Medicare Overpayment Statute of Limitations

An overpayment of federal health benefits must be repaid to the federal government.

Improper billing and payment for excluded and/or unnecessary medical services often result in an overpayment of Medicare benefits. When a Medicare recipient receives an overpayment to which he is not entitled, federal law mandates that the Centers for Medicare & Medicaid Services collect the overpayment.

Effect

Once the Centers for Medicare & Medicare Services has concluded that a Medicare recipient has received an overpayment of benefits, the overpayment is considered to be a legal debt owed to the federal government.

Statute of Limitations

The statute of limitations for collecting an overpayment of Medicare benefits is one year from the date of determination that an overpayment has been made to the recipient. This means that if more than one year has elapsed since Medicare determined that you've received overpayment, Medicare cannot institute any legal proceedings against you based on that overpayment.

Criminal Penalties

Cooperating with the Centers for Medicare & Medicare Services regarding an overpayment is important. Claiming an overpayment of benefits to which you know are you are not entitled to can result in a felony conviction.

References

• Cornell University Law School: U.S. Code § 2415. Time for commencing actions brought by the United States
• Cornell University Law School: U.S. Code § 1320a-7b. Criminal penalties for acts involving Federal health care programs

Resources

• Centers for Medicare & Medicaid Services