.
2006D38	98-1822	07-0028	Whether the Intermediary's adjustment to disallow the Connecticut Sales Tax was proper.
2006D39	01-2871	05-0327	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.
2006D40	01-2872	05-2550	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.
1999D33	91-2887	14-0087	Was the Intermediary's netting of the balance due to Edgewood Hospital of liabilities owed to the program by Edgewood Medical Center proper?
1999D34	97-0354G	Various	Did the Providers properly classify workers' compensation costs under the category of administrative and general costs instead of employees benefits costs?
1999D35	89-1782R	33-0041	Were the Intermediary's adjustments reclassifying the lease rental costs reported as capital costs proper?
1999D36	91-1440	05-0194	Was the Intermediary's adjustment modifying the disproportionate share adjustment amount proper?
1999D37	84-0407; 88-1478	26-6512	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?
1999D38	96-2150	22-5664	Was the Provider entitled to an exemption from the skilled nursing facility routine service cost limits as a "new provider"?
1999D39	93-1522	05-4003	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?
1999D40	88-0373	06-0098	Was the DRG amount, other than outlier payments, calculated correctly under Medicare law and PPS regulations?
1999D41	96-2199	16-0088	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?
1999D42	92-0215; 94-0239	05-0226	Was the Intermediary's adjustment to offset investment income earned from a related organization proper?
1999D43	89-0910	05-0153	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?
1999D44	96-0529	52-5394	Were the Intermediary's adjustments to ancillary cost centers proper?
1999D45	98-0105	23-6616	Was the Intermediary's adjustment to owner's compensation Proper?
1999D46	95-1043	39-5481	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?
1999D47	95-0931	01-0139	Was the Provider's request for an exception to its TEFRA target rate proper?
1999D48	95-0492E; 97-0952E;97-2389E	20-7026	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?
1999D49	93-1505	22-0077	Was the Intermediary's disallowance of Medicare bad debts proper?
1999D51	94-0198	01-0079	Was the Intermediary's attempt to recover Disproportionate Share Hospital (DSH) payments from the Provider for FYs 89 and 90 proper?
1999D52	94-2925	28-0034	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?
1999D53	94-1156	39-4023	Was the Intermediary's application of the 1984 Reasonable Compensation Equivalent (RCE) limits proper?
1999D54	97-3024	55-7160	Was the Intermediary's adjustment reclassifying non-allowable costs of community liason employees to a non-reimbursable cost center proper?
1999D55	94-2504	04-0022	Were the Intermediary's adjustments disallowing the pass-through of nursing education costs proper?
1999D56	96-0174G	Various	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?
1999D57	95-1188R	050235; 55-5046	Was the Intermediary's denial of the Provider's Routine Cost Limits exception proper?
1999D58	95-0308R	05-0235; 55-5046	Was the Intermediary's denial of the Provider's Routine Cost Limit exception proper?
1999D59	97-0139	39-5095	1. Was the Intermediary's reclassification of employment taxes proper?; 2. Was the Intermediary's adjustment to owner's compensation proper?
1999D60	96-2056	23-7141	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?
1999D61	97-2340	01-5049	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?
1999D62	96-0122	38-5161	Was the Intermediary's adjustment limiting contracted occupational therapy and speech therapy costs to $104 per hour proper?
1999D63	94-3180	36-0085	Was the Intermediary's adjustment to the outlier payments proper?
1999D64	96-1263	52-5419	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?
1999D65	94-3026	19-7317	Was the Intermediary's adjustment to Worksheet A-8-3 proper?
1999D66	98-0211GE	Various	Did the Intermediary properly determine that the Providers had less than 100 "beds" for the fiscal years in question?
1999D67	96-0869	19-0207	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?
1999D68	98-2042; 98-2046	33-7005; 33-7002	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?
1999D69	97-0503	21-5282	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?
1999D71	96-1086	44-0182	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?
1999D72	97-2381	26-7140	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 ?
1998D001	92-1498	14-0179	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?
1998D002	91-1163E; 92-0895	24-0036	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?
1998D003	91-0133	03-4001	Is the Provider entitled to an adjustment to its TEFRA limits for malpractice insurance costs for FYEs June 30, 1986 and June 30, 1987?
1998D004	91-1441	06-0015	Was the Intermediary's adjustment reclassifying air ambulance lease rental payments from capital costs to operating expenses proper?
1998D005	96-2054	45-7789	Was the Intermediary's adjustment shifting nursing and home health aide costs to a privite duty nursing cost center proper?
1998D006	93-0228	24-0053	Did the Intermediary properly disallow the physician's Part A compensation?
1998D007	94-3386	33-7243	Was the Intermediary's adjustment reversing the direct assignment of the New York sub-unit costs proper?
1998D008	91-2866M	33-0214	Were the Intermediary's adjustments to the graduate medical education ("GME") base year costs proper?
1998D013	96-2058	10-5883	Is the Provider exempt from the skilled nursing facility ("SNF") routine cost limits as a "new provider"?
1998D014	92-0430	10-5201	Was the Health Care Financing Administration's (HCFA) denial of the Provider's exception request proper?
1998D016	85-1109	39-0079	Were the Intermediary's adjustments to the Provider's interest expense to account for the hospital's 1983 advance refunding of debt proper?
1998D017	89-0303	39-0079	Were the Intermediary's adjustments to the Provider's interest expense to account for the hospital's 1983 advance refunding of debt proper?
1998D018	93-1769	05-5632	Was the Intermediary's classification of the salaries of restorative nursing aides from the physical therapy cost center to the routine cost area proper?
1999D70	92-0110G	Various	Were the pre-composite rate End Stage Renal Disease (ESRD) screens invalid and therefore not applicable to limit the Providers reimbursement for ESRD treatments?
1999D50	95-0523; 96-0510	52-7143	Were the Intermediary's adjustments to reclassify certain costs and visits from skilled nursing to either other visits or private duty visits proper?
1998D019	91-2800M	05-0239	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?
1998D020	91-2842M	05-0103	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?
1998D011	95-0380	52-6514	Was the Intermediary's modification of cost reporting form 2088-79 for the calculation of reimbursable cost proper?
1998D021	89-2023	05-0179	Was the Intermediary's adjustment to the amortization of the loss on the sale of Turlock Community Hospital proper?
1998D015	91-2414M	24-0053	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?
