CMS Pub. 100-06, ch. 4, § 70.17.2

The temporary HIGLAS RTA Status Code for all debts that are returned to agency as Uncollectible (RU)

or Out of Business (RN) shall be systematically updated, by HIGLAS, to ‘DR-RTN-CS’ (Debt Returned

from Cross-Servicing).

The contractor not utilizing HIGLAS shall re-refer to Treasury all debts RTA’d as RU/RN that are:

• Less than or equal to $500,000 (principal balance) and less than 3-years old; or

• Greater than $500,000 (principal balance) and less than 6-years old.

However, if Treasury returns these same debts before the 3 or 6-year age after they have been

re-referred one time, the contractor not utilizing HIGLAS shall not re-refer the debts to Treasury. The

contractor’s weekly RTA Report will allow the contractor to easily assess whether a debt qualifies for

close-out or re-referral to Treasury.

(For contractors utilizing HIGLAS: HIGLAS functionality will systematically re-refer debts that have

been initially RTA’d as RU/RN and do not meet the aforementioned age requirements.)

For RU and RN debts with a combined principal and interest balance less than $25:

• Contractors utilizing HIGLAS shall allow the HIGLAS Auto Write-Off Program to identify these

debts and systematically write them off.

• Contractors not utilizing HIGLAS shall submit for close-out review.

The contractors shall use the RTA report to research the RU or RN debts with a combined principal and

interest balance greater than or equal to $25 in order to determine the current status or final disposition.

The debts already in a recalled status are included so that the contractors will know that Treasury

considers the debts uncollectible or out of business.

The contractors shall determine whether collection by litigation is a viable option for debts with a

combined principal and interest balance greater than or equal to $25 showing a status code of RU or RN.

If so, follow established procedures for referring the debts for litigation (See CMS Pub. 100-06, chapter 3,

section 120).

The contractors shall also consider whether all other appropriate actions to collect debts with a combined

principal and interest balance greater than or equal to $25 have been taken before recommending debts for

Write-Off Closed (WOC), including the criteria listed below:

1. Have there been any collections or payments on this debt in the last year? If so, and the contractor

believes further collections are possible, the contractor shall not recommend the debt for WOC,

but shall continue collection efforts for MSP and Non-MSP debts.

2. Has the debtor submitted any Medicare claims in the last 6 months? If so, and the contractor

believes further collections are possible, the contractor shall not recommend the debt for WOC,

but shall continue collections efforts.

3. Is the debtor receiving Medicaid funds? If so, the contractor shall not recommend the debt for

WOC. The contractor shall instead contact the CMS RO to institute an offset, and shall continue

collection efforts.

4. If applicable, did the debtor undergo a Change of Ownership (CHOW) (a new owner who opts to

receive automatic assignment of the old owner’s provider/supplier agreement)?

If so, the contractor shall determine if collection efforts were pursued from the new owner.

(a) If so, the contractor shall recommend for WOC

(b) If not, the contractor shall follow the normal policies and procedures for debts collection.

5. If applicable, did the debtor file any cost reports that the contractor has not yet settled?

If so, the contractor shall not recommend the debt for WOC. Instead, the contractor shall await

settlement of the cost report to determine whether it results in an underpayment. If it does result in

an underpayment, the contractor shall apply any funds due to the provider/supplier to any

outstanding debts first, before releasing any funds to the debtor

6. If applicable, does the debtor have any outstanding unfiled cost reports less than 1 year overdue?

If so, the contractor shall not recommend the debt for WOC. Instead, the contractor shall await

filing and settlement of the cost report to determine whether it results in an underpayment. If it

does result in an underpayment, the contractor shall apply any funds due to outstanding debts first,

before releasing any funds.

7. If applicable, does the debtor have any funds in suspense due to an unfiled cost report? If so, and

the provider/supplier has been terminated from the Medicare Program, the contractor shall apply

the funds in suspense to recover the debt or any other outstanding debts for the provider/supplier.

8. If applicable, does the debtor have any claims or cost reports subject to re-opening?

If so, the contractor shall not recommend the debt for WOC. Instead, the contractor shall wait

until the expiration of the reopening period. If a cost report reopening during this period results in

an underpayment, the contractor shall apply the underpayment to recover the debt or any other

outstanding debts for the debtor, before releasing any funds.

9. Does the debtor have any open appeal(s)? If so, the contractor shall not recommend the debt for

WOC. Instead, the contractor shall await the final determination on the appeal(s), and apply any

funds due from a favorable decision to any outstanding debts first, before releasing any funds.

10. Does the debtor have an active fraud case? If so, the contractor shall not recommend the debt for

WOC. Instead, the contractor shall forward the debt to the appropriate Unified Program Integrity

Contractor (UPIC) or CMS Centers for Program Integrity that has the open fraud case.

If the contractors have considered all of the above criteria above and are recommending the debts for

WOC, the contractors shall submit a request to the CMS RO for approval. The contractor shall submit

these debts as instructed in Chapter 4, § 70.16. The contractor shall include the Contractor Validation

Statement below with each close-out request submission:

Contractor Validation:

We recommend these debts for termination of collection action, close out and write- off-closed.

We considered all criteria in section 70.17.2 in making this recommendation and determined that

these criteria for referral have all been met.

Total debts recommend for Write-Off-Closed:

Number of Debts: _____ Principal Balance: ____________ Interest Balance: ____________

Signature of Medicare Contractor CFO: ________________________

Date: _______________

The debts recommended for WOC that do not meet the above criteria shall remain open until the criteria

for WOC has been met. The contractors shall report these debts on the appropriate line of the CMS

Forms 751 or the Treasury Report on Receivables (TROR) to indicate Treasury has RTA the debts but the

WOC process has not been completed. (See CMS Pub 100-06, chapter 4, section 70.15.4) For all debts

that meet the criteria above, the contractor utilizing HIGLAS shall change the status to the appropriate

Request for Write-Off status code. The contractors shall submit a report of the debts recommended for

WOC to the CMS using established procedures for recommending debts for WOC.

Once CMS approves the debts for WOC, the contractors shall complete the WOC process including

changing the status to the appropriate Write-Off/Approved/Closed status code, making the appropriate

adjustments in HIGLAS or internal system, and making all appropriate adjustments on CMS Form 751 or

the TROR.