Avoiding an Overpayment at Reconciliation

Have you been in an overpayment situation at Reconciliation for multiple plan years? While some overpayments cannot be avoided, there are a number of common circumstances for which reviewing data carefully throughout the application plan year can help prevent an unnecessary overpayment at Reconciliation.

CMS' RDS Center has identified the following reasons as the most common circumstances causing a Plan Sponsor to be in an overpayment situation at the completion of Reconciliation:

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

For explanations and examples of these errors, refer to Avoid an Overpayment at Reconciliation in the RDS User Guide.