PRRB Review

Decision #
2011D34
Case #
05-1740G
Provider #
Various
Issue
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.
Case Name
Sutter 98-99 Managed Care (CIRP) Group
Decision Date
06/16/2011
Fiscal Year End
12/31/1998; 12/31/1999