Insurance Coverage That Limits Medicare Payment: General Provisions

  1. Law
  2. CFR 42
  3. Public Health
  4. Centers for Medicare & Medicaid Services, Department of Health and Human Services
  5. Medicare Program
  6. Exclusions from Medicare and Limitations on Medicare Payment
  7. Insurance Coverage That Limits Medicare Payment: General Provisions

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Section
411.20

Basis and scope.

Section
411.21

Definitions.

Section
411.22

Reimbursement obligations of primary payers and entities that received payment from primary payers.

Section
411.23

Beneficiary's cooperation.

Section
411.24

Recovery of conditional payments.

Section
411.25

Primary payer's notice of primary payment responsibility.

Section
411.26

Subrogation and right to intervene.

Section
411.28

Waiver of recovery and compromise of claims.

Section
411.30

Effect of primary payment on benefit utilization and deductibles.

Section
411.31

Authority to bill primary payers for full charges.

Section
411.32

Basis for Medicare secondary payments.

Section
411.33

Amount of Medicare secondary payment.

Section
411.35

Limitations on charges to a beneficiary or other party when a workers' compensation plan, a no-fault insurer, or an employer group health plan is primary payer.

Section
411.37

Amount of Medicare recovery when a primary payment is made as a result of a judgment or settlement.

Section
411.39

Automobile and liability insurance (including self-insurance), no-fault insurance, and workers' compensation: Final conditional payment amounts via Web portal.