---
kind: "section"
citation: "42 C.F.R. § 411.32"
title: "42"
number: "411.32"
heading: "Basis for Medicare secondary payments."
url: "https://uscodex.org/cfr/42/411.32"
---

# §411.32. Basis for Medicare secondary payments.

- (a) **Basic rules.**
  - (1) Medicare benefits are secondary to benefits payable by a primary payer even if State law or the primary payer states that its benefits are secondary to Medicare benefits or otherwise limits its payments to Medicare beneficiaries.
  - (2) Except as provided in [paragraph (b)](#b) of this section, Medicare makes secondary payments, within the limits specified in [paragraph (c)](#c) of this section and in [§ 411.33](/cfr/42/411.33.md), to supplement the primary payment if that payment is less than the charges for the services and, in the case of services paid on other than a reasonable charge basis, less than the gross amount payable by Medicare under [§ 411.33(e)](/cfr/42/411.33.md?p=e).
- (b) **Exception.** Medicare does not make a secondary payment if the provider or supplier is either obligated to accept, or voluntarily accepts, as full payment, a primary payment that is less than its charges.
- (c) **General limitation: Failure to file a proper claim.** When a provider or supplier, or a beneficiary who is not physically or mentally incapacitated, receives a reduced primary payment because of failure to file a proper claim, the Medicare secondary payment may not exceed the amount that would have been payable under [§ 411.33](/cfr/42/411.33.md) if the primary payer had paid on the basis of a proper claim.

## Notes

### 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.