CMS Pub. 100-06, ch. 3, § 170.2

The carrier shall not attempt recovery action on individual overpayments if:

A. Total Overpayment Less Than $10

The cost of recovering such a small amount ordinarily exceeds the amount recovered. However, the

Carrier shall accept unsolicited overpayment refunds regardless of the amount. See §160.1 for

termination of collection action procedures.

B - The Carrier Has Not Taken Action to Reopen the Payment Decision Within Four Years (48

Months) after the Date of the Initial Payment Determination

Unless fraud or similar fault is present, a payment determination may not be reopened where the Carrier

has not taken some action (which can be documented) questioning the correctness of the determination

within 4 years (48 months) after the date the initial determination was approved. (See Medicare Claims

Processing, Chapter 30, Correspondence and Appeals for policies governing the reopening and revision

of decisions to allow or disallow a claim.)

C - Payments to Providers for Medically Unnecessary Services or Custodial Care Where Waiver of

Liability Applies

Where both the beneficiary and provider were without fault (see Medicare Claims Processing, Chapter

31, Limitation on Liability), the Carrier shall waive liability for the overpayments.