1998D022	93-1156	38-0018	Was the Provider's request to reopen the calculation of the disproportionate share adjustment to exclude employee self-insured days proper?
1998D023	95-1661	06-6549	Does the Provider Reimbursement Review Board have jurisdiction over Provider extension locations that are not surveyed for purposes of certification?
1998D024	92-0662	47-4001	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?
1998D025	95-0308	05-0235	Was the Intermediary's denial of the Provider's Routine Cost Limit exception proper?
1998D009	92-1679	39-0142	Was the Intermediary's application of the 1984 Reasonable Compensation Equivalent (RCE) limits proper?
1998D010	93-1749	10-6639	Was the Provider entitled to the lower of cost or charges (LCC) carryforward which was generated under the prior ownership?
1998D012	86-0429	05-0289	Was the Intermediary's denial of the full TEFRA incentive payment to the Provider proper?
1998D026	91-2673M	39-0028	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&G) proper?; 4. Was the Intermediary's adjustment reclassifying a portion of the teaching physicians salaries from GME to A&G proper?; 5. Was the Intermediary's adjustment reclassifying costs for the salaries and expenses related to GME support personnel from GME to A&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?
2006D41	00-3942	14-7589	Whether the Intermediary's disallowance of accrued compensation for the Provider's President/Chief Executive Officer (CEO) and Vice-President/Operations Manager was proper.
2006D42	00-3347	34-6538	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?
2006D43	04-0025	17-0032	Whether the Provider was improperly denied a Medicare low-volume adjustment.
2006D44	04-0643	01-0092	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.
2006D45	02-0224	39-0256	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?
2006D46	03-0940	33-0078	Whether the Intermediary properly calculated the Provider's indirect medical education (IME) reimbursement for its fiscal year ending December 31, 1999.
2006D47	03-1587; 03-1592	14-0119	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.
2006D48	98-2103; 99-1746; 00-2563; 03-0127; 03-0484; 03-1471; 03-1472	09-0007	Whether the Intermediary properly adjusted the Provider's available beds for the purpose of determining the amount of its indirect medical education payment.
2006D49	96-2013G	07-5234; 07-5210	Whether the Intermediary's adjustments to disallow rental expense as a cost incurred with a related organization were proper.
2006D50	01-1326G	07-5234; 07-5210; 07-5198	Whether the Intermediary's adjustments to disallow rental expense as a cost incurred with a related organization were proper.
2006D51	02-1212	52-0087	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."
2006D52	04-0565	50-1304	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.
2006D53	96-0480	26-0104	Whether the Intermediary's adjustment that disallowed the consolidation of all of the Provider's therapy services into a single cost center was proper.
2006D54	02-1420	10-0122	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.
2006D55	98-0580; 98-0463	14-5314	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.
2006D56	04-0660	05-0444	Whether the Provider's regular Medicare outpatient bad debts are not allowable until all collection efforts including those of a collection agency have ceased.
2006D57	05-0051	51-5028	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.
2006D58	03-0895	34-0168	Whether the Intermediary's disallowance of Medicare bad debts claimed by the Provider was justified.
2007D01	97-0174	16-0024	Was the Intermediary's disallowance of the loss on disposal of assets resulting from a merger proper?
2007D02	03-0482G	31-0108; 31-0039; 31-0005	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.
2007D03	04-0372	33-7089	Whether the Intermediary's adjustment to reconcile the fiscal year ended (FYE) 12/31/00 home health agency aide charges to the Provider Statistical & Reimbursement Report (PS and R) was proper.
2007D04	99-1159; 01-2664; 02-0866	20-0024	Whether the Intermediary's denial of the Provider's request for an adjustment to its TEFRA target amount was proper.
2009D13	02-0488; 03-1001	05-4144	Whether the Intermediary's determination of the Provider's direct graduate medical education (DGME) payment was proper.
2009D12	08-2907G	Various	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.
2009D11	05-1360G; 05-1362G; 05-1363G; 05-1527G	Various	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".
2009D10	07-1969G	19-5350; 11-5612; 15-5473; 11-5535	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.
2007D12	03-1464	05-0308	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.
2007D10	04-0209	13-0029	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.
2007D09	01-3592G; 02-2153G; 03-0960G	Various	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.
2007D08	05-0448	25-0085	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.
2007D07	01-1443; 01-1444	45-0011	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.
2007D06	04-0575	17-0086	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.
2007D05	02-1833G	Various	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.
2011D06	05-0508G; 06-0784G; 07-0510G; 08-1412G	Various	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.
2011D08	09-1927	37-1633	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.
2011D09	08-2162GC; 08-2165GC; 08-2186G; 08-2233GC et al	Various	Whether the Intermediary properly excluded the Ohio Hospital Care Assurance Program (HCAP) days from the Medicare disproportionate share hospital (DSH) calculation.
2011D10	00-3532G; 04-1657G; 06-0468G; 07-2031G; 08-2585G	Various	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.
2011D11	06-2033	01-0164	Whether the Centers for Medicare and Medicaid Services (CMS), reversal of the Provider's rural referral center (RRC) classification was proper.
2011D12	06-2376; 06-2377; 06-2378; 06-2379; 06-2381; 06-2383; 06-2385; 06-2410	Various	Whether the Fiscal Intermediary properly adjusted the Providers' bad debts for the fiscal year ended December 31, 2004.
2011D13	08-1695	05-0746	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.
2011D14	06-1927G; 08-0138G; 09-1545GC	Various	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.
2011D15	09-1796	05-0018	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.
2011D16	09-1058	33-0094	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?
2011D17	05-1761	51-0022	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.
2011D18	05-1032; 06-1173	09-0001	Whether the Intermediary properly extrapolated the sample error rate to the population in adjusting Medicaid eligible days.
2007D11	97-2446	05-0597	Whether the Intermediary's determination of reimbursable Medicare bad debts for beneficiaries without Medicaid eligibility (non-crossover beneficiaries) was proper.
2009D37	98-3491	39-0160; 39-5580	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.
2009D38	06-0316G; 06-0317G; 06-0318G; 06-0319G	Various	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.
2009D36	06-1080G; 06-1081G	Various	Whether the Intermediary"s adjustments to the Provider's reimbursable capital cost after denying "new hospital" status was proper.
2009D35	04-2261G	Various	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).
2009D34	99-1786; 99-2499; 00-2047; 01-1820	22-0042; 22-5699	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).
