Medicare Financial Management Manual (Pub. 100-06), Ch. 4 § 70.6
Debt Ineligible for Referral (Rev. 11787; Issued:01-
70.6 - Debt Ineligible for Referral (Rev. 11787; Issued:01-
19-23; Effective: 04-21-23; Implementation:04-21-23)
Non-MSP debt ineligible for referral include those: (1) in bankruptcy status, (2) in an appeal status
(pending at any level), (3) at the Department of Justice, (4) where the debtor is deceased,
(5) Federal entity debt where the debtor is a Federal agency, (6) where the principal and interest balance is
less than $25, or (7) debt under fraud and abuse investigation where the investigating unit has provided
the contractor with specific instructions not to attempt collection.
Treasury has also approved a waiver for the mandatory referral of unfiled cost report debt for cross
servicing and/or TOP and for debts less than $100 that do not have a TIN.
Contractors shall monitor debt previously ineligible for referral that become eligible for referral. If the
status of the debt changes to an eligible status, contractors shall determine whether an ITR letter has been
sent. If the ITR letter has been sent, and at least 60 days have passed since the date of the ITR letter
(including the ITR letter returned undeliverable), contractors not utilizing HIGLAS shall refer the debt by
utilizing the Debt Referral Form within ten calendar days of the status change making the debt eligible for
referral. If the ITR letter has not been sent, contractors shall send the ITR letter within ten calendar days
of the status change making the debt eligible for referral, and follow the normal debt referral process.