Sending the ERS Request to the Regional Office (RO) (Rev. 12346;

50.4 – Sending the ERS Request to the Regional Office (RO) (Rev. 12346; Issued:11-01-23; Effective:10-30-23; Implementation:10-30-23) After the contractor has reviewed the provider’s supporting documentation and determines that a referral to the RO is needed, it shall send its recommendation to the RO for consideration of approval. The contractor shall submit the following: 1. A copy of all information the provider submitted. 2. The date of the initial contact between the contractor and the provider regarding the overpayment. 3. Copies of all correspondence, including demand letters and the complete Extended Repayment Schedule (ERS) request. Also include notes of telephone conversations, if any. 4. Part A - The amount of the overpayment; cost report year in which it occurred; dates and amounts of any repayments; dates and amounts of payments (interim or retroactive) held in account. 5. Part B - The amount of the overpayment, claim paid date, dates and amounts of any repayment. 6. Part A - The cost reports in which the overpayments appeared or were found. The contractor shall furnish any information it has on the financial status of related organizations, as determined through audits and other sources, such as mercantile reports. 7. Documentation reflecting current enrollment status along with any bankruptcy, fraud and abuse and other litigation cases. 8. Amount repaid to date on pending ERS request along with current status on any additional outstanding overpayments. 9. The provider’s proposed repayment plan and rationale. 10. The contractor’s recommendation and supporting rationale including a completed ERS protocol (See Exhibit 1) and the last 12 months’ claim and payment history. 11. The contractor’s opinion, based on experience, as to the reliability of the financial data. The RO will grant a provider an ERS of: (a) Up to 36 months if repaying an overpayment in full will constitute a “hardship,” as defined in section 50 of this chapter. (b) 37 months up to 60 months if repaying an overpayment in full will constitute an “extreme hardship,” as defined in section 50 of this chapter. See also 42 CFR 401-607(c)(2)(vi). If the contractor receives no response from the RO in 30 days, the contractor shall follow up with the RO for a status update. NOTE: An ERS shall be repaid through recoupment, unless a provider supplies a valid reason why the ERS shall be paid by another method, such as payment by check.