Supreme Court allows payers to recover funds from patients — 5 key notes

The U.S. Supreme Court overturned a lower court ruling preventing payers from collecting funds through liens, the St. Louis Record reports.

Advertisement

Here’s what you should know.

1. The overturned case stemmed from Missouri. Kansas City-based Coventry Health Care of Missouri insured a man injured in a car crash through the Federal Employees Health Benefits Act.

2. Coventry paid his bills and after the man received a settlement Conventry put a lien on a portion of his funds.

3. The man satisfied the lien, and then filed a lawsuit against Coventry, claiming Missouri prohibited “subrogation or reimbursement.” The payer claimed the Federal Employees Health Benefits Act overruled other applicable laws.

4. The trial court and the Missouri Court of Appeals ruled in favor of the payer. The Missouri Supreme Court reversed the decision saying the federal statute’s scope excluded subrogation and reimbursement.

5. The U.S. Supreme Court reversed the state Supreme Court’s decision saying that Congress doesn’t use “particular linguistic formulation when preempting state law,” the Record reports.

More articles on coding, billing and collections:
Surgical Care Affiliates (SCA) chooses Hstpathways’ ambulatory surgery center software to support outpatient surgery services in all SCA facilities
15 states with the most HMOs
The 4 secrets to scaling your business

Advertisement

Next Up in ASC Coding, Billing & Collections

  • ASCs have taken center stage of many hospital and health systems’ growth and development strategies in recent years as they…

  • Germantown, Md.-based Capital Surgical Solutions plans to open a new ASC in Portland, Ore., in the fourth quarter of 2026,…

Advertisement

Comments are closed.