Federal
Basis for conditional Medicare payment in workers' compensation cases.
42 CFR § 411.45
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42 CFR § 411.45
42 CFR § 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.
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