WHAT’S NEW:

CASE LAW, PUBLICATIONS, SPEAKING ENGAGEMENTS, AND UPCOMING EVENTS

As an update on the Ray v Tabriz FEHBA case discussed in a prior Recent News entry, on January 27, 2025, the United States District Court for the Northern District of Illinois, Eastern Division, ruled that FEHBA expressly preempts the Illinois common fund doctrine.  This is excellent news for FEHBA Plans.  Please contact Matt Stephens at 901-202-4423 if you have any questions. See the Order here!

On October 15, 2024, Matt Stephens presented "Top Ten Best Practices for Maximizing Recoveries" at the second Annual Subrogation Healthcare Alliance (“SHA”) Conference.  This session explored the challenges health plan subrogation units face and shared proven best practices to overcome them. Drawing on over 20 years of experience working with subrogation teams nationwide, Matt Stephens provided strategies to reduce obstacles, increase recoveries, and enhance efficiency.

Below is a summary (and a link to the case) of a new decision impacting FEHBA (FEP) Plans from the Seventh Circuit Court of Appeals (Illinois, Indiana, and Wisconsin).

In Ray v. Tabriz (Decided Aug. 2, 2024), the FEP Plan member obtained a monetary settlement in a med-mal personal injury case brought in Illinois state court.  The Blue Cross and Blue Shield Association (BCBSA) (on behalf of the Office of Personnel Management) asserted a reimbursement lien against the proceeds of the member’s settlement.  The member then challenged the FEP lien by filing a motion for lien adjudication in the state court where the med-mal case was filed.  Specifically, the member’s motion sought a reduction of the FEP lien based on the Illinois common fund doctrine.

BCBSA removed the entire case to federal court, arguing, in part, that the motion for adjudication was removable on federal officer grounds.  Although the Court confirmed that under Cruz II and McVeigh, there was no federal question jurisdiction over the entire case for the FEP Plan, the Court also held that under the federal officer removal statute, removal of the motion was proper.

Among the several reasons the Court provided as to why removal of the motion to federal court was proper, the Court held that BCBSA’s express preemption defense was plausible based on Nevils—that under FEHBA’s express preemption provision, 5 U.S.C. § 8902(m)(1), contractual reimbursement provisions override state laws barring reimbursement.

Now, the federal trial court must decide whether the Illinois common fund doctrine is preempted by FEHBA.   See the full Opinion here!

On April 10, 2024, Matt Stephens presented "Top Ten Best Lines to Use During Negotiations - The Art of Negotiation" at the 2024 National Other Party Liability Group Annual Conference in Seattle, WA.

On November 13, 2023, Matt Stephens presented " Top Ten Best Lines to Use During Negotiations " at the first Annual Subrogation Healthcare Alliance (“SHA”) Conference.  The SHA is an organization of professionals dedicated to promoting excellence, collaboration, and knowledge of subrogation practices within the healthcare industry.

On April 26, 2023, Matt Stephens presented "Subrogation 201 - Wrongful Death Cases: Best Practices for the Best Result" at the National Other Party Liability Group Annual Conference. The National Other Party Liability Group is an organization of professionals who manage other party liability activities in BlueCross BlueShield health plans across the nation.

On April 27, 2022, Matt Stephens presented "Know Notice of Lien" at the National Other Party Liability Group Annual Conference. The National Other Party Liability Group is an organization of professionals who manage other party liability activities in BlueCross BlueShield health plans across the nation.

On April 28, 2021, Matt Stephens presented “The Year of the Ox and A Big Year for Subrogation” at the National Other Party Liability Group Annual Conference. The National Other Party Liability Group is an organization of professionals who manage other party liability activities in BlueCross BlueShield health plans across the nation.

On April 1, 2021, Matt Stephens presented “The Year of the Ox and A Big Year for Subrogation” for Blue Cross Blue Shield of Minnesota in a virtual training session.

