Medicare Program; Limitation on Recoupment of Provider and Supplier Overpayments
medicare · Centers for Medicare and Medicaid Services · Rule · Published 2009-09-16 · Effective 2009-11-16 · 74 FR 47458
Document
Document number
E9-22166
Federal Register citation
74 FR 47458
CFR reference
42 CFR 405
Type
Rule
Action
Final rule.
Category
medicare
Sub-agency
Centers for Medicare and Medicaid Services
Publication date
2009-09-16
Effective date
2009-11-16
HHS docket
CMS-6025-F
Abstract
This final rule implements a provision of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) which prohibits recouping Medicare overpayments from a provider or supplier that seeks a reconsideration from a Qualified Independent Contractor (QIC). This provision changes how interest is to be paid to a provider or supplier whose overpayment is reversed at subsequent administrative or judicial levels of appeal. This final rule defines the overpayments to which the limitation applies, how the limitation works in concert with the appeals process, and the change in our obligation to pay interest to a provider or supplier whose appeal is successful at levels above the QIC.