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Claims on Behalf of the Government Federal Claims Collection Act - 14135_337
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Reports of Care and Treatment - 14135_339
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 compromised. .  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 GOVERNMENT’S 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 government’s 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 governmental  agencies. 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 CHAMPUS  program. 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. PROCEDURES 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. 12-30

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