42 C.F.R. § 411.45 Basis for conditional Medicare payment in workers' compensation cases.
Title 42 - Public Health
(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 capacity, 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. [71 FR 9470, Feb. 24, 2006]
Title 42: Public Health
PART 411—EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT
Subpart C—Limitations on Medicare Payment for Services Covered Under Workers' Compensation
§ 411.45 Basis for conditional Medicare payment in workers' compensation cases.