42 C.F.R. § 411.22 Reimbursement obligations of primary payers and entities that received payment from primary payers.
Title 42 - Public Health
(a) A primary payer, and an entity that receives payment from a primary payer, must reimburse CMS for any payment if it is demonstrated that the primary payer has or had a responsibility to make payment. (b) A primary payer's responsibility for payment may be demonstrated by— (1) A judgment; (2) A payment conditioned upon the recipient's compromise, waiver, or release (whether or not there is a determination or admission of liability) of payment for items or services included in a claim against the primary payer or the primary payer's insured; or (3) By other means, including but not limited to a settlement, award, or contractual obligation. [71 FR 9470, Feb. 24, 2006]
Title 42: Public Health
PART 411—EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT
Subpart B—Insurance Coverage That Limits Medicare Payment: General Provisions
§ 411.22 Reimbursement obligations of primary payers and entities that received payment from primary payers.
