Other Fields
Agency Scheme: 
HHSOMGCR0006
ADJUDICATION STRUCTURE
Hearing Level: Basic Structure
Name of Hearing Office (local name): 
Medicare Geographic Classification Review Board
Name of Hearing Office (global name): 
Department of Health and Human Services: Medicare Geographic Classification Review Board
Sub-Agency/Bureau/Division:: 
Centers for Medicare and Medicaid
Hearing Officer #1 (Title): 
Board Member
Are administrative appeals permitted from final decisions at the hearing-level stage?: 
Yes (All Types of Cases)
Comments/Notes on Adjudication Structure: 

The Medicare Geographic Classification Review Board (MGCRB) (42 U.S.C. 1395ww(d)(10); 42 C.F.R. 412.230-280) reviews geographic reclassification requests of hospitals receiving payment under the inpatient prospective payment system. Hospitals file geographic reclassification applications on three-year cycles and the MGCRB must issue approval or denial decisions with 180 days of the application deadline. Ordinarily, decisions are made on the record without an oral hearing. The MGCRB is composed of 5 members, including a chairperson. These members are appointed by the Secretary of Health and Human Services. While CMS Offices of Hearings staff supports the MGCRB hearing functions throughout the year, the Board members themselves work on part-time basis and are usually paid for 1 day per year, the day of the hearing. The statute provides for the final review of all MGCRB decisions by the Secretary, who delegates that function to the Administrator. There is no right to further judicial review.

PROCESS & PROCEDURE - General Information
Are private parties permitted to have representation at hearings?: 
Yes (All Types of Cases)
Who may serve as a private party representative?: 
Either
About what percentage of private parties were represented at hearings (FY2013)?: 
75.00%
Is the agency permitted to have representation at hearings?: 
No
Regulations/rules of practice for hearings (please include CFR citations): 
42 C.F.R. §412.230-280
PROCESS & PROCEDURE - Pre-Hearing Procedure
Is discovery permitted by either party at the hearing-level stage?: 
No
Briefly describe the scope and type(s) of discovery available (e.g., depositions, interrogatories, etc.): 
Does the hearing officer have subpoena authority?: 
Yes (All Types of Cases)
Are ex parte contacts prohibited?: 
Yes (All Types of Cases)
Are parties provided notice of hearing?: 
No
PROCESS & PROCEDURE - Hearing Procedure
What types of hearings are permitted at the hearing-level stage?: 
Written (Document-Only) Hearing
In-Person
Phone
Please provide the approximate percentage of each type of hearing relative to the total number of hearings (FY2013)
Written (Document-Only) Hearing: 
100%
How is the type of hearing selected: 
By Agency
How many hearing officers preside at each hearing?: 
Four or More
Is witness testimony permitted at hearings?: 
Varies by Case
If "Varies by Case," please describe: 
Witness testimony is permitted if oral hearing is held. Since 1991, there have been no MGCRB oral hearings. This question is not applicable to document-only hearings.
Can parties cross-examine witnesses?: 
Varies by Case
If "Varies by Case," please describe: 
Cross-examination is permitted in oral hearings. This question is not applicable to document-only hearings.
Can third-parties submit amicus briefs and/or evidence?: 
No
Are hearings recorded and/or transcribed?: 
No
N/A (Document-Only Hearings)
Are hearings open to the public?: 
Varies by Case
If "Varies by Case," please describe: 
Hearings are always closed. This question is not applicable to document-only hearings.
PROCESS & PROCEDURE - Post-Hearing Procedure
Who typically drafts the decision at the hearing-level stage?: 
Other
If "Other," please specify (drafts): 
CMS Office of Hearings staff draft decisions for MGCRB members approval.
Who has authority to issue final decisions?: 
Other
If "Other," please specify: 
Board authorizes CMS Hearing Office staff to release decisions approved or denied by the Board.
Do agency regulations or guidance provide time limits for issuance of final decisions?: 
Yes (All Types of Cases)
If "Yes," please specify these time limit(s): 
42 CFR 412.276
About how long does it take on average—as of FY2013—to adjudicate claims/cases at the hearinglevel stage (i.e., from case filing: 
130 Days
Is judicial review available after issuance of a final decision?: 
No
PROCESS & PROCEDURE - Case Management
How are claims/cases processed at the hearing-level stage?: 
Differentiated Case Management
Does the agency permit web-based electronic filing of hearing-related briefs or other documents?: 
No
Are final decisions published and/or posted on the agency website?: 
No
If "Yes (Some Decisions)," how does the agency determine which final decisions to publish/post? Please briefly describe: 
The decisions themselves are not posted, but a summary of the annual requests by provider, including the areas from and to they requested classification, and whether the request was approved or denied is posted to the CMS/MGCRB website.
Do agency regulations/rules of practice specify the contents of the administrative record at the hearing-level stage?: 
Yes (All Types of Cases)
If "Yes," please provide citation(s): 
42 CFR 412.272
Do agency regulations/rules of practice provide for closure of the record at the hearing-level stage (subject to applicable exce: 
Yes (All Types of Cases)
If "Yes," please provide citation(s): 
42CFR 412.272
ADJUDICATORS
Total # of Hearing Officers: 
5
ADR: General Information
Is ADR available at one or more points during the hearing process?: 
No
CASELOAD STATISTICS - Summary Statistics
Total # Cases Filed/Opened (FY2013): 
290
Total # Cases Decided/Closed (FY2013): 
290
Total # Cases Pending (End of FY2013): 
0
CASELOAD STATISTICS - Supplementary Statistics
Does your agency maintain annual caseload statistics for this hearing office by case type (e.g., discrimination complaint, licen: 
No
WRAP-UP
Do you have any additional comments about your agency's responses on this form? If so, please provide comments below.: 
Notices of Hearing are not provided to the parties, as all MGCRB hearings have been held on the record since 1991.
Verified by Agency: 
Verified