 |
Code of Federal Regulations (Last Updated: July 5, 2024) |
 |
Title 42 - Public Health |
|
Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
|
SubChapter B - Medicare Program |
|
Part 411 - Exclusions from Medicare and Limitations on Medicare Payment |
|
Subpart C - Limitations on Medicare Payment for Services Covered Under Workers' Compensation |
§ 411.45 - Basis for conditional Medicare payment in workers' compensation cases.
Latest version.
-
§ 411.45 Basis for conditional Medicare payment in workers' compensation cases.
(a) A conditional Medicare payment may be made under either of the following circumstances:
(1) The beneficiary has filed a proper claim for workers' compensation benefits, but the intermediary or carrier determines that the workers' compensation carrier will not pay promptly. This includes cases in which a workers' compensation carrier has denied a claim.
(2) The beneficiary, because of physical or mental incapacity, failed to file a proper claim.
(b) Any conditional payment that CMS makes is conditioned on reimbursement to CMS in accordance with subpart B of this part.
[71 FR 9470, Feb. 24, 2006, as amended at 73 FR 9685, Feb. 22, 2008]