42 CFR 424.64 - Payment after beneficiary's death: Bill has not been paid.

Status message

There are 9 Updates appearing in the Federal Register for 42 CFR 424. View below or at eCFR (GPOAccess)
§ 424.64 Payment after beneficiary's death: Bill has not been paid.
(a) Scope. This section specifies whom Medicare pays, and the conditions for payment when the beneficiary has died and the bill has not been paid.
(b) Situation.
(1) The beneficiary has received covered Part B services furnished by a physician or other supplier.
(2) The beneficiary died without making an assignment to the physician or other supplier or receiving Medicare payment.
(3) The bill has not been paid.
(c) To whom payment is made. In the situation described in paragraph (b) of this section, Medicare pays as follows:
(1) Payment to the supplier. Medicare pays the physician or other supplier if he or she—
(i) Files a claim on a CMS-prescribed form in accordance with the applicable requirements of this subpart;
(ii) Upon request from the carrier, provides evidence that the services for which it claims payment were, in fact, furnished; and
(iii) Agrees in writing to accept the reasonable charge as the full charge for the services.
(2) Payment to a person who assumes legal obligation to pay for the services. If the physician or other supplier does not agree to accept the reasonable charge as full charge for the service, Medicare pays any person who submits to the carrier all of the following:
(i) A statement indicating that he or she has assumed legal obligation to pay for the services.
(ii) A claim on a CMS-prescribed form in accordance with the requirements of this subpart. (If a claim had been submitted by or on behalf of the beneficiary before he or she died, submission of another claim form is not required; a written request by the person seeking payment meets the requirement for a claim.)
(iii) An itemized bill that identifies the claimant as the person to whom the physician or other supplier holds responsible for payment. (If such an itemized bill had been submitted by or on behalf of the beneficiary before he or she died, submission of another itemized bill is not required.)
(iv) If the intermediary or carrier requests it, evidence that the services were actually furnished.
[53 FR 6634, Mar. 2, 1988, as amended at 53 FR 28388, July 28, 1988]

Title 42 published on 2013-10-01

The following are only the Rules published in the Federal Register after the published date of Title 42.

For a complete list of all Rules, Proposed Rules, and Notices view the Rulemaking tab.

  • 2014-08-01; vol. 79 # 148 - Friday, August 1, 2014
    1. 79 FR 44702 - Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Extended Temporary Moratoria on Enrollment of Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Extension of temporary moratoria.
      Effective Date: July 29, 2014.
      42 CFR Part 424

This is a list of United States Code sections, Statutes at Large, Public Laws, and Presidential Documents, which provide rulemaking authority for this CFR Part.

This list is taken from the Parallel Table of Authorities and Rules provided by GPO [Government Printing Office].

It is not guaranteed to be accurate or up-to-date, though we do refresh the database weekly. More limitations on accuracy are described at the GPO site.


United States Code

Title 42 published on 2013-10-01

The following are ALL rules, proposed rules, and notices (chronologically) published in the Federal Register relating to 42 CFR 424 after this date.

  • 2014-08-01; vol. 79 # 148 - Friday, August 1, 2014
    1. 79 FR 44702 - Medicare, Medicaid, and Children's Health Insurance Programs: Announcement of the Extended Temporary Moratoria on Enrollment of Ambulance Suppliers and Home Health Agencies in Designated Geographic Locations
      GPO FDSys XML | Text
      DEPARTMENT OF HEALTH AND HUMAN SERVICES, Centers for Medicare & Medicaid Services
      Extension of temporary moratoria.
      Effective Date: July 29, 2014.
      42 CFR Part 424