[Code of Federal Regulations]

[Title 42, Volume 2]

[Revised as of October 1, 2005]

From the U.S. Government Printing Office via GPO Access

[CITE: 42CFR411.51]



[Page 395]

 

                         TITLE 42--PUBLIC HEALTH

 

                    CHAPTER IV--CENTERS FOR MEDICARE

                          & MEDICAID SERVICES,

                        DEPARTMENT OF HEALTH AND

                             HUMAN SERVICES

 

PART 411_EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT

--Table of Contents

 

  Subpart D_Limitations on Medicare Payment for Services Covered Under 

                     Liability or No-Fault Insurance

 

Sec. 411.51  Beneficiary's responsibility with respect to no-fault 

insurance.



    (a) The beneficiary is responsible for taking whatever action is 

necessary to obtain any payment that can reasonably be expected under 

no-fault insurance.

    (b) Except as specified in Sec. 411.53, Medicare does not pay until 

the beneficiary has exhausted his or her remedies under no-fault 

insurance.

    (c) Except as specified in Sec. 411.53, Medicare does not pay for 

services that would have been covered by the no-fault insurance 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.