42 CFR 405.358 : Public Health (Part 1 To Parts 1009-1099) — (Subpart A To § 413.355) — Centers For Medicare & Medicaid Services, Department Of Health And Human Services (Subpart A To § 413.355) — Medicare Program (Subpart A To § 413.355) — Federal Health Insurance For The Aged And Disabled (Subpart A To § 405.2472) — Suspension Of Payment, Recovery Of Overpayments, And Repayment Of Scholarships And Loans (§ 405.301 To § 405.380) — Liability For Payments To Providers Or Suppliers And Handling Of Incorrect Payments (§ 405.350 To § 405.359) — When waiver of adjustment or recovery may be applied.

4 Aug 2016

Section 1870(c) of the Act provides that there shall be no adjustment or recovery in any case where an incorrect payment under title XVIII (hospital and supplementary medical insurance benefits) has been made (including a payment under section 1814(e) of the Act with respect to an individual:

(a) Who is without fault, and

(b) Adjustment or recovery would either:

(1) Defeat the purposes of title II or title XVIII of the Act, or

(2) Be against equity and good conscience.

42 CFR 405.358

[61 FR 49271, Sept. 19, 1996]