David Levin, Joan Neri and Monica Novak published an article in Bloomberg BNA’s Health Law Reporter titled, “Recovering Third-Party Payments After Montanile.” The article explores the implications of the Montanile decision and the steps a plan sponsor and plan fiduciaries can take to increase the plan’s likelihood of recovery.
The attorneys suggest plan fiduciaries and plan sponsors review their plan administrative procedures related to subrogation and reimbursement to ensure that the plan:
(1) Requires participants and beneficiaries to notify the plan when a third party may be liable for the injury or illness for which the plan has paid benefits;
(2) Has procedures in place to investigate and track recoverable claims; and
(3) Follows procedures for claiming reimbursement from participants and beneficiaries in a timely manner (i.e., before a participant or beneficiary has the opportunity to dissipate settlement funds).
If the plan’s procedures are less than adequate on this issue, the plan sponsor should consider revising the procedures.