Opinion ID: 3023610
Heading Depth: 3
Heading Rank: 1

Heading: Decision of the PRRB

Text: MHH separately appealed to the PRRB from the successor intermediary’s adjustments to fiscal years 1995-1996 and 1997-1999. After a consolidated hearing, the PRRB reversed the disallowance for fiscal years 1995-1996 but affirmed the disallowance arising out of MHH’s unapproved use of the second alternative allocation method during fiscal years 1997-1999. In reversing the disallowance for fiscal years 1995-1996, the PRRB held that MHH’s reliance on the intermediary’s written instruction should be protected even if the successor intermediary subsequently changes its position. 5 Wellmark, Inc. succeeded Independence Blue Cross as the fiscal intermediary on August 4, 1997, and Cahaba Government Benefit Administrators succeeded Wellmark on June 1, 2000. Because the events at issue include actions taken by both Wellmark and Cahaba, we will refer to them singularly as the “successor intermediary” to Independence Blue Cross. 8