No-Fault Insurance Pays and Medicare Makes No Secondary Payment

40.6 – No-Fault Insurance Pays and Medicare Makes No Secondary Payment (Rev. 12438; Issued: 01-04-24; Effective: 02-06-24; Implementation: 02-06-24) Under 42 C.F.R. § 411.32(b), Medicare does not make a secondary payment if the provider, physician, or other suppliers are either obligated to accept, or voluntarily accepts as full payment, a third party payment that is less than its charges. For example, if the amount of payment for particular services under no-fault insurance is less than the provider, physician, or other supplier’s charges but is deemed payment in full under State law, Medicare benefits are not payable. The insurance payment constitutes a service benefit; i.e., the payment constitutes full discharge of the patient’s liability to the provider, physician, or other supplier.