---
kind: "section"
citation: "42 C.F.R. § 417.458"
title: "42"
number: "417.458"
heading: "Recoupment of uncollected deductible and coinsurance amounts."
url: "https://uscodex.org/cfr/42/417.458"
---

# §417.458. Recoupment of uncollected deductible and coinsurance amounts.


An HMO or CMP agrees not to recoup deductible and coinsurance amounts for which Medicare enrollees were liable in a previous contract period except in the following circumstances:

- (a) The HMO or CMP failed to collect the deductible and coinsurance amounts during the contract period in which they were due because of—
  - (1) Underestimation of the actuarial value of the deductible and coinsurance amounts; or
  - (2) **A billing error.**
- (b) The HMO or CMP has identified the amounts and obtained advance CMS approval of the recoupment and the method and timing of recoupment.
- (c) The HMO or CMP collects these amounts no later than the end of the contract period following the contract period during which they were found to be due.

## Notes

### Amendments

[50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38082, July 15, 1993; 60 FR 45678, Sept. 1, 1995]

### Source

Source: 50 FR 1346, Jan. 10, 1985, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302 and 1395hh, and 300e, 300e-5, and 300e-9, and 31 U.S.C. 9701.

### Amendments

[50 FR 1346, Jan. 10, 1985, as amended at 58 FR 38082, July 15, 1993; 60 FR 45678, Sept. 1, 1995]