Confirmed Identity Theft

110 - Confirmed Identity Theft (Rev. 336: Issued: 02-07-20: Effective:05-08-20: Implementation; 05-08-20) The Centers for Medicare & Medicaid Services (CMS) is addressing instances of identity theft confirmed by the Investigating Unit (IU) through a CMS-approved identity theft victim validation and remediation process. For purposes of this instruction, the IU is the Unified Program Integrity Contractor (UPIC) and the CMS Center for Program Integrity (CPI). When the IU confirms, by letter, to the contractor that a victim’s overpayment(s) resulted from identity theft: • The contractor shall immediately discontinue ALL collection efforts on the overpayment(s). These collection efforts shall include recoupments, sending demand letters, and referring the overpayment(s) to Treasury. • Contractors not utilizing the Healthcare Integrated General Ledger Accounting System (HIGLAS) shall recall the overpayment(s) if it was referred to Treasury. • The contractor shall update the Shared System, HIGLAS, and ViPS Medicare System (VMS), as appropriate, for all affected claims and accounts receivables (ARs) within 5 business days from the confirmation receipt date. • Contractors utilizing HIGLAS shall adjust down the AR(s) with the “DELETE/ADJ TO ZERO” activity code and close the AR(s) by changing the AR status code “CLO-ERR.” The “DELETE/ADJ TO ZERO” activity code will systematically recall the overpayment(s) if it was referred to Treasury. • Contractors not utilizing HIGLAS shall adjust down the related AR(s) to $0.00 and change the status to closed. • The contractor shall refund any monies within 30 calendar days that were recouped or paid to satisfy the overpayment(s). • The contractor shall request CMS to provide a revised (corrected) IRS Form(s) 1099-C if the original IRS Form(s) 1099-C included the overpayment(s). o The contractor shall send the request to MedicareOverpayments@cms.hhs.gov with "Corrected IRS Form(s) 1099-C Request for Confirmed ID Theft" in the subject field. o The contractor shall include in its request, a copy of the IU identity theft confirmation letter and the amount(s) that shall be corrected. o The contractor shall issue the revised (corrected) IRS Form(s) 1099-C to the victim. • The contractor shall issue a revised (corrected) IRS Form 1099-MISC if the original IRS Form 1099-MISC issued to the victim contained amounts related to confirmed identity theft. • The contractor shall notify the victim, by letter, of all activity associated with the overpayment(s) of the confirmed identity theft case. This activity shall include items such as notice of the rescission of the overpayment(s), the revision of the IRS Forms 1099-C and/or 1099-MISC, and the recall of the overpayment(s) from Treasury. The letter shall also include all claim/document control numbers of all affected claims and all original accounts receivable amounts (principal and interest) that were adjusted down.