New York Codes, Rules and Regulations
Title 9 - EXECUTIVE DEPARTMENT
Subtitle KK - Program for Elderly Pharmaceutical Insurance Coverage
Part 9650 - Recovery Of Overpayments
Section 9650.2 - Recovery of overpayments
Current through Register Vol. 46, No. 12, March 20, 2024
(a) The contractor shall establish a procedure to ensure that the value of any benefits received by any person in violation of the eligibility requirements of article 19-K of the Executive Law and these regulations is recovered from the person prior to his/her recertification for entitlement to benefits for any period beyond the initial annual eligibility period.
(b) Where after authorization of benefits to an applicant it is discovered that the applicant was not entitled to benefits or that a participant has received benefits in excess of those to which he/she was entitled, the contractor shall promptly notify the applicant or participant of the overpayment and request that the value thereof be refunded.
(c) Where repayment is not forthcoming from the applicant or participant, the contractor shall attempt collection in a manner consistent with the State debt collection procedures law. Where the contractor is unsuccessful in its collection efforts, the matter shall be referred to the executive director for collection proceedings consistent with the economies of effective administration.
(d) Notwithstanding any provision in this section to the contrary, no person shall be deemed eligible to receive benefits under the program until he/she has repaid the full value of any benefits previously furnished to or on behalf of that person in violation of article 19-K of the Executive Law and these regulations, or has entered into a plan for repayment and remains current with such plan.
