[Code of Federal Regulations]
[Title 42, Volume 2]
[Revised as of October 1, 2002]
From the U.S. Government Printing Office via GPO Access
[CITE: 42CFR411.25]

[Page 309]
 
                         TITLE 42--PUBLIC HEALTH
 
                             HUMAN SERVICES
 
PART 411--EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT--Table of Contents
 
  Subpart B--Insurance Coverage That Limits Medicare Payment: General 
                               Provisions
 
Sec. 411.25  Third party payer's notice of mistaken Medicare primary payment.

    (a) If a third party payer learns that CMS has made a Medicare 
primary payment for services for which the third party payer has made or 
should have made primary payment, it must give notice to that effect to 
the Medicare intermediary or carrier that paid the claim.
    (b) The notice must describe the specific situation and the 
circumstances (including the particular type of insurance coverage as 
specified in Sec. 411.20(a)) and, if appropriate, the time period during 
which the insurer is primary to Medicare.
    (c) If a plan is self-insured and self-administered, the employer 
must give the notice to CMS. Otherwise, the insurer, underwriter, or 
third party administrator must give the notice.

[54 FR 41734, Oct. 11, 1989; as amended at 55 FR 1820, Jan. 19, 1990]