C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & 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

42 C.F.R. § 411.26

Subrogation and right to intervene

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(a) Subrogation. With respect to services for which Medicare paid, CMS is subrogated to any individual, provider, supplier, physician, private insurer, State agency, attorney, or any other entity entitled to payment by a primary payer.

(b) Right to intervene. CMS may join or intervene in any action related to the events that gave rise to the need for services for which Medicare paid.

Notes of Decisions
Cited in 10 cases (6 in the last 5 years), 1994–2025 · leading case: Weston v. AKHappytime, LLC, 445 P.3d 1015 (Alaska 2019).
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Weston v. AKHappytime, LLC, 445 P.3d 1015 (Alaska 2019). “42 C.F.R. § 411.26 (2018). But Medicare does not have a right to subrogation for the negotiated difference between the amounts billed and the amounts paid.”
Densler v. Durrani, 2024 Ohio 14 (Ohio Ct. App. 2024). “” See 42 C.F.R. 411.26(a). Thus, no party disputes that Medicare was a real party in interest to the extent of the payments made on Mr.”
Paluch v. United Parcel Serv., Inc., 2014 IL App (1st) 130621 (Ill. App. Ct. 2014). “See 42 C.F.R. § 411.26 (2006). If a party appears to be shifting his or her obligation to pay for a worker’s future medical expenses onto Medicare by dedicating an insufficient amount for future medical expenses, the settlement will not be recognized.”
Paluch v. United Parcel Serv., Inc., 2014 IL App (1st) 130621 (Ill. App. Ct. 2014). “See 42 C.F.R. § 411.26 (2006). If a party appears to be shifting his or her obligation to pay for a worker's future medical expenses onto Medicare 9 No.”
MSP Recovery Claims, Series LLC v. Massachusetts Bay Ins. Co. (D. Mass. 2024). · cites it 6× “¶ 130) (quoting 42 C.F.R. § 411.26 (a)) (citing 42 C.F.R.”
MSP Recovery Claims, Series LLC v. Massachusetts Bay Ins. Co. (D. Mass. 2025). · cites it 5× “It points to 42 C.F.R. § 411.26 , which provides that “[w]ith respect to services for which Medicare paid, CMS is subrogated to any individual, provider, supplier, physician, private insurer, State agency, attorney, or any other entity entitled to payment by a primary payer.”
MAO-MSO Recovery II, LLC v. Gov't Employees Ins. Co. (GEICO) (D. Maryland 2024). · cites it 4× “In Count II, however, Plaintiffs also reference 42 C.F.R. § 411.26 , entitled “Subrogation,” which states that “[w]ith respect to services for which Medicare paid, CMS is subrogated to any individual, provider, supplier, physician, private insurer, State agency, attorney, or any…”
MSPA Claims 1, LLC v. Gov't Employees Ins. Co. (GEICO) (D. Maryland 2024). · cites it 4× “In Count II, however, Plaintiffs also reference 42 C.F.R. § 411.26 , entitled “Subrogation,” which states that “[w]ith respect to services for which Medicare paid, CMS is subrogated to any individual, provider, supplier, physician, private insurer, State agency, attorney, or any…”
Meador v. United States (D. Mass. 2024). · cites it 2× “These rights include the right to “recover its payments from any entity, including a beneficiary, provider, supplier, physician, attorney, State agency or private insurer that has received a primary payment,” 42 C.F.R. § 411.24 (g), the right to “join or intervene in any action…”
Norman Lee Spencer v. Mary Ann Hannon (Miss. 1994). · cites it 2× “See 42 C.F.R. § 411.26 (a)(1997). In addition, HCFA may join or intervene in any action related to the events that gave rise to the need for services for which Medicare paid.”
— 42 C.F.R. § 411.26(a) — 1 case
Densler v. Durrani, 2024 Ohio 14 (Ohio Ct. App. 2024). “” See 42 C.F.R. 411.26(a). Thus, no party disputes that Medicare was a real party in interest to the extent of the payments made on Mr.”
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