---
kind: "section"
citation: "42 C.F.R. § 411.52"
title: "42"
number: "411.52"
heading: "Basis for conditional Medicare payment in liability cases."
url: "https://uscodex.org/cfr/42/411.52"
---

# §411.52. Basis for conditional Medicare payment in liability cases.

- (a) A conditional Medicare payment may be made in liability cases under either of the following circumstances:
  - (1) The beneficiary has filed a proper claim for liability insurance benefits but the intermediary or carrier determines that the liability insurer will not pay promptly for any reason other than the circumstances described in [§ 411.32(a)(1)](/cfr/42/411.32.md?p=a-1). This includes cases in which the liability insurance carrier has denied the claim.
  - (2) **The beneficiary has not filed a claim for liability insurance benefits.**
- (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]

### 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]