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PRRB dispute resolution on fast track. Interview by Wendy Herr
1Provider Reimbursement Review Board, Baltimore, MD.
Summary
The Provider Reimbursement Review Board (PRRB) is reducing its case backlog through administrative changes and new procedures. Despite recent decreases, future legislation may increase Medicare payment dispute appeals.
Area of Science:
- Healthcare Administration
- Public Policy
Background:
- The Provider Reimbursement Review Board (PRRB) was established by Congress in 1972 as a quasi-judicial panel for Medicare payment disputes.
- Initially handling a low volume of appeals, the PRRB experienced significant growth, receiving a record 3,062 appeals in fiscal year 1991.
Discussion:
- Administrative reforms and procedural adjustments are being implemented to decrease the PRRB's substantial case backlog.
- Efforts focus on resolving cases prior to formal hearing stages to improve efficiency.
Key Insights:
- The PRRB is actively working to manage and reduce its extensive caseload.
- The board anticipates a decrease in appeals for the current year, a reversal of the previous upward trend.
Outlook:
- New legislation is expected to influence future appeal volumes, potentially leading to increased submissions to the PRRB.
- The PRRB continues to adapt its processes to manage Medicare payment dispute resolution effectively.