2007D28	03-0513; 04-0456	44-0070	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.
2008D22	04-0183	31-0014	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.
2008D20	06-0763; 06-2010	24-0213	Whether the Intermediary's refusal to reimburse the Provider for capital-related costs under the hold harmless methodology was proper.
2008D08	99-3188	45-7001	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.
2007D18	02-2080	45-0688	Whether the Intermediary's determination of allowable Medicare bad debts based upon collection effort was proper.
2007D17	97-2936	05-0279	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.
2007D16	03-0818	05-0578	Whether the Intermediary properly increased the number of available beds used to determine the Provider's indirect medical education (IME) payment.
2007D15	00-1836	21-7134	Whether the Intermediary's adjustment to disallow the cost of accrued compensatory time was proper.
2007D14	00-3662G; 00-3663G; 00-3664G; 02-0983G; 04-0180G; 04-0443G	Various	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.
2007D67	03-0522G	Various	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).
1998D030	90-2029	05-0388	Was the Intermediary's adjustment disallowing the costs associated with the repossessed equipment proper?
1998D029	89-1782	33-0041	Were the Intermediary's adjustments reclassifying the lease rental costs reported as capital costs proper?
1998D028	87-0480E	33-0085	Was the Intermediary's denial of the Provider's request for rural referral center status for the fiscal year ended December 3, 1986 proper?
1998D027	95-1188	05-0235	Was the Intermediary's denial of the Provider's Routine Cost Limit exception proper?
2007D24	03-1199G	Various	Whether the Intermediary should include all MediKan patient days, primary and secondary, in the Providers' disproportionate share hospital (DSH) calculation.
2007D23	01-2214	22-0060	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.
2007D22	01-0654; 02-0235	01-7009	Whether the relevant claims were timely filed by Alacare under 42 C.F.R. Section 424.44.
2007D21	03-0268; 03-0269	05-0045	Whether the Intermediary's adjustments disallowing the Provider's regular Medicare bad debts were proper.
2007D20	03-0573	36-0141	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?
2007D19	99-3470; 99-3471	39-0037; 39-0036	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.
2007D13	97-2986	14-0119	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?
1998D031	91-2986M	33-0153	Were the Intermediary's adjustments made foe graduate medical education (GME) settlement purposes proper?
1998D032	95-0495	39-0181	Was the Intermediary's adjustment disallowing the Provider's claimed loss on disposal proper?
1998D033	95-2125	53-7025	Did the Intermediary properly disallow a portion of the owner's compensation?
1998D034	97-1914	11-6670	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?
1998D035	93-2004	10-0114	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?
1998D036	93-0337	05-0034	Was the Provider's request for an adjustment to the TEFRA target amount for the 1989 fiscal year filed on a timely basis?
1998D037	93-0145	52-0091	Was the Intermediary's denial of sole community status under 42 C.F.R. Section 412.92 proper?
1998D038	95-2447	17-7215	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?
1998D039	97-0111G; 97-0112G	Various	Were the Intermediary's adjustments to occupational therapy and speech therapy costs proper?
1998D040	96-2419	52-5569	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)?
1998D042	93-0048	05-0102	Was the Intermediary's adjustment disallowing Medicare bad debts proper?
1998D041	93-0590	36-0062	Was the Intermediary's adjustment offsetting employee benefits proper?
1998D043	92-0033	50-0044	Was the Intermediary's denial of the Provider's request for an adjustment to its TEFRA target rate for its rehabilitation unit proper?
1998D044	96-0320	14-7273	Was the Intermediary's adjustment reducing allowable owner's compensation correct?
1998D046	92-1582	39-6563	Was the Intermediary's adjustment to the Provider's reasonable costs proper?
1998D047	96-2128	39-0023	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?
1998D048	97-0050G	Various	Did the Intermediary properly adjust the Provider's occupational and speech therapy costs?
1998D049	91-2824M	14-0180	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?
1998D050	94-2093G; 94-2094G; 94-2095G; 96-1323G; 96-1325G	Various	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?
2007D68	99-2630; 00-3142;01-1808; 02-1095; 03-1383; 01-2158	24-0063; 24-0210	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)
2007D71	00-3350	34-6538	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)
2007D69	00-3348	34-6538	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)
2007D72	00-3351	34-6538	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)
2007D73	00-3352	42-6548	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)
2007D75	00-3353	42-6548	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&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?
2008D13	00-1904G	Various	Whether the Intermediary's calculation of the disproportionate share hospital (DSH) payment was proper.
1998D055	93-0846	36-5746	Was the Intermediary's adjustment of the nursing cost proper?
1998D054	91-1799	41-0005	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?
1998D053	96-0229	45-7663	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?
1998D052	92-1562	45-0068	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?
1998D051	95-2407G	Various	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?
2011D39	09-0206GC	Various	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.
2011D40	10-0069GC	Various	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.
2011D41	04-1753G; 04-1824G; 04-1825G; 05-0375G; 05-1794G; 06-1093G; 07-0888GC; 09-2062GC; 10-0941GC; et al	Various	Whether Medicare+Choice (M+C) days should be included in the Medicaid fraction used to calculate the disproportionate share hospital (DSH) adjustment.
2011D42	98-2219; 98-2218; 01-2534; 03-1358	45-0610	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?
1998D045	92-0507	05-0457	Did the Intermediary properly adjust outpatient surgery, anesthesia and supply charges?
1998D060	89-1568	37-0094	Was the Intermediary's offset of investment income earned on the Provider's funded depreciation account against interest expense proper?
1998D061	91-2894M; 92-1709; 94-1277; 94-1278; 94-1702; 94-2063	36-0152	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?
1998D059	93-1280	40-0098	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?
1998D057	94-1800C	29-0021	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?
2009D17	09-0764G; 09-1053GC	Various	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?
2009D16	05-1296G; 05-1315G; 05-2197G; 06-1668G	07-0010; 07-0022; 07-0018	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.
2009D15	92-1212; 92-1522	45-0196	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.
2009D14	04-1293	08-5029	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.
2007D74	00-3354	42-6548	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)
2008D19	04-1995G	35-0002; 35-0015	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.
2008D16	89-1584	45-0101	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.
2008D14	01-0215	39-5526	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?
2008D17	04-0088G	Various	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.
