US · guidance
CMS Pub. 100-16, ch. mc86c18b, § 100.1
Under and Over Collection of Premiums
The HCPP is responsible for computing any over or under collection of premiums. All
over collections of premiums must be returned to the Medicare enrollee. The HMO/CMP
may select, with prior approval, one of the following three methods to refund over
collections:
• Adjust future years' premiums;
• Provide a lump sum payment to the enrollee; or
• A combination of premium adjustment and lump sum payment.
Unintentional (or involuntary) under collections of premiums may be collected from the
HCPP's Medicare enrollees by an adjustment to its Medicare enrollees' future premiums.
However, the HCPP must collect the under collections through premium adjustments no
later than the end of the contract period following the contract period during which they
were found to be due. Intentional (or voluntary) under collections of premiums cannot be
recouped by the HCPP from the Medicare enrollee.
History
(Rev. 30, 09-05-03)
Provenance
- Source
- cms.gov
- Retrieved
- 2026-08-25
- Edition
- iom-2026-08-25
- Content hash
7d2227688dbb127a7ab87590b3debb21300b7ff62e45d749fa100534cbc15db1
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