Southwest Consulting Associates Blog

In part 2 of our FY 2020 IPPS Proposed Rule Review series, we will take a look at the one DSH item included in the proposed rule that may be of some interest to you. It appears this item stems from the fact that there are a large number of PRRB appeals involving Medicaid eligible days and the agency is struggling for ways to deal with that issue. It appears that the agency recognizes that there is a legitimate issue to be addressed in terms of including all identified Medicaid eligible days in a hospital’s cost report, but that there might be a better way to proceed and alleviate the backlog of appeals on this issue at the Provider Reimbursement Review Board.

In January, CMS issued a MLN Matters newsletter reviewing the new electronic system for Provider Reimbursement Review Board (PRRB) Medicare cost report appeals. The electronic system, referred to as OH CDMS (Office of Hearings Case and Document Management System), is a web-based portal that allows providers to submit all necessary appeals documents electronically.