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BAM 710 2 of 2 MA OVERPAYMENTS BPB 2026-009 4-1-2026

BRIDGES ADMINISTRATIVE MANUAL STATE OF MICHIGAN DEPARTMENT OF HEALTH & HUMAN SERVICES

• If there would have been a larger LTC, hospital or post- eligibility patient-pay amount, the OP amount is the difference between the correct and incorrect patient-pay amounts or the amount of MA payments, whichever is less. For an OP due to any other reason, the OP amount is the amount of MA payments. OIG Referral The minimum OP amount for OIG referral is $500 unless the local prosecutor sets a lower amount. OIG through regular channels informs affected local offices of lower amounts. Refer an IPV that falls below the established minimum if the group's actions are repetitious, flagrant, or if there is a previous IPV. The referral must be approved by the local office director or designee. Recoupment Before recoupment is initiated, a manager or a designee must review the MA case. After review, notify the client (or legal guardian) in writing that: • MDHHS must seek recoupment, but • Refusal to repay will not cause denial of current or future MA if the client is otherwise eligible. If recoupment is agreed to, complete a DHS-4358B, Recoupment Agreement, have the client/guardian sign it, then forward the original to the local office for collection. If he/she refuses to sign it, inform the local office in writing. A delinquent OP balance can be referred to Treasury for collection if: • The client signed a DHS-4358B, or • Recoupment is court ordered. LEGAL BASE MA 42 CFR 431.230(b) MCL 400.60