{"data":{"id":"us/42-cfr-411.22","jurisdiction":"us","citation":"42 CFR 411.22","heading":"Reimbursement obligations of primary payers and entities that received payment from primary payers.","body":"(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.\n(b) A primary payer's responsibility for payment may be demonstrated by—\n(1) A judgment;\n(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\n(3) By other means, including but not limited to a settlement, award, or contractual obligation.\n(c) The primary payer must make payment to either of the following:\n(1) To the entity designated to receive repayments if the demonstration of primary payer responsibilities is other than receipt of a recovery demand letter from CMS or designated contractor.\n(2) As directed in a recovery demand letter.","path":["Title 42—Public Health","CHAPTER IV—CENTERS FOR MEDICARE \u0026 MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES","SUBCHAPTER B—MEDICARE PROGRAM","PART 411—EXCLUSIONS FROM MEDICARE AND LIMITATIONS ON MEDICARE PAYMENT","Subpart B—Insurance Coverage That Limits Medicare Payment: General Provisions"],"source_url":"https://www.ecfr.gov/api/versioner/v1/full/2026-08-25/title-42.xml","current_through":"2026-08-25","vintage":"","retrieved_at":"2026-08-27T02:26:11Z","sha256":"34f871e5b09f38c7d0e8eac3545ffbe79955fcf8dd0c4f8d85bb450bfdb1b3b1","source_id":"us-cfr","stale":true,"prev":"us/42-cfr-411.21","next":"us/42-cfr-411.23"},"notice":"GroundRules: Original legal text. Not legal advice."}