Prior to passage of the Medicare Modernization Act of 2003 (MMA), CMS was not restricted in recouping overpayments, despite the provider’s ongoing appeal rights.
Finally, as of November 16, 2009, CMS will implement new rules required by MMA to restrict immediate recoupment. Section 1892(f) of the Social Security Act prohibits recoupment of overpayment during a supplier or provider appeal to a Qualified Independent Contractor (QIC), and CMS will also stop recoupment during the first level of appeal (redetermination) upon a timely request.
However, the new rules also allow the assessment of interest dating back to the original overpayment notification.
