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Medicare Overpayments

This revised product comprises Subregulatory Guidance for Medicare Overpayments and its content is based on publicly available content within the SSA Section 1128J(d), SSA Section 1893(f)(2)(A) and 42 CFR Section 405.379. CMS policy or operation subject matter experts also reviewed/cleared this product. This product educates providers about the overpayment collection process. This process happens when provider payments exceed the amounts due and payable by law. Providers must return self-identified and Medicare Advantage Contractor (MAC)-identified overpayments to Medicare. We identify payment options, the recoupment limitation(s), and the overpayment collection process. The revised product contains no substantive changes to the previous version dated March 2021.

The previous version of this product is available to the public and currently posted on the CMS website at https://www.cms.gov/Outreach-and-Education/Medicare-Learning-Network-MLN/MLNProducts/Downloads/OverpaymentBrochure508-09.pdf.

Download the Guidance Document

Final

Issued by: Centers for Medicare & Medicaid Services (CMS)

Issue Date: August 03, 2022

DISCLAIMER: The contents of this database lack the force and effect of law, except as authorized by law (including Medicare Advantage Rate Announcements and Advance Notices) or as specifically incorporated into a contract. The Department may not cite, use, or rely on any guidance that is not posted on the guidance repository, except to establish historical facts.