Dynamic List Information
Dynamic List Data
Decision Number
2008-D23
Case Name
University of Texas M.D. Anderson Cancer Center vs. BlueCross BlueShield Association/TrailBlazer Health Enterprises
Issue
1. Whether the Intermediary properly disallowed the Provider's request for an adjustment to the TEFRA rate-of-increase ceiling to account for the cost of new drugs that were not approved in the 1983 base year. 2. Whether the Intermediary properly calculated the Provider's 1996 reasonable cost that were included in the denominator of the fraction used to determine the payment-to-cost ratio for purposes of the Outpatient Prospective Payment System (OPPS) hold harmless payment.