1998D062	94-3278	23-0132	Was the denial of the TEFRA exception request proper?
1998D063	96-0535	18-0127	Were the Intermediary's adjustments to Medicare bad debts proper?
2009D18	09-0801 thru 09-0810; 09-0815; 09-0816	05-0126	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).
2009D19	05-1873; 05-1879; 05-1880; 05-1881	24-0036	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.
2009D21	09-0380GC	Various	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.
1998D058	85-0058	33-0136	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?
1998D064	96-0340	36-5946	Was HCFA's denial of the Provider's request for an exemption fron the routine cost limit ("RCL") as a new provider proper?
1998D065	96-1352; 96-1353	14-7472	Were the Intermediary's adjustments to disallow legal fees deemed not related to patient care proper?
1998D066	94-0070	36-0054	Does the Provider meet the criteria for receiving disproportionate share payments based on application of undisputed facts?
1998D067	94-1389E; 94-1390E; 94-1525E	39-4001	Did the Intermediary err in reopening the Provider's cost reports to calculate Graduate Medical Education reimbursement?
1998D068	92-1805; 93-0196; 94-0366; 95-0672; 96-0750; 97-0104	14-7407	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?
2010D27	04-0114G; 05-0286G; 06-0943G; 06-1377G; 07-0311G; 04-0940	Various	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.
2010D28	05-0289	33-0224	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.
2010D29	08-1848; 09-1547; 10-0106; 06-1773; 07-2384; 08-2266; 09-1565	10-1406; 10-1416	Was the Intermediary's adjustment disallowing bad debts arising from coinsurance and deductibles for dual eligible Medicare and Medicaid beneficiaries proper?
2010D30	09-0071	11-0034	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.
2010D31	09-0072	11-0034	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.
2009D20	04-1997G	Various	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.
1998D056	93-0509	05-0381	Was the Intermediary's refusal to reopen the Provider's cost reports an abuse of discretion?
1998D069	90-0989	41-0001	Was the Health Care Financing Administration's ( 'HCFA' ) denial of the Provider's request for reconsideration of the TEFRA exception request proper?
1998D070	94-1740	05-0183	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?
1998D071	95-2007	05-0457	Was the Intermediary's refusal to reopen the Provider's cost report an abuse of discretion?
1998D072	90-1070	04-0062	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?
1998D073	91-2671M	23-0032	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?
1998D074	93-0513	11-0198	Was the Intermediary's elimination of space rental costs proper?
1998D076	94-0353	23-0032	Was the Intermediary's denial of the Provider's request to revise the 1985 base year average per resisent amount proper?
1998D077	94-2804	45-0137	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?
1998D079	95-0436	05-0183	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?
1998D080	93-0054	15-4033	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?
2010D32	05-1693; 05-1694	36-0175	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?
2010D33	05-0171G; 05-0172G; 05-0173G; 06-0153G; 07-0453G; 08-1308G; 09-0964GC	Various	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.
2010D34	08-0382; 08-0383	19-1555	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.
2010D35	98-0850G; 09-1633GC; 09-1634GC; 09-1635GC; 07-2034G; 07-2032G; 07-2033G	Various	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.
1998D075	88-1339	10-0060	Did the Intermediary correctly apply the lower of cost or charge limit?
1998D078	91-1509	05-0040	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?
1998D081	92-2398	42-T078	Was HCFA's denial of the Provider's request for an adjustment to its TEFRA target rate for certain costs proper?
1998D083	92-1569	05-0191	Was the Provider's request for an adjustment to the TEFRA limits for the fiscal year ended June 30, 1989 timely?
1998D084	96-0066G	Various	Was the Intermediary's inclusion of neonatal intensive care unit ("NICU") beds in the indirect medical education ("IME") calculation proper?
1998D085	96-0378	05-0281; 55-5294	Should the Provider's Medicaid patient days in its "subacute unit" be included in calculating the disproportionate share hospital ("DSH") adjustment?
2007D25	06-0110G; 06-0111G	67-7270: 37-7097	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?
2009D39	04-1799G	Various	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.
2009D40	05-1291; 05-1292; 05-1293	10-4504; 10-4561; 10-4560	Whether the Intermediary's adjustments reflected in the revised Notices of Program Reimbursement (NPR), that reduced allowable home office costs, were proper.
2009D41	05-0350; 06-0452	33-0004	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.
2009D42	Various	26-2011; 26-2010	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.
2010D01	01-2484	06-0024	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.
2010D02	06-1078G; 06-1079G	Various	Whether the Intermediary's adjustments to the Provider's reimbursable capital costs after denying "new hospital" status was proper.
2010D03	07-0793G	Various	Did the Centers for Medicare & 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?
2007D26	04-1774	42-0023	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.
2007D27	04-0552	24-0001	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.
2007D29	02-0361G	Various	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.
2007D30	99-2858	17-0122	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
2007D31	01-3521G	31-0015; 31-0051	Whether the cost report instructions improperly apply the indirect medical education (IME) full-time equivalent (FTE) cap to discharges prior to October 1, 1997.
2007D32	00-2803	52-0174	Whether the Intermediary's determining disallow post-retirement health benefits costs for a terminated provider was proper.
2007D33	04-2009	45-1320	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).
2007D34	06-0456	05-0222	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.
2010D04	05-0917; 05-0916	26-4020	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.
2010D05	03-0859G; 04-1027G; 05-1256G	Various	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.
2010D06	08-0429	42-0078	Whether the intermediary's disallowance of resident time spent in didactic activities for purposes of the indirect medical education adjustment was proper.
2010D07	06-0301; 06-0302	16-0083	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.
2010D08	08-2068	37-1633	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.
2010D09	00-3325	05-0146; 05-7037	Whether the Provider timely filed its Tax Equity and Fiscal Responsibility Act (TEFRA) exception request.
2010D10	98-3417G	Various	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.
2010D11	04-0228G	Various	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.
2010D37	02-0816	22-5681	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)?
1998D082	94-2577	17-0086	Was the Intermediary's reopening of the Medicare cost report to reduce reimbursement for indirect medical education ("IME") expense proper?
1998D086	94-3045	33-2546	Was the Intermediary's denial of the Provider's request for an exception to its End-Stage Renal Disease ("ESRD") composite rate proper?
1998D087	97-0682G	Various	Were the Intermediary's adjustments to occupational and speech therapy costs proper?
