U.S Code last checked for updates: Nov 22, 2024
§ 1621e.
Reimbursement from certain third parties of costs of health services
(a)
Right of recovery
Except as provided in subsection (f), the United States, an Indian tribe, or tribal organization shall have the right to recover from an insurance company, health maintenance organization, employee benefit plan, third-party tortfeasor, or any other responsible or liable third party (including a political subdivision or local governmental entity of a State) the reasonable charges billed by the Secretary, an Indian tribe, or tribal organization in providing health services through the Service, an Indian tribe, or tribal organization, or, if higher, the highest amount the third party would pay for care and services furnished by providers other than governmental entities, to any individual to the same extent that such individual, or any nongovernmental provider of such services, would be eligible to receive damages, reimbursement, or indemnification for such charges or expenses if—
(1)
such services had been provided by a nongovernmental provider; and
(2)
such individual had been required to pay such charges or expenses and did pay such charges or expenses.
(b)
Limitations on recoveries from States
Subsection (a) shall provide a right of recovery against any State, only if the injury, illness, or disability for which health services were provided is covered under—
(1)
workers’ compensation laws; or
(2)
a no-fault automobile accident insurance plan or program.
(c)
Nonapplicability of other laws
(d)
No effect on private rights of action
(e)
Enforcement
(1)
In general
The United States, an Indian tribe, or tribal organization may enforce the right of recovery provided under subsection (a) by—
(A)
intervening or joining in any civil action or proceeding brought—
(i)
by the individual for whom health services were provided by the Secretary, an Indian tribe, or tribal organization; or
(ii)
by any representative or heirs of such individual, or
(B)
instituting a separate civil action, including a civil action for injunctive relief and other relief and including, with respect to a political subdivision or local governmental entity of a State, such an action against an official thereof.
(2)
Notice
(3)
Recovery from tortfeasors
(A)
In general
(B)
Treatment
(f)
Limitation
(g)
Costs and attorney’s fees
(h)
Nonapplicability of claims filing requirements
(i)
Application to urban Indian organizations
(j)
Statute of limitations
(k)
Savings
(Pub. L. 94–437, title II, § 206, as added Pub. L. 100–713, title II, § 204, Nov. 23, 1988, 102 Stat. 4811; amended Pub. L. 102–573, title II, § 209, Oct. 29, 1992, 106 Stat. 4551; Pub. L. 111–148, title X, § 10221(a), Mar. 23, 2010, 124 Stat. 935.)
cite as: 25 USC 1621e