MedCenters Health Care v. Ochs, 26 F.3d 865 (8th Cir. 1994). · Go Syfert
MedCenters Health Care v. Ochs, 26 F.3d 865 (8th Cir. 1994). Cases Citing This Book View Copy Cite
24 citation events (17 in the last 25 years) across 12 distinct courts.
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At page 867 Determining contract clarity for reimbursement obligations5 citing casesaffirming holding "that the contract’s language was sufficiently clear to require reimbursement1 citing court put it this way
  • Teresa Bell v. Blue Cross & Blue Shield of OK, 823 F.3d 1198 (8th Cir. 2016).published
    In MedCenters Health Care v. Ochs, 26 F.3d 865, 867 (8th Cir. 1994), the court affirmed a district court’s ruling that a subrogation and reimbursement clause in a contract under the Act preempted and superseded Minnesota common law that es…
  • Helfrich v. Blue Cross & Blue Shield Ass'n, 36 F. Supp. 3d 1056 (D. Kan. 2014).published 2 cites
    See Blue Cross and Blue Shield of Illinois v. Cruz, 396 F.3d 793, 799 (7th Cir.2005), vacated and remanded on jurisdictional grounds, 548 U.S. 901 , 126 S.Ct. 2964 , 165 L.Ed.2d 947 (2006); MedCenters Health Care v. Ochs, 26 F.3d 865, 867…
  • Aybar v. New Jersey Transit Bus Operations, Inc., 701 A.2d 932 (N.J. Super. Ct. App. Div. 1997).published 2 cites
    MedCenters Health Care, Inc., supra, 26 F. 3d at 867.
  • Waller v. Hormel Foods Corp., 950 F. Supp. 941 (D. Minn. 1996).published
    In MedCenters Health Care, Inc. v. Ochs, 26 F.3d 865, 867 (8th Cir.1994), the Eighth Circuit affirmed a “well-reasoned” district court opinion refusing to adopt Minnesota’s make-whole rule as federal common law in actions under the Federal…
  • Empire Healthchoice Assurance, Inc. v. McVeigh, 396 F.3d 136 (2d Cir. 2005).published 3 cites
    See MedCenters Health Care v. Ochs, 26 F.3d 865, 866-67 (8th Cir.1994) (citing Westendorf v. Stasson, 330 N.W.2d 699, 703 (Minn.1983)). .
At page 866 cited at this page1 citing case
  • Empire Healthchoice Assurance, Inc. v. McVeigh, 396 F.3d 136 (2d Cir. 2005).published 3 cites
    See MedCenters Health Care v. Ochs, 26 F.3d 865, 866-67 (8th Cir.1994) (citing Westendorf v. Stasson, 330 N.W.2d 699, 703 (Minn.1983)). .
Other citing cases2 with no pin cite or quoted language on record
MEDCENTERS HEALTH CARE, doing business as MedCenters Health Plan, Inc.
v.
Lezlie OCHS and Gary Ochs, parents and legal guardians of Michael A. Ochs, a minor
No. 93-2804.
Court of Appeals for the Eighth Circuit.
Jun 17, 1994.
Published opinion
26 F.3d 865
1994 WL 263779
Thomas 0. Albers, Minneapolis, MN, argued, for appellant., Richard L. Jasperson, Saint Paul, MN, argued, for appellee.
Arnold, Fagg, Lively.
Cited by 6 opinions  |  Published
RICHARD S. ARNOLD, Chief Judge.

This case involves the subrogation provisions of a health-plan contract entered into under the Federal Employees Health Benefit Act (FEHBA), 5 U.S.C. § 8901 et seq. Lez-lie Ochs and her son, Michael, had health coverage with MedCenters under a Federal Employees Health Benefit Plan (FEHBP) contract. In 1987, Michael was badly scalded, and MedCenters provided medical care. The Ochses then brought a tort action in a state court, and MedCenters intervened, claiming a right of subrogation for $114,-301.91. The state court approved a settlement agreement between the Ochses and all parties except MedCenters, but specifically found that the Ochses were not being fully reimbursed for their damages. The agreement also provided that the Ochses would be held harmless from any subrogation claims.

The Ochses refused to repay MedCenters out of the settlement proceeds, and MedCen-ters filed this action, alleging breach of contract, equitable subrogation, and unjust enrichment. MedCenters claimed that the health-plan-contract language entitled it to payment of its costs up to the amount of the Ochses’ recovery. The contract states in part:

Third Party Actions
If a covered person is injured through the act or omission of another, the Plan requires that it be reimbursed for the benefits provided, in an amount not to exceed the amount of the recovery, or that it be subrogated to the person’s rights to the extent of the benefits received under this Plan, including the right to bring suit in the person’s name.

The District Court[1] granted summary judgment to MedCenters.

The District Court first considered Minnesota’s full-recovery rule, which states that “subrogation will not be allowed where the insured’s total recovery is less than the insured’s actual loss,” except when there are “express contract terms to the contrary.” Westendorf v. Stasson, 330 N.W.2d 699, 703 (Minn.1983). The Court concluded that the contract provisions conflicted with the Minnesota rule, since the contract language[*867] entitled MedCenters to reimbursement regardless of whether the Ochses fully recovered their losses. Next, the Court determined that, under the choice-of-law provision of FEHBA,[2] federal law controls this case. Finally, the Court rejected the Ochses’ suggestion that it adopt the Minnesota full-recovery rule as federal common law. Instead, it applied the text of the contract, which clearly required reimbursement. The Court determined that this approach would best serve the federal interests of uniformity and low premiums.

On appeal, the Ochses make three contentions. First, they say that MedCenters has failed to prove federal jurisdiction. Second, they claim that, even if the District Court properly exercised its jurisdiction, the state-law rule of decision should be applied. Finally, the Ochses argue that ambiguities require the contract to be interpreted in their favor. We review the District Court’s grant of summary judgment de novo. Having considered the arguments of the parties in full, we conclude that the District Court properly exercised its authority to decide this case and correctly determined that FEHBA pre-empted the state-law rule in this instance. Moreover, the Court was correct in holding that the contract’s language was sufficiently clear to require reimbursement of MedCenters. Accordingly, we affirm, substantially for the reasons set out in the District Court’s well-reasoned opinion.

Affirmed.

1

The Honorable Donald D. Alsop, Senior United States District Judge for the District of Minnesota.

2

The provisions of any contract under this chapter which relate to the nature or extent of coverage or benefits (including payments with respect to benefits) shall supersede and preempt any State or local law, or any regulation issued thereunder, which relates to health insurance or plans to the extent that such law or regulation is inconsistent with such contractual provision.

5 U.S.C. § 8902(m)(l).