Overpayments Subject to Limitation on Recoupment

200.1.1 - Overpayments Subject to Limitation on Recoupment (Rev. 293, Issued: 09-14-17, Effective: 04- 02-18, Implementation: 04-02-18) This applies to most Fee-For-Service claims for which a demand letter is issued (refer to 42 CFR, 405.379), such as: A. Post-pay denial of claims (refer to 200.1.2 for exclusions). B. Medicare Secondary Payer (MSP) Duplicate Primary Payment (DPP). (That was referred to the MAC contractor by the BCRC, CRC, other MAC contractor, or due to Self-Reporting (42 CFR 411.25)). C. MSP recovery due to provider's failure to file a proper claim with the third party payer plan, program, or insurer for payment. D. Final Claims associated with a Home Health Agency (HHA) Request for Anticipated Payment (RAP) under Home Health Prospective Payment System (HH PPS), (refer to 200.1.2(D) for exclusions).