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Medicaid TPL Rights Postponed

In 2006 the United States Supreme Court decided Ahlborn v. Arkansas 547 U.S. 268 (2006). There, the Court in interpreting Medicaid’s long standing statutory rights of recovery held that from an unallocated third party settlements, Medicaid was only entitled to recover that portion of  an unallocated settlement that represented past medicals.  Thus extinguishing Medicaid’s long standing, […]

FEHBP Plans Not Subject to State Laws

FEHBP Plans Not Subject to State Laws Coventry Health Care of Missouri, Inc. v. Nevils April 18, 2017 S. Sup. Ct. 16–149 The U.S. Supreme Court ruled yesterday that Contractual subrogation and reimbursement rights of federal employees’ private health insurance carriers override state laws barring subrogation and reimbursement (Ginsburg, J.) In a unanimous decision, the […]

WC Carriers allowed indirect Third Party Subrogation claim against third parties

Pa highest court clarifies road map for Workers Comp  carriers to protect Subrogation claims.   The Honorable Judge Olson has clarified the “Magic words “ by which a  Workers Comp Carrier in Pennsylvania can assert a Subrogation claim against a Third Party pursuant to the much litigated Section 319 of the Pa Workers Comp Act.  […]

New York Court of Appeals Upholds No-Fault Rule Denying Health Insurer Reimbursement and Equitable Subrogation Rights

New York Court of Appeals Upholds No-Fault Rule Denying Health Insurer Reimbursement and Equitable Subrogation Rights Members Left in the Middle   In a well-reasoned yet anti-consumer opinion, the NY Court of Appeals in the matter of Aetna v. Hanover has reconfirmed a position taken by the NYS Insurance Department since 2008 that health insurers […]

Health Plans must take more active role protecting subrogation (Montanile v. National Elevator)

The U.S. Supreme court today in the case of  Montanile v. National Elevator  ruled that ERISA health Benefit Plans are limited under the laws of Equity to recover only those specific traceable funds available from a settlement .   In the case of Montanile, the Defendant settled his personal injury case for $500,000 arising from an […]

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