[Code of Federal Regulations]

[Title 42, Volume 3]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR489.42]



[Page 952]

 

                         TITLE 42--PUBLIC HEALTH

 

  CHAPTER IV--CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF 

                  HEALTH AND HUMAN SERVICES (CONTINUED)

 

PART 489_PROVIDER AGREEMENTS AND SUPPLIER APPROVAL--Table of Contents

 

               Subpart D_Handling of Incorrect Collections

 

Sec. 489.42  Payment of offset amounts to beneficiary or other person.



    (a) In order to carry out the commitment to refund amounts 

incorrectly collected, CMS may determine that amounts offset in 

accordance with Sec. 489.41 are to be paid directly to the beneficiary 

or other person from whom the provider received the incorrect 

collection, if:

    (1) CMS finds that the provider has failed, following written 

request, to refund the amount of the incorrect collection to the 

beneficiary or other person; and

    (2) The provider agreement has been terminated in accordance with 

the provisions of subpart E of this part.

    (b) Before making a determination to make payment under paragraph 

(a) of this section, CMS will give written notice to the provider (1) 

explaining that an incorrect collection was made and the amount; (2) 

requesting the provider to refund the incorrect collection to the 

beneficiary or other person; and (3) advising of CMS's intention to make 

a determination under paragraph (a) of this section.

    (c) The notice will afford an authorized official of the provider an 

opportunity to submit, within 20 days from the date on the notice, 

written statement or evidence with respect to the incorrect collection 

and/or offset amounts. CMS will consider any written statement or 

evidence in making a determination.

    (d) Payment to a beneficiary or other person under the provisions of 

paragraph (a) of this section:

    (1) Will not exceed the amount of the incorrect collection; and

    (2) May be considered as payment made to the provider.