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Code of Federal Regulations Title 42. Public Health § 42.411.53 Basis for conditional Medicare payment in no-fault cases

Current as of January 02, 2025 | Updated by Findlaw Staff

(a) A conditional Medicare payment may be made in no-fault cases under either of the following circumstances:

(1) The beneficiary has filed a proper claim for no-fault insurance benefits but the intermediary or carrier determines that the no-fault insurer will not pay promptly for any reason other than the circumstances described in § 411.32(a)(1). This includes cases in which the no-fault insurance carrier has denied the claim.

(2) The beneficiary, because of physical or mental incapacity, failed to meet a claim-filing requirement stipulated in the policy.

(b) Any conditional payment that CMS makes is conditioned on reimbursement to CMS in accordance with subpart B of this part.

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Cite this article: FindLaw.com - Code of Federal Regulations Title 42. Public Health § 42.411.53 Basis for conditional Medicare payment in no-fault cases - last updated January 02, 2025 | https://codes.findlaw.com/cfr/title-42-public-health/cfr-sect-42-411-53/

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