1998D088	90-1201;91-1310	45-0021	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?
1998D089	91-2907M	39-0196	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?:
1998D090	92-0948	50-0064	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?
1998D091	95-1921	05-0468	Should the Provider's Medicaid patient days in its "subacute unit" be included in calculating disproportionate share hospital ("DSH") adjustment?
1998D092	95-0303	05-4078	Was the Intermediary's adjustment to the property tax expense proper?
1998D093	92-0591	16-0083	Was the Intermediary's allowcation of the Provider's physician billing costs proper?
1998D094	95-0100	39-0110	Did the Intermediary use the proper bed count when computing the Provider's indirect medical education ("IME") adjustment for fiscal year 1992?
1998D095	97-2589	10-0237	Did the Intermediary improperly reopen the Provider's fiscal year ended ("FYE") september 30, 1001 cost report? adjustment to
1998D096	97-3046	67-7584	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?
2008D18	01-0801	14-0174	Whether the Intermediary's adjustment disallowing the loss on disposal of depreciable assets through consolidation was proper.
2008D21	01-1910	05-6833	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.
1998D108	96-0568G	Various	Was the Intermediary's audit adjustments reducing charges for occupational and speech therapy services based upon the prudent buyer concept proper?
1998D107	96-2053G	Various	Was the Intermediary's audit adjustments reducing charges for occupational and speech therapy services based upon the prudent buyer concept proper?
1998D106	96-0175G	Various	Were the Intermediary's audit adjustments reducing charges for occupational and speech therapy services based upon the prudent buyer concept proper?
1998D105	96-0590	50-5344	Was the Intermediary's audit adjustment reducing charges for occupational and speech therapy services based upon the prudent buyer concept proper?
1998D104	94-0284G	Various	Was the Intermediary's inclusion of neonatal intensive care unit ("NICU") beds in the indirect medical education ("IME") calculation proper?
1998D103	93-0429	05-0230	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?
1998D102	94-1146	36-0045	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?
1998D101	89-0706	05-0578	Was the Intermediary's determination of the amount of Medicare outlier payments proper?
1998D100	93-1013	05-0152	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?
1998D099	89-1522	05-0327	Was the Provider's computation of the self-disallowance amount of investment income offset against interest expense proper?
1998D098	89-1753	05-0450	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)?
1998D097	97-3047	67-7413	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?
2008D15	00-1182	39-0242	Whether the Intermediary's denial of the loss on disposal of assets claimed by Allentown Osteopathic Medical Center (AOMC) was proper?
2008D25	05-1788	05-0599	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.
2008D24	01-0679; 02-0244	05-0043	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.
2008D23	04-1953; 05-1582	45-0076	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.
2010D40	01-1346G	Various	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").
2010D41	04-0495G	Various	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").
2010D42	98-1025	23-0029	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.
2010D43	02-0162	10-5990	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?
2010D44	04-2270; 07-0278; 07-1351; 08-0169	37-0202	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.
2010D45	04-0380; 05-1209; 06-0688	03-0064	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.
2000D22	96-1930; 97-1708; 98-2034	34-0061	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?
2000D23	96-1736	31-0062	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?
2000D24	94-0302G; 94-0304G	Various	Were the Intermediary's adjustments to the Providers' home office cost statementsproper?
2000D25	95-0326	50-0057	Were HCFA's determinations of the Provider's ESRD exception requests proper?
2000D26	95-1566	31-0075	Was the Intermediary's failure to apply updated reasonable compensation equivalents limits proper?
2000D27	96-0036	36-0085	Was the Intermediary's adjustment to the outlier payments proper?
2000D28	91-2846M	33-0354	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?
2000D29	91-2887	14-0087	Was the Intermediary's netting of the balance due to Edgewater Hospital of liabilities owed to the program by Edgewater Medical Center proper?
2000D30	95-0459	05-0684	Was the Intermediary's elimination of square footage statistics for the fourth floor storage area correct?
2000D48	96-0861	24-2004	Was the Intermediary's adjustment to disallow the Minnesota Care Tax proper?
2000D49	96-0804	24-0003	Was the Intermediary's adjustment to disallow the Minnesota Care Tax proper?
2000D50	96-0918	51-0001	Was the Intermediary's adjustment reclassifying the depreciable assets as "new" capital proper?
2000D47	96-0644	24-0063	Was the Intermediary's adjustment to disallow the Minnesota Care Tax proper?
2000D46	97-2385	36-6007	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)?
2000D45	94-0614	14-0087	Was the Intermediary's calculation of the Provider's disproportionate share ("DSH") adjustment proper?
2000D44	94-0616	14-0087	Was the Intermediary's calculation of the Provider's disproportionate share ajustment ("DSH") proper?
2000D43	96-0527	01-0068	Was the Intermediary's adjustment disallowing portions of compensation paid to physicians based on the application of the 1984 reasonable compensation equivalents ("RCE") proper?
2000D42	95-0577	39-0049	Was HCFA's denial of the Provider's request for an exception to the renal dialysis composite rate based on atypical service intensity proper?
2000D41	96-2423	33-0048	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?
2000D40	95-0535	52-0098	Was HCFA's denial of the Provider's request for an exception rate for self-dialysis training using an accelerated method proper?
2000D39	91-2592M; 94-0951; 94-0952; 94-0953; 94-1386	49-0063	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?
2000D38	98-0273	45-6689	Was the Intermediary's adjustment to the accrued salaries proper?
2000D37	95-2401; 95-2402; 95-2403	39-0029	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?
2000D36	97-0795	01-7009	Was the Intermediary's adjustment calculation proper to bring the expenses of Healthstar, Inc., a related party, to the cost of ownership?
2000D35	97-2148	43-0077	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?
2000D34	97-2064	43-0077	Was the Intermediary's classification of School of Nursing Joint Education Program cost proper?
2000D31	96-2587	34-7021	Was the Intermediary's adjustment disallowing the Provider's employee recruitment expense proper?
2000D32	98-0448	24-0053	Was the Intermediary's disallowance of the physician Part A compensation due to inadequate physician time studies proper?
2000D33	97-2391	33-0158	Were the Intermediary's adjustments to the reasonable compensation equivalent ("RCE") limits proper?
2000D52	96-2570	16-0059	Was the Intermediary's adjustment disallowing the Provider's loss on the sale of its assets proper?
