CONNECTICUT DEPARTMENT OF SOCIAL SERVICES SUBROGATION RIGHTS

General Statutes § 17b–265 (a),1 provides in relevant part that the

Department of Social Services (department) “shall be subrogated to any

right of recovery ․ that an applicant or recipient of medical assistance ․ has

against an insurer or other legally liable third party ․ that is ․ legally

responsible for payment of a claim for a health care item or service,”

authorizes the department or its designated assignee to seek

reimbursement from a Medicaid recipient for medical costs that the

recipient has recovered from a liable third party.

 

The department has the right to be subrogated to any right of recovery that

the Medicaid [recipient] may have against a third party. Relying on § 17b-

265 (b), which provides that the department may assign its right to

subrogation to a designee or health care provider participating in the

Medicaid program, the court concluded that the department properly

assigned its statutory rights to [Health Net]. § 17b–265 permitted [Health

Net/assignee] to bring an action against the plaintiffs (Medicaid recipient)

to recover its collateral source payments. Rathbun v. Health Net of the

Northeast, Inc., 304 Conn. 905, 38 A.3d 1201 (2012)

 

Under Connecticut law, [Health Net], as the assignee of the department,

was not required to bring a separate action against [a third-party]

tortfeasor to recover the medical expenses expended on behalf of the

Medicaid [recipient]. Further, the court found that [Health Net’s right to]

reimbursement was limited to the amount of Medicaid funds expended by

[Health Net] and identified as part of any settlement or judgment.”

(Footnote altered.) Rathbun v. Health Net of the Northeast, Inc., supra, 133

Conn. App. at 204-207, 35 A.3d 320.

 

If you have any questions concerning state subrogation rights, regarding a personal injury claim, please feel free to contact

Attorney Robert M. Singer

2572 Whitney Avenue

Hamden, CT  06518

203-248-8278

rsingerct@yahoo.com

 

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