TN 10 (04-21)

HI 00825.075 Processing Returned SMI Refund Checks

Due to various Premium Collection Operation (PREMCO) actions or State buy-in actions for SMI, etc., beneficiaries are issued checks representing overpayments of SMI premiums. The Benefit Authorizer is responsible for the disposition of all returned SMI refund checks. Such determinations will be based on an analysis of folder documentation plus HIQR informationals.

Returned SMI refund checks will be handled in a manner similar to regular benefit checks except that extreme caution is required when determining if suspension or termination of monthly benefits is appropriate. That is, if a definite reason for suspension or termination (work, death, etc.) is reflected on the refund check or accompanying correspondence, effectuate such action. However, if the reason for return is not definable (“no comment”, etc.), do not suspend or terminate monthly benefits based solely on the returned SMI refund check.