Healthcare Payers: Subrogating Specialized Healthcare Claims

Healthcare payers are confronted with an increasingly demanding healthcare environment—one defined by rising healthcare expenses and reduced benefits for plan participants. In particular, specific high-expense claims make up a large portion of the factors driving these changes. Subrogation remains a crucial tool for healthcare payers to tackle these challenges. Payers can exercise their legal obligation to promote cost containment by aggressively pursuing these subrogation opportunities.

Many payers are already pursuing subrogation in other areas, such as duplicative payments and automobile accidents. While those efforts remain important, they are no longer sufficient to meet the growing pressure to contain costs. The most complex and expensive claims that drive rising expenditures often involve injuries caused by prescription drugs, medical devices or toxic exposures.

However, few healthcare payers have the expertise or resources necessary to identify and pursue these complex forms of recovery. As a result, traditional subrogation practices fail to capture all possible recoveries in these high-expense areas.

Schwarz Mongeluzzi Law has a strategic relationship with Healthcare Recovery Solutions (HRS). HRS’s state-of-the-art, proprietary technology helps identify previously unknown subrogation opportunities so healthcare payers may pursue recovery of expenses paid—due to illness or harm caused by pharmaceuticals, medical devices and toxic exposures—that would otherwise have been overlooked. The combined efforts and experience of our attorneys and strategic partners maximize subrogation recoveries and, as a result, significantly reduce plan costs for healthcare payers.