Scheme Nickname: 
Medicare Geographic Hospital Classification Review

The Medicare Geographic Classification Review Board (MGCRB) decides on requests of Prospective Payment System (PPS) hospitals for reclassification to another area (Urban or in some cases Rural) for the purposes of receiving a higher wage index. The MGCRB's decisions must be rendered within a statutorily mandated 180 day time frame that begins on September 1st of each year. Statute requires the Board to be comprised of five members, two of whom are representative of rural PPS hospitals. The term of office is three years, except that the Secretary may reappoint members for more than one term.
Under section 1886(d)(10) of the Social Security Act and the regulations at 42 C.F.R. 412.230, et seq., the Administrator has the authority to review decisions of the Medicare Geographic Classification Review Board (MGCRB). Regulations provide for Administrator's review both at the hospital's request or at the discretion of the Administrator. The Administrator must issue a decision on a hospital's request for review not later than 90 days from the date of the receipt of the request. Discretionary review must be completed within 105 days of the date of the MGCRB's decision. The regulations governing the procedures and criteria for Administrator review are contained at 42 C.F.R. 412.278, et seq.

Types of Adjudication: 
Type B
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