Overpayment Recovery Across Shared Tax ID Numbers Put Into Action

Section 1866j(6) of the Social Security Act gives the Secretary the authority to make “any necessary adjustments” to the payments of a healthcare provider who shares a tax identification number (TIN) with a provider that has an outstanding Medicare overpayment.  Regardless of a provider’s NPI or PTAN billing identifier, if provider “A” shares a TIN with provider “B” the law allows the Secretary to offset “A’s” overpayment against “B’s” payments.

While the statute is nothing new, because of a new and improved capability to track and capture Medicare payment analytics, CMS has made it clear that it will begin using Section 1866j(6) authority to increase the recovery of overpayments.  See MLN Matters Article, SE1612, issued in June 2016.  CMS has enhanced its financial accounting system and it will recover payments made to any provider that shares the same TIN with a provider that has an outstanding Medicare overpayment across multiple states within a Medicare Administrative Contractor (MAC) jurisdiction.