Recovery of Expenses by the Department of the Army in Personal Injury Cases
Lawyers who practice personal injury and accident law in Maryland and across the United States are often surprised to learn that the United States has a right to recover from third parties the reasonable value of medical care and pay that has been furnished or will be furnished in the future to accident victims. See Army Regulation 27-20
42 U.S.C. §§ 2651-53
In any case where the United States is authorized or required to pay for hospital, medical, surgical, or dental care and treatment under circumstances creating tort liability on a third person, the United States has an independent right to recover from the third person, or his insurer, the reasonable value of care and treatment furnished. The United States has a right to be subrogated to any claim that the injured person has against a third person to the extent of the reasonable care and treatment furnished. The United States may also require that the injured party assign his claim or cause of action against the third person to the extent of that right or claim.
If state law provides an alternative system of compensation or reimbursement for expenses of hospital, medical, surgical, or dental care or treatment under a policy of insurance, contract, medical, or hospital service agreement, or similar agreement, the United States is a third party beneficiary. The United States shall be subrogated to any right or claim the injured person has under the policy, contract, agreement, or arrangement to the extent of the reasonable value of care and treatment.
To enforce these rights, the United States may intervene or join an action brought by the injured person against the third person liable for the injury, the insurance carrier, or the other entity responsible for payment or reimbursement of medical expenses. The United States can bring an action on its own against any of those entities if a proceeding is not commenced within six months after the first day care and treatment is furnished or paid for by the United States.
With respect to the right to bring an action as outlined above, the United States may compromise, settle, or execute a release of any claim, or it may waive any such claim.
10 U.S.C. § 1095
Third party payer: an entity that provides an insurance, medical service, or health plan by contract or agreement, and any other plan or program designed to provide compensation or coverage for expenses incurred by a beneficiary for health care services or products.
When a person is a covered beneficiary, the United States has the right to collect from a third party payer reasonable charges for health care services incurred by the United States to the extent that the person would be eligible to receive reimbursement or indemnification from the third party payer if the person were to incur charges on his own behalf. If a copayment or deductible is required, the United States may collect from the third party payer a reasonable charge for the care provided less the copayment or deductible.
The United States may institute legal proceedings against a third party payer to enforce these rights.
31 U.S.C. § 3711
The head of an executive, judicial, or legislative agency shall try to collect a claim of the US government for money arising out of the activities of the agency. The head of such an agency may compromise a claim or may suspend or end collection if it appears that no person liable has the ability to pay or that the cost of collecting would likely be more than the amount recovered.
5 U.S.C. § 3106
The head of an Executive or military department may not employ an attorney for litigation in which the United States, an agency, or employee is a party or is interested.
32 C.F.R. § 220.9
Uniformed Services beneficiaries are not required to pay to the facility any amount greater than charges for normal medical services. When payment from a third party payer is received, it will satisfy normal medical services charges and the beneficiary will not be required to make any further payment.
Uniformed Services beneficiaries are required to provide information regarding whether particular health care services might be covered by a third party payer’s plan, including services arising from an accident or workplace injury or illness. The information provided must be sufficient to carry out 10 U.S.C. § 1095 (see above).
For more information, please call the Maryland personal injury and accident lawyers at STSW.