The U.S. Supreme Court has ruled 5-4 that health insurers serving federal employees must seek reimbursement of monies paid to claimants under state law, not federal law.
An official in the Washington office of the Blue Cross and Blue Shield Association expressed disappointment with the court’s ruling.
But Larry Akey, a spokesman for America’s Health Insurance Plans, Washington, says the decision was made on technical grounds concerning jurisdiction and does not appear to narrow a May decision that dealt with subrogation, or reimbursement of health insurers by third parties who have helped to pay for insureds’ medical care.
“Subrogation is a big issue,” Akey says. “But this case was decided purely on jurisdictional issues. We are not concerned as much about this case, because it does not deal directly with subrogation, but as to whether state or federal courts have jurisdiction in this narrowly defined set of circumstances.”
In the May decision, Sereboff vs.MAMSI, the Supreme Court ruled that health plans can ask for reimbursement for previously provided benefits from a recipient if the recipient receives payment for the services from someone else.