Health Insurer Has Right To Recoup Payments: High Court

By Jeff Sistrunk (April 18, 2017, 4:57 PM EDT) -- The U.S. Supreme Court ruled Tuesday that Coventry Health Care of Missouri has a right to recoup benefits paid to a federal employee injured in a car crash, holding that a provision in the Federal Employees Health Benefits Act preempts a Missouri law barring insurers from seeking reimbursement of payments to policyholders.

Pursuant to FEHBA's so-called express-preemption provision, terms of contracts negotiated under the statute will preempt certain state laws if the terms "relate to the nature, provision, or extent of coverage or benefits." For years, contracts that the Office of Personnel Management has negotiated with private insurance companies have permitted...

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