2000D53	88-0649	22-3026; 22-5190	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?
2000D54	96-2623	05-0559	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?
2000D51	95-2202	33-0399	Was the Intermediary's adjustment reducing the allowable cost to charge retio that should be applied to outpatient charges proper?
2000D55	97-1810	10-7123	Was the Intermediary's adjustment to the Provider's visit statistic proper?
2000D56	96-1215	44-0072	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?
2000D58	96-2027; 97-2271	53-0002	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?
2000D57	96-0939	05-0267	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?
2000D59	96-2619	03-5104	Was the Intermediary's adjustment disallowing indigent Part B bad debts proper?
2009D25	00-3473G	Various	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.
2007D35	95-0795; 97-1098; 00-3556G; 01-2892G; 01-2936G; 01-2937G; 02-1810G; 03-1423G	Various	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.
2007D36	98-2095	33-7019	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.
2007D37	00-0774	53-7025	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.
2007D38	00-01032; 01-2147	24-5610	Whether the denial of the Provider's request for a new provider exemption from the skilled nursing facility routine cost limits was proper.
2007D39	04-0644	23-0230	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.
2007D40	04-2269	05-0150	Whether the Provider's regular Medicare outpatient bad debts are not allowable until all collection efforts including those of a collection agency have ceased.
2000D60	95-0079; 95-2394; 96-0287	26-7002	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)?
2000D61	96-2534	23-0132	Was the denial of the TEFRA exception request proper?
2000D63	97-0643; 98-0770; 99-3555; 99-0613	55-7253	1. Was the Intermediary's adjustment to Physical Therapy costs proper?; 2. Was the Intermediary's adjustment to owner's compensation proper?
2000D64	96-0847	24-0106	Was the Intermediary's adjustment offsetting the Provider-paid surcharge (tax) to the Minnesota Medicaid Program proper?
2000D65	91-2887R	14-0087	Was the Intermediary's netting of the balance due to Edgewater Hospital of liabilities owed to the program by Edgewater Medical Center proper?
2000D66	92-0209; 94-2362; 98-0428; 99-0130; 99-0131	01-0068	Was the Intermediary's adjustment disallowing portions of compensation paid to physicians based on the application of the 1984 reasonable compensation equivalents proper?
2000D67	94-0654	45-0358	Was the Intermediary's adjustment reclassifying costs related to equipment which was part of a aupply purchase agreement proper?
2000D68	99-0286	31-7062	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?
2000D69	90-1357	05-0076	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?
2000D70	97-0407	36-0125; 36-6048	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)?
2000D62	92-0668R	34-0113	Did the Intermediary properly reopen the Provider's cost report and recoup an overpayment made to the Provider?
2000D71	95-1279; 95-1280	13-0037	Were the Intermediary's adjustments disallowing costs associated with the Certified Nurse Anesthetist proper?
2000D72	93-1920; 94-0007	05-0226	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?
2000D73	94-1477; 94-1520	45-0023	Were the Intermediary's initial, amended and reopening adjustments to interest expense and bond related cost proper?
2000D74	88-1494G; 88-1495G; 88-1496G	Various	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?
2000D75	93-0073G; 92-1509G; 93-0888G	Various	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?
2011D19	09-0003GC; 04-2135G; 04-2136G; 04-2137G; 06-1907G; 06-1906G; 08-2753GC; 08-2757GC; 08-2847GC	Various	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).
2011D20	08-2752GC; 04-2131G; 04-2132G; 04-2133G; 04-2134G; 08-2845GC; 08-2756GC	Various	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).
2011D21	04-0327; 04-0328	45-0728	Whether the Provider is entitled to payment of "fair compensation" pursuant to 42 C.F.R.Section 413.13.
2011D22	04-0661; 04-0663	45-0705	Whether the Provider is entitled to payment of "fair compensation" pursuant to 42 C.F.R. Section 413.13.
2011D23	05-0476	45-0068	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.
2011D25	00-2803	52-0174	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.
2011D26	08-0384	19-1555	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.
2011D27	08-1474	33-0005	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.
2010D12	06-2136G; 07-2590G;08-2765GC;082961GC;08-2963GC; 08-2964GC	Various	Whether the Intermediary's disallowance of the Illinois provider tax assessment was proper.
2010D13	06-1800	10-1440	Was the Intermediary's adjustment disallowing bad debts arising from coinsurance and deductibles for dual eligible Medicare and Medicaid beneficiaries proper?
2010D14	05-0828	10-0061	Whether the provider has a right to hearing on correction of its cost report to reclassify certain nurse expenses.
2010D15	08-1816	36-0151	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?
2010D16	07-2546; 07-2547; 07-2548; 07-2549	22-1990	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.
2010D17	07-2533; 08-0470	05-1991	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.
2010D18	07-2532	05-1993	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.
2010D19	07-2538; 07-2544	45-1990	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.
2010D20	00-4034G; 00-4035G; 00-4036G; 05-0157G	Various	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.
2010D21	07-2829	10-1472	Was the Intermediary's adjustment disallowing bad debts arising from coinsurance and deductibles for dual eligible Medicare and Medicaid beneficiaries proper?
2010D22	04-2157; 05-0706	39-0204; 39-0022	Whether General Assistance (GA) days should be added to the numerator of the "Medicaid" proxy in the Disproportionate Share (DSH) payment calculation.
2010D23	07- 0459; 07-2370	03-5143	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.
2010D24	01-2257	12-0001	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.
2010D25	08-0251G	Various	Whether the CMS must-bill policy applies to the Providers' dual-eligible bad debts when the Providers did not participate in the Medicaid program.
2010D26	05-1790G	Various	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)?
2011D24	03-1199G	17-0040; 17-0086; 17-0122	Whether the Intermediary should include all MediKan patient days, primary and secondary, in the Providers' disproportionate share hospital (DSH) calculation.
2000D76	98-0455	26-7281	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?
2000D77	97-2085	05-7470	Was the Intermediary's disallowance of interest expense proper?
2000D78	98-2068G	05-7470; 55-7643; 55-7625	Was the Intermediary's disallowance of interst expense proper?
2000D79	98-1396G	Various	Was the Intermediary's adjustment to worker's compensation expense proper?
2000D80	96-0184G	Various	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?
2000D81	96-2281G	Various	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?
2009D22	99-1340	39-0028	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.
