42 C.F.R. § 411.43

Beneficiary's responsibility with respect to workers' compensation.

Last amended: 2017Year: 2026Length: 102 wordsSubsections: 4Official source

Cite as 42 C.F.R. § 411.43 (2026)

(a) The beneficiary is responsible for taking whatever action is necessary to obtain any payment that can reasonably be expected under workers' compensation. (b) Except as specified in § 411.45(a), Medicare does not pay until the beneficiary has exhausted his or her remedies under workers' compensation. (c) Except as specified in § 411.45(b), Medicare does not pay for services that would have been covered under workers' compensation if the beneficiary had filed a proper claim. (d) However, if a claim is denied for reasons other than not being a proper claim, Medicare pays for the services if they are covered under Medicare.
Cross-references to the CFR
411.45
42 C.F.R. § 411.43: Beneficiary's responsibility with respect to workers' compensation. | Justis AI