42 CFR §411.53
Verified against eCFR.gov as of June 20, 2026View official text on eCFR.gov ↗
- (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.