2009D23	99-0584R (on Remand)	39-0080	Whether the Jeanes Hospital merger was a bona fide sale.
2009D24	99-2786	22-0118	Whether the Intermediary's disallowance of the Provider's claim for a loss in connection with its October 1, 1996 statutory merger was proper.
2000D82	96-2052	52-5504	Was the Intermediary's recalculation of the Provider's gross-up method proper?
2000D83	Various	Various	Was the Intermediary's inclusion of maintenance treatments in the Provider's cost aportionment statistics for Medicare reimbursement proper?
2000D84	95-0711	52-0094	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?
2000D85	96-2085	05-0090	Was the Intermediary's calculation of the Skilled Nursing Facility (SNF) Routine Cost Limits (RCL) proper?
2000D86	97-2707	45-0717	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?
2000D87	95-0634	05-0017	Was HCFA's denial of the Provider's routine cost limit (RCL) exception request proper?
2000D88	99-3515G	Various	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?
2000D89	97-2390	52-0109	Were the Intermediary's adjustments offsetting investment income related to the sale of HMO stock proper?
2000D90	97-2601	20-0016	Was the Intermediary's denial of the Provider's request for a sole community hospital decreased volume adjustment proper?
2010D36	07-2626G; 06-2111GC; 09-2298GC	Various	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 & Medicaid Services Ruling CMS-1498-R, which if valid, render moot and deny jurisdiction over the dual-eligible group appeals?
2007D41	04-0805	05-4135	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.
2007D42	00-1882G	Various	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.
2007D43	98-1942	44-0048	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.
2007D44	01-2519	45-0039	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).
2007D45	02-0162	10-5990	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.
2009D27	05-1370	52-0051	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).
2009D26	Various	Various	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.
2009D33	06-0814	45-0296	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.
2009D32	05-1133; 06-0127	05-0234	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.
2009D31	05-2010	45-0299	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.
2009D30	04-2128G	Various	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.
2009D29	98-0892	17-0122	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.
2009D28	04-0597G; 05-0663G; 06-0682G; 03-0282G; 04-0598G	Various	Whether paid lunch period time should be added to hours used to calculate the Providers' hourly wage rates.
2007D50	00-1757; 00-1859; 01-0958; 03-0180; 04-0110	44-0049	Whether the Intermediary's adjustment to the Provider's per resident amount (PRA) was proper.
2007D49	01-1010	38-0033	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.
2007D48	05-0310	23-2029	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).
2007D47	05-0658	45-7789	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.
2007D46	97-1239; 97-1240	21-5279; 21-5280	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.
2008D26	02-0326; 03-0730; 04-1130	05-0327	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.
2008D28	02-0463	03-7205	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.
2008D27	05-1219	17-1302	Was the Intermediary's adjustment to the provider's claimed owner's compensation proper?
2008D30	02-0050; 02-0615	14-4036	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)
2008D29	05-0133G; 05-243G	Various	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.
2008D31	02-0705	05-0241	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.
2008D32	03-0778; 04-0914	23-0216	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)
2008D33	98-0019; 02-0785	22-5682	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.
2007D70	00-3349	34-6538	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)
2008D39	00-1456	39-0098	Whether the Intermediary's adjustments disallowing the loss on disposal of depreciable assets through consolidation were proper.
2008D37	04-1083; 04-1091; 04-1093; 04-1950	22-0033	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.
2008D38	00-1454	39-0067	Whether the Intermediary's adjustments disallowing the loss on disposal of depreciable assets through consolidation were proper.
2008D40	06-0987	27-1328	Whether the Intermediary's adjustment to Certified Registered Nurse Anesthetist (CRNA) cost was proper.
2008D41	06-0614	23-0097	Whether the Intermediary correctly limited the Provider's ambulance reimbursement to its charges.
2008D43	04-1792; 05-2073; 05-2074; 05-2154; 06-0010; 06-0300	37-0078	Whether the Intermediary properly adjusted the Provider's indirect medical education full-time equivalent (FTE) cap?
2008D42	04-0393G	23-0412; 23-0270; 23-0176	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.
2007D78	02-0328; 03-0383; 04-0283; 05-1327	05-0396	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.
2008D01	05-0686	15-0011	Whether the recission of the hospital's approved request for Sole Community Hospital (SCH) status was proper.
2008D03	01-2270; 02-1573; 03-1015	10-0032	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.
2008D02	01-1674G	Various	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.
2008D05	06-1478	31-5381	Whether the Intermediary properly adjusted Medicare bad debts.
2008D07	03-1056	52-0051	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.
2008D44	03-1643	37-0190	Whether the Intermediary properly treated the Provider as an acute care prospective payment system (PPS) facility instead of an excluded cancer hospital.
2008D06	99-3140	05-0369	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.
2007D77	00-3356	44-6530	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)
2008D45	05-1891; 05-1887; 04-1831; 05-0731; 06-1938	14-0228	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.
2011D43	05-0023	33-0201	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.
2011D44	05-1144	33-0201	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.
2011D45	05-1802	39-3050	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.
2011D46	08-1452; 08-1800; 08-2699; 08-2533; 08-2534; 08-1156; 08-2532; 09-0914	Various	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.
2011D47	09-2261CG	23-0024; 23-0104; 23-0273; 23-0277	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.
2012D01	Various	Various	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).
2012D02	08-2202; 08-2203	25-0117	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.
2012D03	09-0957	23-0021	Whether the Intermediary's disallowance of Medicare bad debts that had been referred to an outside collection agency was proper.
2011D28	08-2579	05-0126	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?
2011D29	05-0148	31-0091	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.
2011D30	07-0084GC	Various	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.
2011D31	04-0848	09-0001	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.
2011D32	06-2319	06-0009	Whether the Intermediary properly disallowed the Provider's entire Medicare disproportionate share hospital (DSH) payment.
2011D33	08-1168; 08-1169; 08-1170; 08-1171; 09-0911; 09-0130; 09-1195	19-0090	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.
2011D34	05-1740G	Various	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.
2011D35	09-1970	14-0094	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.
2011D36	06-1431; 06-2384	40-0110	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.
2011D37	06-0867GC; 08-2122GC; 08-1592GC	Various	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?
2011D38	07-0522	50-1312	Whether the Intermediary's adjustment to the Provider's ambulance service rates was proper.
2007D76	00-3355	42-6548	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)
2007D51	01-0883	20-0018	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)
2007D52	02-0530G	Various	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.
