Recoupment

40.5 - Recoupment (Rev. 77, Issued: 10-28-05, Effective Date: 10-28-05) (42 CFR 417.458) A Medicare cost plan agrees not to recoup deductible and coinsurance amounts for which Medicare enrollees were liable in a previous contract period except in the following circumstances: • The Medicare cost plan failed to collect the deductible and coinsurance amounts during the contract period in which they were due because of: o Underestimation of the actuarial value of the deductible and coinsurance amounts; or o A billing error; • The Medicare cost plan has identified the amounts and obtained advance CMS approval of the recoupment and the method and timing of recoupment; • The Medicare cost plan collects these amounts no later than the end of the contract period following the contract period during which they were found to be due.