Provider is No Longer Participating in Medicare But Is Participating in

20.3 - Provider is No Longer Participating in Medicare But Is Participating in Medicaid (Rev.12946, Issued:11-08-24; Effective: 12-10-24; Implementation:12-10-24) If the Contractor discovers an overpayment upon the filing of a cost report, or on determination of the amount of program reimbursement for a former Medicare provider that is still participating in Medicaid, it shall immediately contact the provider to obtain a refund in a lump sum, if it has not been made. The Initial demand letter shall be sent and all subsequent collection activities performed as specified in §20.1 and Chapter 4, §10-20. The Initial demand letter must provide notice (See Chapter 4, §10-20 and §60) that action to withhold its Federal share of Medicaid payments will be requested if repayment arrangements are not made within 15 days of the date of this notice. The Contractor shall send the ITR letter 60 days from the date of the Initial demand letter if the provider has not responded, even though procedures for withholding the Federal share of payments in title XIX have been initiated, so that if recoupment efforts and withholding of Medicaid funds are not effective, the case will be ready for referral to the Department of Treasury. If the terminated provider has sold the entity to a participating provider refer to Chapter 3, §130 for change of ownership instructions.