CMS issued a final rule on June 27 on the use of repayment plans for Medicare provider and supplier overpayments that includes criteria and processes for use of an extended repayment schedule (ERS). 73 Fed. Reg. 36443. The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (Pub. L. 108-173) added a requirement that CMS use certain statutory criteria in evaluating whether a provider or supplier should be granted a repayment schedule of at least six months and up to five years. In response, CMS issued the Use of Repayment Plans proposed rule in November 2006. This final rule makes no change to the proposed rule and will become effective July 28. Under current ERS policies, CMS primarily focuses on the provider's or supplier's ability to repay the overpayment, by conducting a review of the debtor's financial status. However, under certain circumstances, the final rule allows CMS to waive financial documentation requirements when seeking a six-month ERS. In addition, the final rule adds criteria to existing regulations and procedures for determining a debtor's ERS and allows CMS to evaluate whether a provider or supplier should be granted a repayment schedule based on "hardship" or "extreme hardship."