630.460. Overpayment, defined--overpayment reimbursement request by department, procedure, review procedure--interest, amount, when--collection of overpayment, attorney general.

MISSOURI STATUTES AND CODES

630.460. Overpayment, defined--overpayment reimbursement request by department, procedure, review procedure--interest, amount, when--collection of overpayment, attorney general.

Overpayment, defined--overpayment reimbursement request by department,procedure, review procedure--interest, amount, when--collection ofoverpayment, attorney general.

630.460. 1. For the purposes of this section, the term "overpayment"means any payment by the department to a vendor providing care, treatment,habilitation or rehabilitation services to clients under contract with thedepartment, which is:

(1) In excess of the contracted rate less payments by the client oron his behalf as required to be made by the standard means test containedin department rules;

(2) In payment of services not provided;

(3) In payment for any service not authorized in the contract withthe department; or

(4) In payment for services provided contrary to the provisions ofthe contract with the department.

2. The department shall notify the vendor in writing by certifiedmail, return receipt requested, of the amount of the overpayment, the basisfor such overpayment and request reimbursement. Within thirty days ofreceipt of the notice of overpayment, a provider may request a review ofthe overpayment and reimbursement request by the department director or hisdesignee. Such review shall be conducted in person if requested by theprovider. The department director or his designee shall review theoverpayment within fifteen days of the request for review.

3. If any overpayment is not fully repaid within forty-five days ofthe date of notice of overpayment, the department shall assess interest onthe unpaid balance. Interest shall be charged on any unpaid balancebeginning from the date of notice of overpayment and shall accrue at a ratenot to exceed the annual rate established pursuant to the provisions ofsection 32.065, RSMo, plus three percentage points.

4. The department and the vendor shall have forty-five days fromreceipt of the notice of the overpayment to negotiate a repayment plan torecover the amount of the overpayment as finally determined plus accruedinterest at the rate established in subsection 3 of this section over aperiod determined by the department, but not to exceed twelve months fromthe date of final disposition of any overpayment review authorized by thissection. The department shall determine the method of repayment which mayinclude direct payment by the vendor, deduction from future amounts due tothe vendor from the department, or both.

5. If any overpayment plus accrued interest not subject to arepayment plan pursuant to subsection 4 of this section is not fully repaidwithin six months of the date of notice of overpayment, the department maycertify the amount due to the office of the attorney general, or take otherappropriate collection actions. If any portion of an overpayment plusaccrued interest which is subject to a repayment plan pursuant tosubsection 4 of this section, but which is not repaid pursuant to the termsof the plan, the department may certify all or a portion of the overpaymentplus accrued interest due to the office of the attorney general, or takeother appropriate collection actions.