42 CFR 411.24 - Recovery of conditional payments

Cite as42 CFR 411.24
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157 practice notes
  • Federal claims collection: Interest rates on overdue debts,
    • United States
    • Federal Register March 08, 2007
    • March 8, 2007
    ...of the DCIA, the MSP provisions of the Medicare statute (section 1862(b) of the Social Security Act) and implementing regulations (42 CFR 411.24(m)) provide CMS separate, independent authority for assessing interest on delinquent MSP Comment: One commenter noted that proposed Sec. 30.24(b) ......
  • In re Dow Corning Corp., No. 95-20512.
    • United States
    • United States Bankruptcy Courts. Tenth Circuit. U.S. Bankruptcy Court — Eastern District of Michigan
    • June 22, 2000
    ...party payer must reimburse Medicare even though it has already reimbursed the beneficiary or other party." Id. at 5 n. 1 (quoting 42 C.F.R. § 411.24(i)(2)). The affirmative obligations that the MSPA places upon an entity such as the Debtor are discussed in greater detail below. Suffice it t......
  • Health Ins. Ass'n of America, Inc. v. Shalala, Nos. 92-5196
    • United States
    • United States Courts of Appeals. United States Court of Appeals (District of Columbia)
    • May 13, 1994
    ...Chevron U.S.A. v. Natural Resources Defense Council, 467 U.S. 837, 842-43, 844, 104 S.Ct. 2778, 2782, 81 L.Ed.2d 694 (1984). A. 42 CFR Sec. 411.24(e)--third-party administrator Both appellants are associations of health-insurance companies whose members often enter into contracts with emplo......
  • Aetna Life Ins. Co. v. Guerrera, CIVIL ACTION NO. 3:17-cv-621 (JCH)
    • United States
    • United States District Courts. 2nd Circuit. United States District Court (Connecticut)
    • March 13, 2018
    ...has a right of action to recover its payments from any entity, including a beneficiary, ... that has received a primary payment." 42 C.F.R. § 411.24(g). Aetna further cites the court to the government’s cause of action in the MSP, subsection (2)(B)(iii), which states that "the United States......
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125 cases
  • In re Dow Corning Corp., No. 95-20512.
    • United States
    • United States Bankruptcy Courts. Tenth Circuit. U.S. Bankruptcy Court — Eastern District of Michigan
    • June 22, 2000
    ...party payer must reimburse Medicare even though it has already reimbursed the beneficiary or other party." Id. at 5 n. 1 (quoting 42 C.F.R. § 411.24(i)(2)). The affirmative obligations that the MSPA places upon an entity such as the Debtor are discussed in greater detail below. Suffice it t......
  • Health Ins. Ass'n of America, Inc. v. Shalala, Nos. 92-5196
    • United States
    • United States Courts of Appeals. United States Court of Appeals (District of Columbia)
    • May 13, 1994
    ...Chevron U.S.A. v. Natural Resources Defense Council, 467 U.S. 837, 842-43, 844, 104 S.Ct. 2778, 2782, 81 L.Ed.2d 694 (1984). A. 42 CFR Sec. 411.24(e)--third-party administrator Both appellants are associations of health-insurance companies whose members often enter into contracts with emplo......
  • Aetna Life Ins. Co. v. Guerrera, CIVIL ACTION NO. 3:17-cv-621 (JCH)
    • United States
    • United States District Courts. 2nd Circuit. United States District Court (Connecticut)
    • March 13, 2018
    ...has a right of action to recover its payments from any entity, including a beneficiary, ... that has received a primary payment." 42 C.F.R. § 411.24(g). Aetna further cites the court to the government’s cause of action in the MSP, subsection (2)(B)(iii), which states that "the United States......
  • Cooper Hosp. Univ. Med. Ctr. v. Selective Ins. Co. of Am., A-46 September Term 2020
    • United States
    • United States State Supreme Court (New Jersey)
    • December 22, 2021
    ...insurers make payment to the provider, however, the provider must reimburse CMS for the amount that CMS paid. See ibid.; 42 C.F.R. §§ 411.22, 411.24.--------...
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14 firm's commentaries
  • Protecting The Interests Of Medicare Advantage Plans In Settlement Involving Plan Beneficiaries
    • United States
    • Mondaq United States
    • May 24, 2018
    ...also establishes and defines a cause of action by the United States to recover from a primary plan. Id. § 1395y(b)(2)(B)(iii); see also 42 C.F.R. § 411.24 (describing a Government cause of action against a primary plan or any other person that received a primary payment). However, paragraph......
  • Medicare Secondary Payer – A Lot Less Boring Now
    • United States
    • Mondaq United States
    • January 16, 2017
    ...a beneficiary, provider, supplier, physician, attorney, State agency or private insurer that has received a primary payment." 42 C.F.R. §411.24(g) (emphasis added). Because the defendant lawyer and law firm allegedly "received a primary payment" when they cashed those settlem......
  • Medicare Secondary Payer – A Lot Less Boring Now
    • United States
    • LexBlog United States
    • January 16, 2017
    ...a beneficiary, provider, supplier, physician, attorney, State agency or private insurer that has received a primary payment.” 42 C.F.R. §411.24(g) (emphasis added). Because the defendant lawyer and law firm allegedly “received a primary payment” when they cashed those settlement checks from......
  • Exploring Options for Conditional Payment Resolution
    • United States
    • LexBlog United States
    • July 7, 2021
    ...that the primary payer has paid or will make, or in the case of a primary payment beneficiary, the amount of the primary payment.” 42 C.F.R. 411.24(c)(1). Section 411.37(d) of the regulations provides: “If Medicare payments equal or exceed the judgment or settlement amount, the recovery amo......
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10 books & journal articles

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