§ 5.14 Federal Third-Party Payer Claims

• Jurisdiction: Arizona

§ 5.14 – Federal Third-Party Payer Claims

The third-party payer statute, 10 U.S.C. § 1095, is another federal law implicated in cases where the United States furnishes medical care to an injured person. The statute was enacted in 1985 and is a corollary to the FMCRA in that it provides a direct means of recovery against automobile insurers—including first-party insurers. See generally 32 C.F.R. §§ 220.1 to 220.14 and 32 C.F.R. § 757.14(e) (explaining § 1095 provides an alternate means for recovery as a third-party beneficiary of an insurance contract of the injured party where recovery under the FMCRA is not possible because no tort liability exists).

a. The Scope of Federal Third-Party Payer Claims

Although the phrase “third-party beneficiary” does not appear in the statute, “[t]he plain language of 10 U.S.C. § 1095 is clear that the United States’ right to reimbursement from third-party payers includes reimbursement from automobile insurers.” Warmbrod, 367 S.W.3d 778, 782 (App. Tex. 2012). Indeed, “the only way that a third-party payer can satisfy § 1095 is to pay the United States.” United States v. Chartis Ins. Agency, Inc., 834 F. Supp. 2d 459, 464 (E.D. Va. 2011) (emphasis...