---
kind: "section"
citation: "42 C.F.R. § 433.312"
title: "42"
number: "433.312"
heading: "Basic requirements for refunds."
url: "https://uscodex.org/cfr/42/433.312"
---

# §433.312. Basic requirements for refunds.

- (a) **Basic rules.**
  - (1) Except as provided in [paragraph (b)](#b) of this section, the State Medicaid agency has 1 year from the date of discovery of an overpayment to a provider to recover or seek to recover the overpayment before the Federal share must be refunded to CMS.
  - (2) The State Medicaid agency must refund the Federal share of overpayments at the end of the 1-year period following discovery in accordance with the requirements of this subpart, whether or not the State has recovered the overpayment from the provider.
- (b) **Exception.** The agency is not required to refund the Federal share of an overpayment made to a provider when the State is unable to recover the overpayment amount because the provider has been determined bankrupt or out of business in accordance with [§ 433.318](/cfr/42/433.318.md).
- (c) **Applicability.**
  - (1) The requirements of this subpart apply to overpayments made to Medicaid providers that occur and are discovered in any quarter that begins on or after October 1, 1985.
  - (2) The date upon which an overpayment occurs is the date upon which a State, using its normal method of reimbursement for a particular class of provider (e.g., check, interfund transfer), makes the payment involving unallowable costs to a provider.

## Notes

### Amendments

[54 FR 5460, Feb. 3, 1989, as amended at 77 FR 31511, May 29, 2012]

### Source

Source: 54 FR 5460, Feb. 3, 1989, unless otherwise noted.

### Authority

Authority: 42 U.S.C. 1302.

### Source

Source: 43 FR 45201, Sept. 29, 1978, unless otherwise noted.

### Amendments

[54 FR 5460, Feb. 3, 1989, as amended at 77 FR 31511, May 29, 2012]