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