Medicare and Medicaid program; withholding the federal share of payments to recover Medicare or Medicaid overpayments--Health Care Financing Administration. Proposed rule.

We propose to amend Medicare and Medicaid regulations to implement sections 905 of the Omnibus Reconciliation Act of 1980 (Pub. L. 96-499) and 2104 of the Omnibus Budget Reconciliation Act of 1981 (Pub. L. 97-35). Section 905 expands HCFA's authority to withhold the Federal share of Medicaid payments in order to recover Medicare overpayments. Section 2104 provides new authority for HCFA to withhold Medicare payments to recover Medicaid overpayments. The provisions apply with respect to institutions or persons that participate (or have participated) in both programs, and to whom an overpayment under either program may have been made but cannot be recovered under that program. The intent of the statute is to facilitate recovery through offset of payments due the entity under the second program. Previously, HCFA could suspend Federal Medicaid payments to State agencies to recover Medicare overpayments for an institutional provider of Medicare services when that provider (1) had withdrawn or been terminated from participation in the Medicare program; (2) failed to repay or make satisfactory arrangements to repay the appropriate information to determine the amount of overpayment, if any. No authority existed with respect to individual practitioners or other suppliers, nor was there any provision for recovering Medicaid overpayments through Medicare.