[Code of Federal Regulations]
[Title 42, Volume 2]
[Revised as of October 1, 2007]
From the U.S. Government Printing Office via GPO Access
[CITE: 42CFR411.25]

[Page 397]
 
                         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  Primary payer's notice of mistaken Medicare primary payment.

    (a) If a primary payer learns that CMS has made a Medicare primary 
payment for services for which the primary 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]