Q. I’ve heard there are some new rules regarding Medicare overpayments. What do I need to know?
A. Yes, you’re correct, there are new rules for recovering Medicare overpayments and it is very important that you understand what constitutes an overpayment and how Medicare collects overpayments.
“A Medicare overpayment is a payment that a physician or supplier has received in excess of amounts due and payable under Medicare statute and regulations.”
If an overpayment of $10 or more is identified the following steps will be taken:
- A demand letter will be sent to the provider requesting payment.
- If no response is received a second demand letter is sent.
- If no response is received within 41 days from the date of the first letter then recoupment procedures will begin.
Recoupment involves withholding future payments. They can also raid your bank account using the Electronic Funds Transfer process. An appeal will stop recoupment, but it has to be filed within 30 days.