As of November 1st, CMS instituted changes to the Medicare Overpayment Notification Process. Instead of sending three notification letters, only the Initial Demand letter will be sent. If the overpayment is not paid within 90 days of the initial notification, providers will receive the letter for Intent to Refer the debt for collection. Recoupment action will continue to occur 41 days after the initial letter. Also, provider appeal rights will remain the same.