[Code of Federal Regulations] [Title 42, Volume 2] [Revised as of October 1, 2002] From the U.S. Government Printing Office via GPO Access [CITE: 42CFR411.53] [Page 316] TITLE 42--PUBLIC HEALTH 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. 411.53 Basis for conditional Medicare payment in no-fault cases. A conditional Medicare payment may be made in no-fault cases under either of the following circumstances: (a) The beneficiary, or the provider or supplier, has filed a proper claim for no-fault insurance benefits but the intermediary or carrier determines that the no-fault insurer will not pay promptly for any reason other than the circumstances described in Sec. 411.32(a)(1). This includes cases in which the no-fault insurance carrier has denied the claim. (b) The beneficiary, because of physical or mental incapacity, failed to meet a claim-filing requirement stipulated in the policy. [[Page 317]]