2007D53	00-1081	08-0003	Whether the Intermediary's application of the reasonable compensation equivalent (RCE) limits was proper.
2007D54	00-1411	39-0128	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).
2007D55	02-1565; 03-0517; 04-0338	23-0070	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 & 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).
2007D56	04-0823	35-0070	Whether the Provider is entitled to Transitional Outpatient Payments (TOPs).
2007D57	00-2326	14-0088	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.
2007D58	03/0759	22-0089	Whether the Provider's Notice of Program Reimbursement (NPR) dated September 24, 2002 was an original or a revised NPR.
2008D04	04-1796	22-0070	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.
2008D11	03-1549	31-0001	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.
2008D09	03-0811	04-0091	Whether the Provider's Disproportionate Share Hospital (DSH) adjustment was correctly calculated.
2008D10	02-0363	31-0001	Whether the Intermediary's adjustments to the Provider's direct graduate medical education and indirect medical education full-time equivalent counts were proper.
2008D12	04-1491; 04-1495; 04-1496	18-0080	Whether the Intermediary properly adjusted Medicare bad debts accounts considered indigent by the Provider.
2008D35	05-2054	36-0112	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.
2008D34	02-1010; 02-0892; 02-1663; 02-2148; 30-0597; 03-1011; 04-0021; 04-0022	23-0053	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.
2008D36	99-3519M	05-0625	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.
2009D01	96-1627G	39-0001	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.
2001D18	99-2430; 00-0769	17-7087	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?
2001D15	94-0463	24-0053	Were the Intermediary's adjustments to SNF routine cost limits proper?
2001D21	97-1287	37-0161	Were the Intermediary's adjustments reducing the loss on asset disposal proper?
2009D09	07-1153	27-1325	Whether the Intermediary's disallowance of the Provider's certified registered nurse anesthetist (CRNA) on-call costs was proper.
2009D08	98-3176G	05-0008; 05-0058; 05-0132; 05-0152; 05-0655	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.
2009D07	05-1420G	Various	Whether the Intermediary's adjustment to utilization review costs was proper.
2009D06	04-1790G	03-0002; 03-0065; 03-0018	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.
2009D05	06-1300; 06-1301; 06-1307	03-0103	Whether the Intermediary used proper cost to charge ratios in calculating the Provider's outlier payments.
2009D03	04-2130G	50-0024	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).
2009D04	04-1915	03-0023	Whether the Intermediary properly calculated and applied the Provider's ambulance cost per trip limit.
2009D02	04-0596G	Various	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.
2007D66	01-3169; 03-1194	23-5472; 23-0121	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.
2007D65	03-0132	44-0048	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.
2007D64	04-0831; 04-0833	08-5034	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.
2007D63	03-0721; 04-0473	23-0059	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?
2007D62	96-2468	05-0279	Whether the Intermediary's determination of non-allowable physician office and vacant space costs was proper.
2007D61	96-1582	33-0059	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.
2007D59	05-1792	05-0260	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.
2007D60	04-1341; 04-1369	65-0001	Whether the Intermediary's adjustment disallowing the Provider's claimed withholding tax expense was proper.
2005D33	03-0055	05-8034	Was the Intermediary's adjustment to start-up costs proper?
2004D45	00-2151G	Various	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?
2004D34	99-3196; 00-0018	39-7001	Were the Intermediary's adjustments applying Medicare's Physical Therapy Compensation Guidelines to the Provider's employee physical therapists proper?
2004D12	97-1685	23-0122	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?
2011D01	06-0419G; 06-1433G; 06-1482G; 06-1451G; 07-0020G	Various	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.
2011D02	06-1009; 07-0237	06-0031	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.
2011D03	08-0298G	Various	Whether the Intermediary's adjustments to the Providers' Medicare bad debts were proper.
2011D04	06-0828	05-0090	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.
2011D05	05-2270	19-7717	Whether the Provider Statistical and Reimbursement Reports (PS&Rs) used to settle the Provider's cost reports for the fiscal years ended May 31, 1998 and March 17, 1999 are accurate.
2010D53	05-1261	23-0053	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.
2010D52	Various	Various	Whether Medicare+Choice (M+C) days should be included in the Medicaid fraction used to calculate the disproportionate share hospital (DSH) adjustment.
2010D51	04-2159	18-0141	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.
2010D50	06-1889; 06-1886; 06-1890; 02-1517; 06-1888; 06-1887; 06-0755; 06-0524; 06-1142	03-0061	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).
2010D49	10-0056	37-1635	Whether the amount in controversy requirement under 42 C.F.R. Section 405.1835 is satisfied.
2010D48	Various	Various	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 & 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?
2010D47	08-2017	14-0132	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).
2010D46	97-0206	05-0008	Whether the Intermediary properly denied the Provider's Tax Equity and Fiscal Responsibility Act (TEFRA) exception request because of the timeliness of the request.
2012D04	09-0894; 08-1351; 09-0892	23-0142	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.
2012D05	02-0531G	Various	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?
2012D06	10-1386GC	Various	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.
2012D07	06-1709; 05-0627; 06-0192; 06-1710	28-0081	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?
2012D08	96-0819; 97-1814	14-0119	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?
2012D09	00-2351	14-0119	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?
2012D10	98-0460	05-0211	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.
2012D11	07-0900; 06-1259; 07-0824; 09-0905; 09-0908; 09-0903; 09-0904	05-0464	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.
2012D12	06-0269	26-0027	Whether the Intermediary's determination of additional amounts paid to the Provider for nursing and allied health (N&AH) education costs associated with Medicare+ Choice (M+C) enrollees was proper.
2012D13	02-0529G	Various	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).
2012D14	09-0704	07-0034	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.
2012D15	09-0008	19-1555	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.
2011D07	00-1489	05-0107	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.
2012D16	07-0552; 07-2253	28-0081	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?
2012D17	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	Various	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.
2012D18	08-1404	36-0152	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.
2012D19	02-0387GC	Various	Whether the Intermediary's adjustments to the Laundry and Linen and the Central Service and Supply statistics were proper.
2012D20	08-1417	14-0124	Whether the Intermediary's exclusion of the physician malpractice expense from Worksheets A-8-2 and D-9 of the cost report was proper.

Page last Modified: 03/06/2012 11:20 PM
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