Instructions

REVISED PRRB RULES - (Revised/Effective July 1, 2009) 

The Board has made revisions to the PRRB Rules issued August 21, 2008 (See ALERT 5 under the "Current Alerts" tab.) These revisions are effective July 1, 2009. These instructions supersede those previously issued. The changes to the PRRB Rules have been highlighted and dated with the effective date of the change. The Board may revise these Rules to reflect changes in the law, regulations or the Board's policy and procedures. The PRRB Rules 2009 can be found below under "Downloads."

CORRESPONDENCE NOTICE:

The PRRB often sends official correspondence via e-mail (including the Acknowledgment and Critical Due Dates letter, Notice of Hearing, Notice of Record Hearing, etc.).  Please modify your spam filter to accept e-mail from the PRRB.  This will help ensure that you receive the Board's correspondence and it is not sent to your spam or junk e-mail box.

In addition, on June 29, 2009, the Provider Reimbursement Review Board's (PRRB) computer systems are being upgraded to Microsoft Office 2007.  Therefore, all letters issued electronically by the PRRB as of that date will be issued in Microsoft Word 2007.  If you use Microsoft Word 2003, or other word processing software that is not compatible with Word 2007, you will need to visit Microsoft's website and download the conversion tool (free).  This download takes about 30 seconds and will be needed in order to open Word 2007 documents.  The direct link for the Microsoft conversion took can be found below under "Related Links Outside CMS."

We have also updated the PRRB model forms to make them more "user-friendly."  Please begin using the revised model forms as soon as possible.  We have also converted the revised model forms to a fillable PDF format, which can be found below under "Downloads."

In addition, please watch this website for Current Alerts, Answers to Frequently Asked Questions and other notices.

NEW REGULATIONS - 2008

The Centers for Medicare & Medicaid Services issued new appeal regulations for Medicare Part A provider appeals on May 23, 2008.  These regulations will affect Provider Reimbursement Review Board (PRRB) appeals pending as of or filed on or after August 21, 2008.  The regulations are available for download.  (See "Related Links Outside CMS" at the bottom of the page.)

SUGGESTIONS:

We welcome written suggestions regarding these Rules.  Please send your suggestions to PRRB@cms.hhs.gov.  We will consider every suggestion but may not respond to each one.

SUPPLEMENTAL INSTRUCTIONS FOR ESRD APPEALS

A set of supplemental instructions which set forth hearing procedures for ESRD appeals. See link under "Downloads" below.  [Issued March 15, 2001]

SUPPLEMENTAL INSTRUCTIONS FOR APPEALS OF CHILDRENS HOSPITAL GRADUATE MEDICAL EDUCATION (CHGME)

A set of supplemental instructions which set forth hearing procedures for Appeals of Children's Hospital Graduate Medical Education (CHGME). See link under "Downloads" below.  [Issued May 03, 2004]