Legal Opinion
Sebelius v. Auburn Regional Medical Center
Supreme Court of the United States
Decided January 22, 2013No. 11-1231PublishedCited by 500 opinions
1Opinion of the CourtJustice Ginsburg
This case concerns the time within which health care providers may file an administrative appeal from the initial determination of the reimbursement due them for inpatient services rendered to Medicare beneficiaries. Government contractors, called fiscal intermediaries, receive cost reports annually from care providers and notify them of the reimbursement amount for which they qualify. A provider dissatisfied with the fiscal intermediary’s determination may appeal to an administrative body named the Provider Reimbursement Review Board (PRRB or Board). The governing statute, § 602(h)(1)(D), 97…
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