Alabama Administrative Code
Title 560 - ALABAMA MEDICAID AGENCY
Chapter 560-X-33 - RECOUPMENTS, ESTATE RECOVERIES AND LIENS
Section 560-X-33-.04 - Recoupments
Current through Register Vol. 43, No. 02, November 27, 2024
(1) Direct Reimbursement - At the time of original identification of the expected amount of recoupment, a letter will be sent to the recipient/authorized representative or provider outlining the allegations and stating the amount of reimbursement and the specific dates when overpayment or recoverable benefits occurred. The recipient/authorized representative or provider will be offered the opportunity to present evidence to rebut the requirement for recoupment or to submit the reimbursement. If no rebuttal is offered, the original assessment will be presumed correct. The Alabama Medicaid Agency will accept direct reimbursement from the recipient/authorized representative or provider to satisfy the recoupment.
(2) Time Payment Plan
(3) Fiscal Agent Recoupment
(4) Civil Actions - Civil actions through the courts may be initiated on cases where the above procedures have not resulted in a satisfactory resolution.
Author: Keith Thompson, Director, Third Party Liability
Statutory Authority: Social Security Act; State Plan; U.S.C. §1396p; 42 C.F.R. Parts 431, 433, and 455; Code of Ala. 1975, §§ 22-1-11, 22-6-8.