Are carriers restricted in their ability to unilaterally recoup alleged overpayments to providers?
Yes. Any efforts to recoup alleged overpayments of HCAPPA-governed claims must comply with all HCAPPA statutory and procedural requirements and limitations. As offsets sought to be taken against HCAPPA-governed claims are subject to statutory notice requirements, appeal rights and time limitations, efforts may not be made to collect alleged overpayments of claims that are not HCAPPA-governed through offsets against amounts payable for claims that are HCAPPA-governed.
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