42 C.F.R. § 411.53 Basis for conditional Medicare payment in no-fault cases.
Title 42 - Public Health
(a) A conditional Medicare payment may be made in no-fault cases under either of the following circumstances: (1) The beneficiary has filed a proper claim for no-fault insurance benefits but the intermediary or carrier determines that the no-fault insurer will not pay promptly for any reason other than the circumstances described in §411.32(a)(1). This includes cases in which the no-fault insurance carrier has denied the claim. (2) The beneficiary, because of physical or mental incapacity, failed to meet a claim-filing requirement stipulated in the policy. (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 D—Limitations on Medicare Payment for Services Covered Under Liability or No-Fault Insurance
§ 411.53 Basis for conditional Medicare payment in no-fault cases.