§1395vv Withholding Payments From Certain Medicaid Providers

Summary

The Secretary can reduce or hold back Medicare Part A and Part B payments to a hospital or other provider that has a Medicare agreement under section 1395cc, or to a person paid by assignment under section 1395u(b)(3)(B)(ii), when that provider also had an agreement with a State Medicaid agency under the State plan (subchapter XIX) and the State either cannot get back Medicaid overpayments or cannot get the information it needs to figure how much was overpaid. The Secretary must write rules that make sure the State gave proper notice and a chance to appeal or to supply information, that set how much Medicare pay can be used to cover the Medicaid overpayment, and that return any money taken that turns out to be more than the overpayment. Money recovered will be paid to the State from the trust funds under sections 1395i and 1395t and counted as Medicaid overpayment recoveries.