Final Settlement Payment for Medicare Cost-Based

20.2.2 - Final Settlement Payment for Medicare Cost-Based HMO/CMPs (Rev. 4, 10-01-01) If the final settlement determination is greater than payments already made to the HMO/CMP through monthly capitation payments and interim settlement, an underpayment will be declared, and CMS will make a lump-sum payment to the HMO/CMP. Conversely, if the final settlement determination is less than the total payment made, the HMO/CMP has been overpaid, and CMS must recover the overpayment.