Medicare Advantage Refund Request

EDCODER

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Fort Wayne Indiana
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Doe any one know if CMS has a time period for refund requests? Can they go back unlimited number of years and request a refund?

The NGS Medicare 101 manual doesn't state anything. I have also reviewed the CMS IOM Chapter 3 - Overpayments and Chapter 4 - Debt Collection and I was unable to find any thing that states a time frame for refund requests. NGS customer service was unable to provide an answer either.

Thanks in advance for any replys!
 

Tantoncic

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If you look in the Federal Register you should be able to do a search to find the information. However, the CMS guidelines state that you must refund the money no more than 30 days after the account becomes a credit balance. Also, they can request refunds far back but, more than likely they will recoup the money from a future remittance if you do not refund.
 

drakena74

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Local Chapter Officer
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Fullerton, CA
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CMS refund recoup

From the last Medicare seminar I went to, I believe they stated that CMS can only recoup refunds from physicians as far back as four years. If medicare is requesting the refund you have upto 30-days to refund the money.

Jennifer D.
 
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