Frequently Asked Questions

How is an overpayment defined?

An overpayment is defined as any funds a provider received or retained under the Medicare/Medicaid program to which the provider is not entitled. Examples of overpayments include but are not limited to:

• Medicare/Medicaid payments for billed non-covered services
• Duplicate payments
• • Receipt of Medicare/Medicaid payments when another payor had the primary responsibility for payment
• Medicare/Medicaid payment in excess of the allowable amount for an identified covered service
• Errors and non-reimbursable expenditures on cost reports