CMS Pub. 100-06, ch. 5, § 270.19

(Principal & Interest)

(Rev. 111; Issued: 10-27-06; Effective: 04-01-07; Implementation: 04-02-07)

The contractor enters the total number and amount of delinquent receivables 181 days

delinquent and greater, which are in one of the following categories:

(a) Referred to the Department of the Treasury for Cross Servicing. For MSP,

this means debts entered into the DCS. For Non-MSP, this means debts that have

been transmitted to DCC by CMS Central Office and the Medicare contractor has

acknowledged and verified the validity and accuracy of the debts transmitted.

(b) Not Eligible for Referral, the number and dollar amount is equal to the sum of

lines (1) through (12) of this section.

1) Bankruptcy;

2) Appeal;

3) Department of Justice/Litigation;

4) Fraud and Abuse Investigation, if the contractor has received specific

instructions from the investigating unit (i.e., Office of Inspector General or

Office of General Counsel, etc.) not to attempt collection;

5) Deceased Debtor, debts where the debtor is deceased and the estate is

closed;

6) Debts less than $25;

7) Federal Entity Debts, MSP only, where the only entity which received

the last demand letter is the employer and the employer is a Federal

agency;

8) Beneficiary Debts, Non-MSP only;

9) Pending Request for Waiver or Compromise;

10) CMS Identified Exclusions, MSP only, debts where CMS has

identified a specific debt or group of debtors as excluded from DCIA

referral.

11) Other Exclusions, must footnote.

12) In the Process of Internal Offset (Previously Under Medicare

Modernization Act, Section 935 Appeal).

(c) Eligible for Referral, debts that are eligible for referral to the Department of the

Treasury for cross servicing but not yet referred.

270.20 - Line 4c, Collections Deposited at Another Location (Principal

& Interest) - (Rev. 5, 08-30-02)

A1-1923.20, A1-1943.20, B1-4923.20, B1-4943.20

The contractor enters the distribution of collections on receivables, by location, for

amounts offset or received and deposited at another location. The total amounts listed in

this section must equal the amount reflected in Section A, Line 4c of this report.

270.21 - Line 10, Cash/Offsets Received for Receivables at Another

Location (Principal & Interest) - (Rev. 5, 08-30-02)

A1-1923.21, A1-1943.21, B1-4923.21, B1-4943.21

This will not apply to Medicare contractors.