RDS User Guide Updated - Avoid an Overpayment at Reconciliation

CMS' RDS Center has added a new Avoid an Overpayment at Reconciliation section to the RDS User Guide. An overpayment can occur if a Plan Sponsor does not meet the Reconciliation Deadline for an application when interim payments have been received, or the sum of interim payment requests exceeds the current subsidy amount based on the most recent Allowable Retiree Costs and the Mandatory Payment Reduction.

This new section explores the following common circumstances that can lead to an overpayment at Reconciliation:

  • Doubling Costs
  • Reduction in Retirees
  • Overstating Gross Retiree Costs
  • Underestimating Cost Adjustments
  • Underreporting Threshold Reduction and Limit Reduction

Avoid an Overpayment at Reconciliation provides explanations and examples of these common errors. Plan Sponsors are encouraged to review the information to help avoid an unnecessary overpayment at Reconciliation.

If you have questions or need additional information, contact CMS' RDS Center.