Opinion ID: 487477
Heading Depth: 2
Heading Rank: 3

Heading: Alleged Adverse Practical Consequences

Text: 26 The D.C. Circuit identified three closely related adverse consequences that it feared would result if the Board could review cost items not claimed before an intermediary. First, 27 a provider could list every conceivable cost on its cost report, without claiming reimbursement, and hope that the intermediary will reimburse it for the reported but unclaimed costs, secure that it nevertheless will have until 180 days following the [final determination] to concoct some reasons to urge upon the [Board] for reimbursement.... 28 Athens II, 743 F.2d at 6. 29 We do not believe that our interpretation of the statute encourages frivolous padding of cost reports any more than the Athens II interpretation encourages frivolous cost claims. If providers are prepared to list every conceivable cost on their cost reports, there is nothing to stop them from overtly disclosing and claiming those costs in the manner mandated by the Athens II court. In both cases, abuses are contained by the antifraud provisions of 42 U.S.C. Sec. 1395nn. There is no evidence in the record that abuses have occurred. 30 The second adverse consequence asserted is that our interpretation would deprive [the Board] of the intermediary's analysis and conclusions and make the [Board] the tribunal of original jurisdiction, eliminating a tier of review. Athens II at 6-7 (quoting Athens Community Hospital, Inc. v. Schweiker, 686 F.2d 989, 997 (D.C.Cir.1982) (Athens I )). We believe that this consequence is not always adverse. As remarked earlier, in the present cases it would have been pointless to present the providers' claims to the intermediaries, which had no power to grant relief. There is no reason to think, in these cases, that the intermediaries' analysis and conclusions would have helped the Board. 5 Moreover, it appears that Congress deliberately set up the Board's review procedure as a  'hybrid,' exhibiting some features of initial factfinding (witnesses, cross-examination, new evidence) and some features of review. St. Luke 's, 810 F.2d at 328. 31 The third apprehended consequence is that our interpretation would 32 render virtually meaningless the time limits for the filing of cost reports established by [42 C.F.R. Sec. 405.453(f)(2) (1983) ]. Instead of being required to file within three months, with a maximum extension of 30 days, the provider could file new cost claims for as long as its appeal as to any claim was pending before the [Board]. 33 Athens II, 743 F.2d at 7 (quoting Athens I, 686 F.2d at 997). 34 We note that this consequence arises only if the Board is allowed to review matters totally omitted from a cost report. We have expressly left this issue open (see note 3, supra ). Even if the Board's review were extended to matters omitted from a cost report, however, the three month filing regulation would not be meaningless. It would still require a cost report to be filed within three months of the end of the reporting period. If no report were filed, the provider would have no relief. See Athens I, 686 F.2d at 994 & n. 7. 35