Medicare Compliance & Reimbursement

Industry Notes:

Ensure Your Team Knows The Rules On Recoupment

Keep staff in the loop to avoid issues.

Educating your personnel on how recoupment requests of Medicare overpayment are handled and how your MAC can come grab back your reimbursement are essential.

Details: On Feb. 15, the Centers for Medicare & Medicaid Services (CMS) updated its Limitation on Recoupment of Medicare Overpayments guidance in CR 11808. CMS advises that all staff know:

  • Medicare recoupment of overpayments is limited to the first and second levels of appeals only.
  • The timeline for the recoupment process as well as when to request either an extended repayment plan (ERS) or immediate recoupment.
  • How interest is calculated and paid for overpayments.

CR 11808 is effective as of July 1, 2024, but don’t delay educating your staff on the update.

Review the MLN Matters release at www.cms.gov/files/document/mm11808-limitation-recoupment-medicare-overpayments.pdf.