---
kind: "section"
citation: "42 C.F.R. § 411.45"
title: "42"
number: "411.45"
heading: "Basis for conditional Medicare payment in workers' compensation cases."
url: "https://uscodex.org/cfr/42/411.45"
---

# §411.45. Basis for conditional Medicare payment in workers' compensation cases.

- (a) A conditional Medicare payment may be made under either of the following circumstances:
  - (1) 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.
  - (2) **The beneficiary, because of physical or mental incapacity, failed to file a proper claim.**
- (b) Any conditional payment that CMS makes is conditioned on reimbursement to CMS in accordance with subpart B of this part.

## Notes

### 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]