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Code of Federal Regulations (Last Updated: October 10, 2024) |
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Title 42 - Public Health |
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Chapter IV - Centers for Medicare & Medicaid Services, Department of Health and Human Services |
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SubChapter B - Medicare Program |
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Part 411 - Exclusions from Medicare and Limitations on Medicare Payment |
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Subpart D - Limitations on Medicare Payment for Services Covered Under Liability or No-Fault Insurance |
§ 411.52 - Basis for conditional Medicare payment in liability cases.
Latest version.
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§ 411.52 Basis for conditional Medicare payment in liability cases.
(a) A conditional Medicare payment may be made in liability cases under either of the following circumstances:
(1) The beneficiary has filed a proper claim for liability insurance benefits but the intermediary or carrier determines that the liability insurer will not pay promptly for any reason other than the circumstances described in § 411.32(a)(1). This includes cases in which the liability insurance carrier has denied the claim.
(2) The beneficiary has not filed a claim for liability insurance benefits.
(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]