Obama's Supreme Court Pick and Federal Employees
Alex Parker pointed me to this court decision Sonia Sotomayor, President Obama's pick to join the Supreme Court, wrote in deciding a case about insurance reimbursements and the Federal Employees Health Benefits Program. It's not a hugely complicated case: a FEHBP participant was injured in an accident, resulting in more than $150,000-worth of care paid for by his insurance company. When his family won more than $3 million in a lawsuit over his injuries, his insurance provider put a lien on them for the money and then sued them to recover it. The provider argued that the rules governing FEHB contracts constitute federal common law, giving judges the ability to enforce them, saying that if state reimbursement laws could preempt FEHB contracts, it would result in uneven enforcement. Sotomayor ruled that her court did not have jurisdiction because the contracts are contracts, rather than common law, and that the risk of uneven enforcement is very low. In other words, the case doesn't strike at any core benefits issues. But it does show that Sotomayor views FEHB as a business arrangement rather than federal law.
COMMENTS
Post a Comment
By using this Service you agree not to post material that is obscene, harassing, defamatory, or otherwise objectionable. Although GovExec does not monitor comments posted to this site (and has no obligation to), it reserves the right to delete, edit, or move any material that it deems to be in violation of this rule.
ABOUT THIS BLOG
Government Executive Editor in Chief Tom Shoop, along with other editors and staff correspondents, take a fresh look at news affecting the management and operations of the federal bureaucracy.
How about the Law of Common Sense. If the award of $3 million to the FEHBP participant included payment for their medical expenses (which isn’t addressed in the article), why shouldn’t the participant reimburse the provider the $150,000 they paid for his health care? Shouldn’t we care about the rising health care costs associated with duplicate payments?
ExFed Posted Wednesday, May 27, 2009 7:37 AMIt's not fair to characterize Sotomayor's view that way. To ignore the principle of subrogation would have turned insurance law on its head.
Jim Posted Wednesday, May 27, 2009 9:20 AMIt is my understanding that in a personal injury civil suit the compensation the complainant is asking for is for things like lost wages, personally incurred (out of pocket) medical expenses and the ubiqutous pain and suffering. Insurance companies are not part of the suit EXCEPT in those cases when they are part of the suit to recover their costs due to negligence of the defendent.
So unless the insurance company was not a party in the suit then the contract, which does fall under federal law, is to be honored.
Jeffrey Bower Posted Wednesday, May 27, 2009 9:42 AMThis is a jurisdiction decision and your summary is incorrect. Read, "federal common-law rule-making is only appropriate if the operation of state law would "`significant[ly] conflict'" with "uniquely federal interest[s".
Karl Merchant Posted Wednesday, May 27, 2009 10:47 AM