CMS issues new rule on recoupment of Medicare funds

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The federal government no longer will be able to recoup Medicare funds from healthcare providers during the first stage of an appeal of an overpayment finding, according to a rule published in the Federal Register on Wednesday.

Under the new rule, the Centers for Medicare & Medicaid Services cannot seek to recoup overpayments during the re-determination phase. It goes further than a September 2006 version of the rule that proposed limiting recoupment during the second level of the appeals process—after providers request a reconsideration of an overpayment finding by a qualified independent contractor. To recoup overpayments, the Medicare program cuts present or future Medicare payments to providers or suppliers and applies the amount withheld against the debt.

The rule will take effect of Nov 16 of this year. To view the rule, visit http://edocket.access.gpo.gov/2009/pdf/E9-22166.pdf.