The deadline for adding new issues to existing Medicare reimbursement appeals before the Provider Reimbursement Review Board (PRRB) is rapidly approaching. According to the rule adopted by CMS, that deadline is 60 days from the August 21, 2008 effective date of the new PRRB rule, or October 19, 2008. See, 73 Fed. Reg. 30190 (May 23, 2008). Since October 19 is a Sunday, the next business day, October 20, would be the actual deadline according to additional clarifications made in the new PRRB rule. However, it is critical to remember that, under the new rule, the request to add issues must be received by the PRRB on or before the deadline.
As discussed in the August 19, 2008 Executive Alert, the PRRB recently adopted new "model forms" governing the appeals process, and hospitals seeking to add issues to their existing appeals should use "Model Form C – Request to Add Issue(s) to an Individual Appeal," which can be found at the end of the PRRB's new rules. Issues not added to existing appeals by the deadline will be lost (or, at a minimum, become very difficult to include). Thus, hospitals should take the opportunity to review their docket of existing PRRB appeals and add any issues for which they have a legitimate basis, even under circumstances where the hospital has traditionally waited to add such issues (e.g., issues with pending reopening requests).