[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: 42CFR411.45]

[Page 313-314]
 
                         TITLE 42--PUBLIC HEALTH
 
                             HUMAN SERVICES
 
PART 411--EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT--Table of Contents
 
 Subpart C--Limitations on Medicare Payment for Services Covered Under 
                          Workers' Compensation
 
Sec. 411.45  Basis for conditional Medicare payment in workers' compensation cases.

    A conditional Medicare payment may be made under either of the 
following circumstances:

[[Page 314]]

    (a) The beneficiary has filed a proper claim for workers' 
compensation benefits, but the intermediary or carrier determines that 
the workers' compensation carrier will not pay promptly. This includes 
cases in which a workers' compensation carrier has denied a claim.
    (b) The beneficiary, because of physical or mental incapacity, 
failed to file a proper claim.