FEHBA (Federal Employees Health Benefits Act) Claims

Current and former federal employees and their dependents may have medical coverage provided under the Federal Employee Health Benefits (FEHB) program. If so, you may have a lien issue arising under Federal Employees Health Benefits Act (FEHBA) of 1959 (5 U.S.C. 8901 et seq.)

FEHBA health plans administered under FEHBA can assert aggressive lien and subrogation rights. FEHBA liens are unique and can be difficult to resolve. Like Medicare, FEHBA coverage is secondary to the liability coverage of the third-party tortfeasor. FEHBA health plan contracts preempt state law and are able to define their own rules regarding subrogation and reimbursement liens. However, these plans are not immune to challenge. We analyze plan terms, evaluate jurisdictional defenses, and identify preemption limitations. Our attorneys are well-versed in the nuances of federal benefit plans and can effectively negotiate repayment demands while protecting your client's recovery. When appropriate, we push back against unsupported claims and ensure FEHBA plans adhere to governing legal standards.