---
kind: "section"
citation: "42 C.F.R. § 411.22"
title: "42"
number: "411.22"
heading: "Reimbursement obligations of primary payers and entities that received payment from primary payers."
url: "https://uscodex.org/cfr/42/411.22"
---

# §411.22. Reimbursement obligations of primary payers and entities that received payment from primary payers.

- (a) A primary payer, and an entity that receives payment from a primary payer, must reimburse CMS for any payment if it is demonstrated that the primary payer has or had a responsibility to make payment.
- (b) A primary payer's responsibility for payment may be demonstrated by—
  - (1) A judgment;
  - (2) A payment conditioned upon the recipient's compromise, waiver, or release (whether or not there is a determination or admission of liability) of payment for items or services included in a claim against the primary payer or the primary payer's insured; or
  - (3) **By other means, including but not limited to a settlement, award, or contractual obligation.**
- (c) The primary payer must make payment to either of the following:
  - (1) To the entity designated to receive repayments if the demonstration of primary payer responsibilities is other than receipt of a recovery demand letter from CMS or designated contractor.
  - (2) **As directed in a recovery demand letter.**

## Notes

### Amendments

[71 FR 9470, Feb. 24, 2006, as amended at 73 FR 9684, Feb. 22, 2008]

### Authority

Authority: 42 U.S.C. 1302, 1395w-101 through 1395w-152, 1395hh, and 1395nn.

### Source

Source: 54 FR 41734, Oct. 11, 1989, unless otherwise noted.

### Amendments

[71 FR 9470, Feb. 24, 2006, as amended at 73 FR 9684, Feb. 22, 2008]