---
kind: "section"
citation: "42 U.S.C. § 1395vv"
title: "42"
title_heading: "The Public Health and Welfare"
number: "1395vv"
heading: "Withholding payments from certain medicaid providers"
release: "119-102"
date: "2026-07-12"
url: "https://uscodex.org/usc/42/1395vv"
units:
  - "Chapter 7 — Social Security"
  - "Subchapter XVIII — Health Insurance for Aged and Disabled"
  - "Part E — Miscellaneous Provisions"
---

# §1395vv. Withholding payments from certain medicaid providers

- (a) **Adjustments by Secretary—** The [Secretary](/usc/42/1301.md?p=a-6) may adjust, in accordance with this section, payments under parts A and B to any institution which has in effect an agreement with the [Secretary](/usc/42/1301.md?p=a-6) under [section 1395cc of this title](/usc/42/1395cc.md), and any [person](/usc/42/1301.md?p=a-3) who has accepted payment on the basis of an assignment under [section 1395u(b)(3)(B)(ii) of this title](/usc/42/1395u.md?p=b-3-B-ii), where such institution or [person](/usc/42/1301.md?p=a-3)—
  - (1) has (or previously had) in effect an agreement with a [State agency](/usc/42/629a.md?p=a-3) to furnish [medical care](/usc/42/1301.md?p=a-7) and services under a [State](/usc/42/1395x.md?p=x) plan approved under subchapter XIX, and
  - (2) from which (or from whom) such [State agency](/usc/42/629a.md?p=a-3) (A) has been unable to recover overpayments made under the [State](/usc/42/1395x.md?p=x) plan, or (B) has been unable to collect the information necessary to enable it to determine the amount (if any) of the overpayments made to such institution or [person](/usc/42/1301.md?p=a-3) under the [State](/usc/42/1395x.md?p=x) plan.
- (b) **Implementing regulations; notice, opportunity to be heard, etc.** The [Secretary](/usc/42/1301.md?p=a-6) shall by regulation provide procedures for implementation of this section, which procedures shall—
  - (1) assure that the authority under this section is exercised only on behalf of a [State agency](/usc/42/629a.md?p=a-3) which demonstrates to the [Secretary](/usc/42/1301.md?p=a-6)’s satisfaction that it has provided adequate notice of a determination or of a need for information, and an opportunity to appeal such determination or to provide such information,
  - (2) determine the amount of the payment to which the institution or [person](/usc/42/1301.md?p=a-3) would otherwise be entitled under this subchapter which shall be treated as a setoff against overpayments under subchapter XIX, and
  - (3) assure the restoration to the institution or [person](/usc/42/1301.md?p=a-3) of amounts withheld under this section which are ultimately determined to be in excess of overpayments under subchapter XIX and to which the institution or [person](/usc/42/1301.md?p=a-3) would otherwise be entitled under this subchapter.
- (c) **Payment to States of amounts recovered—** Notwithstanding any other provision of this chapter, from the trust funds established under sections [1395i](/usc/42/1395i.md) and [1395t](/usc/42/1395t.md) of this title, as appropriate, the [Secretary](/usc/42/1301.md?p=a-6) shall pay to the appropriate [State agency](/usc/42/629a.md?p=a-3) amounts recovered under this section to offset the [State agency](/usc/42/629a.md?p=a-3)’s overpayment under subchapter XIX. Such payments shall be accounted for by the [State agency](/usc/42/629a.md?p=a-3) as recoveries of overpayments under the [State](/usc/42/1395x.md?p=x) plan.

## Source credit

(Aug. 14, 1935, ch. 531, title XVIII, § 1885, as added Pub. L. 97–35, title XXI, § 2104, Aug. 13, 1981, 95 Stat. 788.)