§411.43. Beneficiary's responsibility with respect to workers' compensation.
42 C.F.R. § 411.43
The beneficiary is responsible for taking whatever action is necessary to obtain any payment that can reasonably be expected under workers' compensation.
Except as specified in § 411.45(a), Medicare does not pay until the beneficiary has exhausted his or her remedies under workers' compensation.
Except as specified in § 411.45(b), Medicare does not pay for services that would have been covered under workers' compensation if the beneficiary had filed a proper claim.
However, if a claim is denied for reasons other than not being a proper claim, Medicare pays for the services if they are covered under Medicare.
Notes, amendments, and revision history
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.