- Home
- Books and Journals
- New York State Bar Association
- Construction Site Personal Injury Litigation (NY)
- XIV How To Resolve Liens and Claimed Rights of Reimbursement
C. The Most Common Entities Seeking Repayment Of Expenses In A Personal Injury Action
Jurisdiction | New York |
C. The Most Common Entities Seeking Repayment of Expenses in a Personal Injury Action
The following entities commonly seek recovery of medical expenses in a personal injury action.
1. Medicare
There is a statutory right of recovery running to the U.S. government for Medicare payments conditionally made to an injured party pending payment by a liability insurer or other primary plan.1312 We discuss Medicare liens in detail at section XIV.
2. Medicaid
This is a statutory right of recovery running to the states and administered through local districts for medical assistance and other services, asserted by notice of lien under SSL § 104-b and assignment of benefits by the Medicaid recipients as a condition of receiving payments and services.1313 Effective October 1, 2017, WOS v. E.M.A. ex rel. Johnson1314 and Arkansas Department of Health & Human Servs. v. Ahlborn1315 have been legislatively overruled. Congress did not extend a stay of implementation on that portion of the Bipartisan Budget Act of 2013 which made Medicaid liens recoverable on a dollar for dollar basis.
3. Health Insurance Contracts
Private health insurers claim rights of reimbursement for injury related medicals provided through their health insurance contracts. General Obligations Law § 5-335(a) now bars these claims when a plaintiff settles with a tortfeasor.1316
4. Self-Funded Private Employer Health Plans
Self-funded private employer health plans seek to recoup their payment of injury related medical service payments to their private employees. This right of recovery arises under the Employer Retirement Income Security Act of 1974 (ERISA) to recoup all expenses irrespective of the recovery amount, or the equity of such recoupment from the injured plaintiff's recovery.1317 Case law has held that GOL § 5-335 does not apply to these statutory rights of reimbursement.1318
In US Airways v. McCutchen,1319 the U.S. Supreme Court held that an injured party could not assert equity defenses such as the "make whole" doctrine against an ERISA recovery action based on an equitable lien by agreement, i.e., the Plan language. But, the Supreme Court found that due to gaps in the Plan language at bar, traditional equity principles could fill those gaps. The gap pertained to whether the Plan had to share part of the fees and costs incurred in getting the recovery. Lower courts have followed McCutchen to uphold full recovery under ERISA plans where there are no gap fillers.1320
The Supreme Court on January 20, 2016 held that when an ERISA fund participant dissipates an entire settlement on nontraceable items, such as food, the fiduciary of the ERISA plan cannot bring a suit to attach the participant's general assets...
To continue reading
Request your trial- Construction Site Personal Injury Litigation (NY)
- XIV How To Resolve Liens and Claimed Rights of Reimbursement
- XIV. How To Resolve Liens And Claimed Rights Of Reimbursement
- A. Evaluating And Assessing Liens And Rights Of Subrogation
- B. Medical Benefits Carrier Intervention
- C. The Most Common Entities Seeking Repayment Of Expenses In A Personal Injury Action
- D. Resolving Medicare Liens
Subscribers can access the reported version of this case.
You can sign up for a trial and make the most of our service including these benefits.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.
Subscribers are able to see a list of all the cited cases and legislation of a document.
You can sign up for a trial and make the most of our service including these benefits.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.
Subscribers are able to see a list of all the documents that have cited the case.
You can sign up for a trial and make the most of our service including these benefits.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.
Subscribers are able to see the revised versions of legislation with amendments.
You can sign up for a trial and make the most of our service including these benefits.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.
Subscribers are able to see any amendments made to the case.
You can sign up for a trial and make the most of our service including these benefits.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.
Subscribers are able to see a visualisation of a case and its relationships to other cases. An alternative to lists of cases, the Precedent Map makes it easier to establish which ones may be of most relevance to your research and prioritise further reading. You also get a useful overview of how the case was received.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.
Subscribers are able to see the list of results connected to your document through the topics and citations Vincent found.
You can sign up for a trial and make the most of our service including these benefits.
Why Sign-up to vLex?
-
Over 100 Countries
Search over 120 million documents from over 100 countries including primary and secondary collections of legislation, case law, regulations, practical law, news, forms and contracts, books, journals, and more.
-
Thousands of Data Sources
Updated daily, vLex brings together legal information from over 750 publishing partners, providing access to over 2,500 legal and news sources from the world’s leading publishers.
-
Find What You Need, Quickly
Advanced A.I. technology developed exclusively by vLex editorially enriches legal information to make it accessible, with instant translation into 14 languages for enhanced discoverability and comparative research.
-
Over 2 million registered users
Founded over 20 years ago, vLex provides a first-class and comprehensive service for lawyers, law firms, government departments, and law schools around the world.