Recovery of Overpayment Due to Overdue Cost Report

80.2 - Recovery of Overpayment Due to Overdue Cost Report (Rev. 12946, Issued:11-08-24; Effective: 12-10-24; Implementation:12-10-24) Where CMS approves a change of the Contractor, the change is effective on the first day following the close of the fiscal year in which the provider gave timely notice. (See Pub 100-04, Medicare Claims Processing Manual, Publication 100-04, Chapter 1, General Billing Requirements.) A. Reminder Letter The outgoing Contractor is responsible for effecting final settlement for the cost report periods during which it serviced the provider. It issues the reminder letter required under §30.1 to ensure the timely receipt of the cost report. B. Initial Demand Letter If no cost report has been filed by the first day after the due date of the cost report (including extensions), the outgoing Contractor sends the first demand letter. (See Medicare Financial Management Manual, Publication 100-06, Chapter 4, Debt Collection, §20.2, Exhibit l, Column B.) It sends copies of the reminder letter and the first demand letter to the RO and incoming Contractor. Upon receipt of its copy of the letter, the incoming Contractor suspends the interim payment. C. Intent to Refer Letter The Contractor shall issue a “modified Intent to Refer (ITR) Letter for Unfiled Cost Reports,” if the provider has not filed the cost report and the overpayment balance has not been paid. (See Medicare Financial Management Manual, Publication 100-06, Chapter 4, §20.2 Exhibit 7 for a sample intent letter) D. Receipt of Delinquent Cost Report If the delinquent cost report is sent to the incoming Contractor, it sends the cost report to the outgoing Contractor to make the final settlement. After the outgoing Contractor has completed its review of the delinquent cost report, it notifies the incoming Contractor whether the cost report is acceptable, and the final settlement. The incoming Contractor, in accordance with Medicare Financial Management Manual, Publication 100-06, Chapter 4, §40.1, disposes of funds withheld during the suspension of interim payments.