C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 405—FEDERAL HEALTH INSURANCE FOR THE AGED AND DISABLED › Subpart C—Suspension of Payment, Recovery of Overpayments, and Repayment of Scholarships and Loans

42 C.F.R. § 405.358

When waiver of adjustment or recovery may be applied

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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.

[61 FR 49271, Sept. 19, 1996]
Notes of Decisions
Cited in 3 cases, 2003–2006 · leading case: In re Zyprexa Prods. Liab. Litig., 451 F. Supp. 2d 458 (E.D.N.Y. 2006).
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In re Zyprexa Prods. Liab. Litig., 451 F. Supp. 2d 458 (E.D.N.Y. 2006). “§ 1395gg(c); 42 C.F.R. § 405.358 . See also, e.g., Fanning v.”
Action All. of Senior Citizens v. Leavitt, 456 F. Supp. 2d 11 (D.D.C. 2006). · cites it 2× “42 C.F.R. 405.358. 5 Finally, the Social Security Administration Program Operations Manuals System (“POMS”) provides that the same standards for Medicare benefit overpayments apply to overpayments of Medicare premiums under Part A and Part B, thereby extending the right to seek…”
Fanning v. United States, 346 F.3d 386 (3d Cir. 2003). “See 42 C.F.R. § 405.358 ; 20 C.F.R. § 404.508 (a).”
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