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WHAT’S NEW:

CASE LAW, PUBLICATIONS, SPEAKING ENGAGEMENTS, AND UPCOMING EVENTS

As an update on the Ray v Tabriz FEHBA case discussed in a prior Recent News entry, on January 27, 2025, the United States District Court for the Northern District of Illinois, Eastern Division, ruled that FEHBA expressly preempts the Illinois common fund doctrine.  This is excellent news for FEHBA Plans.  Please contact Matt Stephens at 901-202-4423 if you have any questions. See the Order here!

On October 15, 2024, Matt Stephens presented "Top Ten Best Practices for Maximizing Recoveries" at the second Annual Subrogation Healthcare Alliance (“SHA”) Conference.  This session explored the challenges health plan subrogation units face and shared proven best practices to overcome them. Drawing on over 20 years of experience working with subrogation teams nationwide, Matt Stephens provided strategies to reduce obstacles, increase recoveries, and enhance efficiency.

Below is a summary (and a link to the case) of a new decision impacting FEHBA (FEP) Plans from the Seventh Circuit Court of Appeals (Illinois, Indiana, and Wisconsin).

In Ray v. Tabriz (Decided Aug. 2, 2024), the FEP Plan member obtained a monetary settlement in a med-mal personal injury case brought in Illinois state court.  The Blue Cross and Blue Shield Association (BCBSA) (on behalf of the Office of Personnel Management) asserted a reimbursement lien against the proceeds of the member’s settlement.  The member then challenged the FEP lien by filing a motion for lien adjudication in the state court where the med-mal case was filed.  Specifically, the member’s motion sought a reduction of the FEP lien based on the Illinois common fund doctrine.

BCBSA removed the entire case to federal court, arguing, in part, that the motion for adjudication was removable on federal officer grounds.  Although the Court confirmed that under Cruz II and McVeigh, there was no federal question jurisdiction over the entire case for the FEP Plan, the Court also held that under the federal officer removal statute, removal of the motion was proper.

Among the several reasons the Court provided as to why removal of the motion to federal court was proper, the Court held that BCBSA’s express preemption defense was plausible based on Nevils—that under FEHBA’s express preemption provision, 5 U.S.C. § 8902(m)(1), contractual reimbursement provisions override state laws barring reimbursement.

Now, the federal trial court must decide whether the Illinois common fund doctrine is preempted by FEHBA.   See the full Opinion here!

On April 10, 2024, Matt Stephens presented "Top Ten Best Lines to Use During Negotiations - The Art of Negotiation" at the 2024 National Other Party Liability Group Annual Conference in Seattle, WA.

On November 13, 2023, Matt Stephens presented " Top Ten Best Lines to Use During Negotiations " at the first Annual Subrogation Healthcare Alliance (“SHA”) Conference.  The SHA is an organization of professionals dedicated to promoting excellence, collaboration, and knowledge of subrogation practices within the healthcare industry.

On April 26, 2023, Matt Stephens presented "Subrogation 201 - Wrongful Death Cases: Best Practices for the Best Result" at the National Other Party Liability Group Annual Conference. The National Other Party Liability Group is an organization of professionals who manage other party liability activities in BlueCross BlueShield health plans across the nation.

On April 27, 2022, Matt Stephens presented "Know Notice of Lien" at the National Other Party Liability Group Annual Conference. The National Other Party Liability Group is an organization of professionals who manage other party liability activities in BlueCross BlueShield health plans across the nation.

On April 28, 2021, Matt Stephens presented “The Year of the Ox and A Big Year for Subrogation” at the National Other Party Liability Group Annual Conference. The National Other Party Liability Group is an organization of professionals who manage other party liability activities in BlueCross BlueShield health plans across the nation.

On April 1, 2021, Matt Stephens presented “The Year of the Ox and A Big Year for Subrogation” for Blue Cross Blue Shield of Minnesota in a virtual training session.

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