What is your State Medicaid "look-back period" for Medicaid overpayments payments?Iowa's is 5 years and we are working to reduce this to 24 months https://www.legis.iowa.gov/docs/code/249A.42.pdf Iowa code refers to this as "overpayment" so don't get too hung up on the terminology. Iowa Medicaid continues to go back these 5 years and recoup (take back) funds from the Managed Care Organizations who turn around and withhold this amount from providers' current/future payments. In the end, providers are left with no means of recourse even though services were provided in good faith – eligibility was verified at the time, authorizations were received, services were provided, claims submitted & approved and the funder made payment to the provider AND then up to 5 years later, state can come back & go "oops" our mistake, we should not have paid you & now we're taking the money back.
CMS Program Integrity Manual (pg 8) https://www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/mpi115c01.pdf
Federal Regulations 42 CFR 433.316 https://www.law.cornell.edu/cfr/text/42/433.316