Look to These Resources for Compliant Overpayment Recoupment
Question: Is there a specific window in which payers are entitled to recoup any overpayments? Michigan Subscriber Answer: Every payer has a different policy, and each payer’s policy probably depends on state law. The rules, regulations, or timelines applicable to a payer and provider in New York is different from those in North Carolina or Michigan or California, and so on. Generally speaking, states that have specified regulations feature timelines ranging from six to 60 months, but many states have no time limits at all. The states that do have timeline specifications often have other guidance for payers who seek to recoup overpayments to providers, including limits and exemptions. For information specific to Medicare, see this Medicare Learning Network fact sheet on Medicare overpayments. Medicare seeks to recoup any overpayments swiftly and can levy serious consequences if providers don’t cooperate, including the U.S. Department of Treasury being able to enforce wage garnishment or referring the offending provider to the U.S. Department of Justice for litigation. Rachel Dorrell, MA, MS, CPC-A, CPPM, Production Editor, AAPC 
