Medicare Managed Care Manual (Pub. 100-16), Ch. 18b § 100.1

Under and Over Collection of Premiums

Last amended: 2003Year: 2003Length: 151 wordsOfficial source
100.1 - Under and Over Collection of Premiums (Rev. 30, 09-05-03) The HCPP is responsible for computing any over or under collection of premiums. All over collections of premiums must be returned to the Medicare enrollee. The HMO/CMP may select, with prior approval, one of the following three methods to refund over collections: • Adjust future years' premiums; • Provide a lump sum payment to the enrollee; or • A combination of premium adjustment and lump sum payment. Unintentional (or involuntary) under collections of premiums may be collected from the HCPP's Medicare enrollees by an adjustment to its Medicare enrollees' future premiums. However, the HCPP must collect the under collections through premium adjustments no later than the end of the contract period following the contract period during which they were found to be due. Intentional (or voluntary) under collections of premiums cannot be recouped by the HCPP from the Medicare enrollee.
Medicare Managed Care Manual (Pub. 100-16), Ch. 18b § 100.1: Under and Over Collection of Premiums | Justis AI