a reasonable time (usually 3 years), or when the
responsible party refuses to pay and the
government is unable to enforce collection
within a reasonable time, the claim may be
. Referral to Department of Justice. Unsettled
claims may be referred to the Department of Justice for
litigation. The referral is made by OJAG and not by the
local authority directly.
MEDICAL CARE RECOVERY ACT
The Medical Care Recovery Act (MCRA) provides
that, when the government treats or pays for the
treatment of a military member, retiree, or dependent, it
may recover its expenses from any third party legally
liable for the injury or disease. The key to understanding
the complexities of the MCRA is to realize that the
federal government operates one of the largest health
care systems in the world.
THE GOVERNMENTS RIGHT
The MCRA created an independent cause of action
for the United States.
Its right of recovery is not
dependent upon a third party. The requirement that the
United States furnish care to an injured party is merely
a condition precedent to the governments independent
right of recovery.
If the tortfeasor has a procedural
attack or defense against the injured party, it will not
serve as a bar to a possible recovery by the government.
The extent of any MCRA recovery by the federal
government is determined by the law where the injury
occurred. The federal government enjoys no greater
legal rights or remedies than the injured person would
under the same circumstances.
Thus, if the injured
person would be legally entitled to compensation for
injuries from the responsible party under the law where
the injury occurred, the federal government may recover
its expenses in treating the injured person.
MCRA claims may be asserted against private
individuals, corporations, associations, and nonfederal
They also may be asserted
against a federal employee responsible for the injuries,
except that no such claim may be asserted against a
service member injured as a result of his or her own
willful or negligent acts for two reasons. First, the
wording of the MCRA, 42 U.S.C. § 2651-2653 (1982),
is explicit in providing a right of action against third
parties. The injured member does not qualify as a third
party. Second, to allow such a claim would violate the
provisions and spirit of 10 U.S.C. § 1074 (1982) that
provides the entitlement of active duty service members
to medical care free of charge. However, the United
States can subrogate against any insurance coverage that
the member may have that might cover medical care and
treatment as a result of the self-injury.
If the party responsible for the injuries is insured, an
MCRA claim maybe asserted against the insurer. Since
a large portion of injuries resulting in MCRA claims
involve automobile accidents, assertions against
insurance companies are commonplace.
MEASURE OF DAMAGES
The federal government may recover the reasonable
value of medical services it provided, either directly at
a U.S. Government hospital or indirectly through the
The value of treatment at federal government
facilities is computed on a flat rate per diem basis for
inpatient care and a per-visit charge for outpatient
treatment, rather than the itemized charges used by most
civilian hospitals. These are issued by the Office
of Management and Budget (OMB).
The federal government may recover the amount
actually paid to, or on behalf of, a military dependent
under the CHAMPUS program.
The federal government may recover amounts it
paid to civilian facilities for emergency medical
treatment provided active duty personnel.
STATUTE OF LIMITATIONS
MCRA claims must be asserted within 3 years after
the injury occurs.
MCRA procedures tire governed by JAGINST
5890.1, enclosure (6), section B. Notable aspects of
MCRA procedures include the following:
l JAG designees.
Primary responsibility for
assertion and collectiom of MCRA claims rests with JAG
designees (officers delegated MCRA responsibilities by
JAG). JAG designees include certain officers in OJAG
and COs of most NLSOs. Designees outside of OJAG
have been assigned geographic responsibility. JAG
designees may assert and receive full payment of
MCRA claims in any amount, but they may
compromise, settle, or waive claims up to $40,000.
Claims in excess of $40,000 may be compromised.