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Indiana Administrative Code (Last Updated: December 20, 2016) |
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Title 405. OFFICE OF THE SECRETARY OF FAMILY AND SOCIAL SERVICES |
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Article 405IAC1. MEDICAID PROVIDERS AND SERVICES |
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Rule 405IAC1-1.5. Provider Reimbursement Appeal Procedures |
Section 405IAC1-1.5-5. Repayment of overpayment to office
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(a) The office of Medicaid policy and planning (office) may require the repayment of any amount determined by the office to have been paid to the provider in error, prior to an evidentiary hearing or summary review, unless an appeal is pending and the provider has elected not to repay an alleged overpayment pursuant to 405 IAC 1-1-5(d)(3). The office may, in its discretion, recoup any overpayment to the provider by the following means:
(1) Offset the amount of the overpayment against current Medicaid payments to a provider.
(2) In the case of an institutional provider, offset the amount of the overpayment to any or all of the Medicaid facilities owned by the provider until the overpayment has been satisfied.
(3) Require that the provider satisfy the overpayment by refunding the entire amount of the overpayment to the office directly.
(4) Enter into an agreement with the provider in accordance with 405 IAC 1-1-5.
(b) Interest from the date of the overpayment will be assessed even if the provider repays the overpayment to the office within thirty (30) days after receipt of the notice of the overpayment. This subsection applies to any of the methods of recoupment set out in this section. Interest on overpayments shall not exceed the percentage set out in IC 12-15-13-3(f)(1) [IC 12-15-13-3 was repealed by P.L.229-2011, SECTION 270, effective July 1, 2011.].
(c) Notwithstanding any other rule in this article, for hospitals who receive a notice that the provider has been underpaid by the office as a result of the cost settlement process, the office will pay interest to the hospital on the amount of the underpayment. Such interest will accrue from the date of the underpayment at the rate of interest set out in IC 12-15-13-3(f)(2) [IC 12-15-13-3 was repealed by P.L.229-2011, SECTION 270, effective July 1, 2011.]. (Office of the Secretary of Family and Social Services; 405 IAC 1-1.5-5; filed Oct 31, 1994, 3:30 p.m.: 18 IR 864; filed Jul 18, 1996, 3:00 p.m.: 19 IR 3374; readopted filed Jun 27, 2001, 9:40 a.m.: 24 IR 3822; readopted filed Sep 19, 2007, 12:16 p.m.: 20071010-IR-405070311RFA; readopted filed Oct 28, 2013, 3:18 p.m.: 20131127-IR-405130241RFA)