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CMS Guidance Document Department of Health &
Human Services (DHHS)
Pub 100-06 Medicare Financial Management Centers for Medicare &
Medicaid Services (CMS)
Executive Guidance Number 0249 Date: January 30, 2008
Planned Web Site Address http://www.cms.hhs.gov/manuals/ Release planned: 02/13/08
PROGRAM AREA: Contractor Business Practices
SUBJECT: Revisions to Debt Referral Instructions
APPLIES TO: Contractors
SUMMARY OF DOCUMENT: As part of ongoing operations, changes and revisions have been made to
certain aspects of the debt referral process and contractor business practices. This CR updates several areas
of Chapter 4, Section 70 to: (1) Remove references to the Provider Overpayment Reporting (POR) and
Physician/Supplier Overpayment Reporting (PSOR) systems, (2) Revise Exhibit 1, Intent to Refer Letter to
add offset of state payments to the Treasury Offset Program, and (3) Revise Exhibit 4, DCS User Guide.
The subsection numbering and titles of this chapter section were also revised accordingly.
II. CHANGES IN POLICY INSTRUCTIONS: (If not applicable, indicate N/A)
STATUS: R=REVISED, N=NEW, D=DELETED.
Status CHAPTER/SECTION/SUBSECTION/TITLE
R 4/70 Table of Contents
R 4/70.3/Treasury Offset Program
R 4/70.6/Debt Ineligible for Referral
R 4/70.7/Intent to Refer Letter
D 4/70.7.1/Delinquent Non-MSP Fiscal Intermediary Debt Including Debt on
the Provider Overpayment Reporting (POR) System
D 4/70.7.2/Delinquent Non-MSP Medicare Carrier Debt, Including Individual
Debt on the Physician/Supplier Overpayment Reporting (PSOR) System
Updates
D 4/70.7.3/Intermediary Claims Accounts Receivable
D 4/70.7.4/Physician/Supplier Overpayment Reporting (PSOR) System
Summary Entry Debts (Carriers Only)
D 4/70.7.5/Delinquent Non-MSP Debt Previously Ineligible for Referral
R 4/70.8/Response to Intent to Refer Letter
R 4/70.9/Debt Collection System
R 4/70.10/Cross Servicing Collection Efforts
R 4/70.11/Actions Subsequent to DCS Input
R 4/70.12/Transmission of Debt
R 4/70.13/Update to DCS After Transmission
R 4/70.14/Collections
R 4/70.14.1/Background
R 4/70.14.2/Intra-governmental Payment and Collection (IPAC) System
R 4/70.14.3/Collections Posted to the Debt Collection System
D 4/70.14.3.1/Background
D 4/70.14.3.2/Intra-governmentall Payment and Collection (IPAC) System
D 4/70.14.3.3/Debt Collection System (DCS)
D 4/70.14.3.4/Collection/Refund Spreadsheet
D 4/70.14.3.5/Financial Reporting for Collection/Refund Spreadsheet
D 4/70.14.3.6/Debt Paid in Full
D 4/70.14.3.7/Extended Repayment Schedule (ERS)
D 4/70.14.3.8/Excess Collections
D 4/70.14.3.8.1/Applying Excess Collections
D 4/70.14.3.8.2/If the Debtor Has Other Outstanding Debt
D 4/70.14.3.8.3/If the Debtor Has No Other Outstanding Debt
N 4/70.14.4/Collection/Refund Spreadsheet
N 4/70.14.5/Debt Paid in Full
N 4/70.14.6/Extended Repayment Schedule (ERS)
N 4/70.14.7/Excess Collections
N 4/70.14.8/Applying Excess Collections
N 4/70.14.8.1/ If the Debtor Has Other Outstanding Debt
N 4/70.14.8.2/ If the Debtor Has No Other Outstanding Debt
R 4/70.15.1/Financial Reporting for Non-MSP Debt
R 4/70.15.3/Financial Reporting for Collections Received on Debts From
Cross Servicing
N 4/70.16/Intermediary Claims Accounts Receivable (A/R)
R 4/70.90/Exhibit 1/Intent to Refer Letter
R 4/70.90/Exhibit 4/DCS User Guide
R 4/70.90/Exhibit 5/Treasury Cross Servicing Dispute Resolution
III. CLEARANCES:
Clearance & Point of Contact (POC) Name/Telephone/Component
Senior Official Clearance Hill, Tim, Director OFM/ 410-786-5448
Agency POC Parzynski, Deborah OFM/AMG/DDRO 410 786-5435
IV. TYPE (Check appropriate boxes for type of guidance)
Audit Guide
X Change Request
HPMS
Joint Signature Memorandum/Technical Director Letter
Manual Transmittal/Non-Change Request
State Medicaid Director Letters
Other
V. STATUTORY OR REGULATORY AUTHORITY: N/A


How are Treasury issues debt? How Treasury Issues Debt Congressional Research Service Summary The U.S. Department of the Treasury (Treasury), among other roles, manages the country’s debt. The primary objective of Treasury’s debt management strategy is to finance the government’s borrowing needs at the lowest cost over time. To accomplish this Treasury adheres to three

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