§ 411.20 Basis and scope
§ 411.21 Definitions
§ 411.22 Reimbursement obligations of primary payers and entities that received payment from primary payers
§ 411.23 Beneficiary’s cooperation
§ 411.24 Recovery of conditional payments
§ 411.25 Primary payer’s notice of primary payment responsibility
§ 411.26 Subrogation and right to intervene
§ 411.28 Waiver of recovery and compromise of claims
§ 411.30 Effect of primary payment on benefit utilization and deductibles
§ 411.31 Authority to bill primary payers for full charges
§ 411.32 Basis for Medicare secondary payments
§ 411.33 Amount of Medicare secondary payment
§ 411.35 Limitations on charges to a beneficiary or other party when a workers’ compensation plan, a no-fault insurer, or an employer group health plan is primary payer
§ 411.37 Amount of Medicare recovery when a primary payment is made as a result of a judgment or settlement
§ 411.39 Automobile and liability insurance (including self-insurance), no-fault insurance, and workers’ compensation: Final conditional payment amounts via Web portal

Terms Used In CFR > Title 42 > Chapter IV > Subchapter B > Part 411 > Subpart B - Insurance Coverage That Limits Medicare Payment: General Provisions

  • Appeal: A request made after a trial, asking another court (usually the court of appeals) to decide whether the trial was conducted properly. To make such a request is "to appeal" or "to take an appeal." One who appeals is called the appellant.
  • Beneficiary: A person who is entitled to receive the benefits or proceeds of a will, trust, insurance policy, retirement plan, annuity, or other contract. Source: OCC
  • Common law: The legal system that originated in England and is now in use in the United States. It is based on judicial decisions rather than legislative action.
  • Contract: A legal written agreement that becomes binding when signed.
  • Entitlement: A Federal program or provision of law that requires payments to any person or unit of government that meets the eligibility criteria established by law. Entitlements constitute a binding obligation on the part of the Federal Government, and eligible recipients have legal recourse if the obligation is not fulfilled. Social Security and veterans' compensation and pensions are examples of entitlement programs.
  • Fiduciary: A trustee, executor, or administrator.
  • Obligation: An order placed, contract awarded, service received, or similar transaction during a given period that will require payments during the same or a future period.
  • Remainder: An interest in property that takes effect in the future at a specified time or after the occurrence of some event, such as the death of a life tenant.
  • Settlement: Parties to a lawsuit resolve their difference without having a trial. Settlements often involve the payment of compensation by one party in satisfaction of the other party's claims.