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Frequently Asked Questions

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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


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