C.F.R. » Title 42 » CHAPTER IV—CENTERS FOR MEDICARE & MEDICAID SERVICES, DEPARTMENT OF HEALTH AND HUMAN SERVICES › SUBCHAPTER B—MEDICARE PROGRAM › PART 424—CONDITIONS FOR MEDICARE PAYMENT › Subpart F—Limitations on Assignment and Reassignment of Claims

42 C.F.R. § 424.86

Prohibition of assignment of claims by beneficiaries

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(a) Basic prohibition. Except as specified in paragraph (b) of this section, Medicare does not pay amounts that are due a beneficiary under § 424.53 to any other person under assignment, power of attorney, or any other direct payment arrangement.

(b) Exceptions—(1) Payment to a government agency or entity. Subject to the requirements of the Assignment of Claims Act (31 U.S.C. 3727), Medicare may pay a government agency or entity under an assignment by a beneficiary (or by the beneficiary's legal guardian or representative payee).

(2) Payment under an assignment established by court order. Medicare may pay under an assignment established by, or in accordance with, a court order if the assignment meets the conditions set forth in § 424.90.

Notes of Decisions
Cited in 2 cases, 2019–2020 · leading case: Yuhasz v. Centers for Medicare & Medicaid Servs. (cms) (D.N.J. 2019).
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Yuhasz v. Centers for Medicare & Medicaid Servs. (cms) (D.N.J. 2019). · cites it 2× “Except under limited circumstances not applicable here, 42 C.F.R. § 424.86 prohibits Medicare from paying amounts due to a beneficiary to any other person, including through a power of attorney.”
Yuhasz v. Centers for Medicare & Medicaid Servs. (cms) (D.N.J. 2020). · cites it 2× “Except under limited circumstances not applicable here, 42 C.F.R. § 424.86 prohibits Medicare from paying amounts due to a beneficiary to any other person, including through a power of attorney.”
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