CMS Final Rule Limiting Recoupment of Provider and Supplier Overpayments
On September 16, 2009 the Centers for Medicare and Medicaid Services issued a Final Rule Limiting Recoupment of Provider and Supplier overpayments. The Final Rule implements a provision of the Medicare Prescription Drug Improvement, and Modernization Act of 2003 (MMA). Prior to the MMA, overpayments could be recouped regardless of whether the provider or supplier had appealed the determination. Section 935 of the MMA prohibits recoupment during a provider or supplier appeal to a QIC. However, with this Final Rule CMS will also stop recoupment during the first level of appeal, redetermination, if the provider or supplier files a timely appeal.
Final Rule: 74 Fed. Reg. 47458
Effective date of the Final Rule: November 11, 2009
