New Medicare PRRB Appeal Opportunity

Toyon is in the process of setting up appeals for its clients related to the recent ruling that opens the door for an appeal of “predicate facts,” or factual determinations that are relevant to the fiscal year at issue but which were actually decided in a year outside of the current year in dispute. Examples of now appealable predicate facts include IPPS standardized payment rates, SCH and MDH base rates, IME/GME base year resident counts, and GME base year per-resident amounts.

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