Recoupment of the Accelerated Payment

150.3 - Recoupment of the Accelerated Payment (Rev. 227, Issued: 09 17-13, Effective: 10-04-13, Implementation: 10-04-13) The Medicare Contractor shall attempt to recover any accelerated payment within 90 days after it is issued. To the extent that a delay in the provider’s billing process is the basis for the accelerated payment, recoupment is made by a 100 percent withhold against the provider’s bills processed by the (Part A) contractor or other monies due the provider after the date of issuance of the accelerated payment. Any remainder is recovered by direct payment by the provider not later than 90 days after issuance of the accelerated payment. If the payment is necessitated by abnormal delays in claims processing and/or payment by the contractor, recovery by recoupment will be reasonably scheduled to coincide with improvement in the contractor’s bill processing situation and such recoupment will not impair the provider’s cash position. In this situation, recoupment shall be completed within 90 days of the contractor processing the provider’s claims. If recovery is not complete 90 days after the accelerated payment is issued or 90 days after the contractor begins processing claims, the accelerated payment is considered delinquent. The contractor shall immediately send out an initial demand letter. This letter shall state that 100 percent recoupment by withhold of all payments is in effect and that the recoupment will remain so until the debt is paid in full or acceptable payment arrangements are made. Contractors shall include the “Intent to Refer” language required to refer the debt to the Treasury Department. (See Chapter 4, §70) Interest shall begin to accrue on the 31st day after the date of the demand letter at the prevailing rate set by the Treasury Department. If the contractor does not hear from the provider within 15 days from the date of the demand letter, the contractor shall attempt to contact the provider by telephone. If the demand letter is returned undeliverable the contractor shall attempt to locate the provider using some of the guidelines set forth in Chapter 4, §10. If the contractor does not hear from the provider within 60 days of the date of the demand letter, the contractor shall input the debt into the Debt Collection System for referral to the Treasury Department for additional collection activity. SAMPLE FORMAT FOR PROVIDER REQUEST FOR ACCLERATED PAYMENT: 1. Provider:_________________________________ Provider Number:_________ Address:____________________________________________________________________________ ___________________________________________________________ 2. Contractor: ____________ 3. Check (a) or (b) if applicable: Cash balance is seriously impaired due to: (a) Abnormal delay in Title XVIII claims processing and/or payment by the health insurance Contractor. (b) Delay in provider billing process of an isolated temporary nature beyond the provider’s normal billing cycle and not attributable to other third party payers or private patients. Note: If 3b is checked the provider should also include a narrative explaining the nature of the problem, how it will be fixed, and the expected duration of the delay. 4. a. General fund cash position for provider as of ________ $_____ b. Anticipated receipts from all sources (exclusive of accelerated $_____ payments) in the next 30 days c. Anticipated expenditures in next 30 days $_____ d. Indicated cash position in next 30 days $ ____ (a + b – c)