§411.45. Basis for conditional Medicare payment in workers' compensation cases.
42 C.F.R. § 411.45
A conditional Medicare payment may be made under either of the following circumstances:
The beneficiary has filed a proper claim for workers' compensation benefits, but the intermediary or carrier determines that the workers' compensation carrier will not pay promptly. This includes cases in which a workers' compensation carrier has denied a claim.
The beneficiary, because of physical or mental incapacity, failed to file a proper claim.
Any conditional payment that CMS makes is conditioned on reimbursement to CMS in accordance with subpart B of this part.
Notes, amendments, and revision history
Amendments
[71 FR 9470, Feb. 24, 2006, as amended at 73 FR 9685, 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 9685, Feb. 22, 2008]