Should Accident Victims Recover their Medical Bills Twice?

Faegre Drinker Biddle & Reath LLP
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Most of us think that accident victims should be able to recover for their medical bills.  But recover twice?  That issue is at the heart of the case argued before the United States Supreme Court on March 1.

The Federal Employees Health Benefits Act (FEHBA) empowers the Office of Personnel Management (OPM) to contract with private insurance companies to provide health benefits to federal employees.

When federal employee Jodie Nevils was injured in a car wreck, Coventry Health Care paid for his medical care.  When he received a settlement payment from the other driver, Coventry placed a lien on it, as required by the subrogation provision in its contract with the OPM.  Jodie repaid Coventry, satisfying the lien.

Then Jodie filed a class action against Coventry, alleging that Missouri’s common law anti-subrogation doctrine prohibited Coventry from seeking reimbursement.  Coventry relied on the preemption provision of the FEHBA, which says any OPM contract term “shall supersede and preempt any State or local law … which relates to health insurance plans.”

The Missouri Supreme Court rejected Coventry’s argument, ruling that the preemption provision doesn’t apply to state anti-subrogation laws.  The U. S. Supreme Court granted Coventry’s petition for certiorari and heard oral argument on March 1.  Press reports indicate that the justices appeared skeptical of the position taken by Jodie and the Missouri Supreme Court.

If Jodie wins, it means that at least in Missouri, a federal worker can (a) have his medical bills paid by his insurance company and then (b) recover and keep that same amount from the person responsible for the injuries.

The case is Coventry Health Care of Missouri v. Nevils, No. 16-149, argued Mar. 1, 2017.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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