Medicare Compensation Recovery Notice of Judgment or Settlement form (MO022)

Use this form to tell us about a judgment or settlement for Medicare Compensation Recovery.

You must download our forms to fill them in. We have help available if you use assistive technology or if you need a translator or interpreter. Find out how to use our forms.

Download and complete the Medicare Compensation Recovery Notice of Judgment or Settlement form.

The compensation payer or their nominated representative must send us this completed form within 28 days of the date the amount of compensation was fixed.

Page last updated: 20 June 2025.
QC 19031