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COVENTRY HEALTH CARE OF MO., INC. v. NEVILS 

Syllabus 

reimbursement in this context, Coventry had unlawfully obtained re-
imbursement.    Coventry  countered  that  §8902(m)(1)  preempted  the 
state law.  The trial court granted summary judgment in Coventry’s 
favor, and the Missouri Court of Appeals affirmed.  The Missouri Su-
preme  Court  reversed.    Finding  §8902(m)(1)  susceptible  to  diverse
plausible  readings,  the  court  invoked  a  “presumption  against
preemption”  to  conclude  that  the  federal  statute’s  preemptive  scope
excluded  subrogation  and  reimbursement.    On  remand  from  this 
Court for further consideration in light of OPM’s 2015 rule, the Mis-
souri  Supreme  Court  adhered  to  its  earlier  decision.    A  majority  of 
the  Missouri  Supreme  Court  also  held  that  §8902(m)(1)  violates  the
Supremacy Clause. 

Held: 

1. Because  contractual  subrogation  and  reimbursement  prescrip-
tions  plainly  “relate  to  . . .  payments  with  respect  to  benefits,”
§8902(m)(1),  they  override  state  laws  barring  subrogation  and  reim-
bursement.  Pp. 6–9.

(a) This  reading  best  comports  with  §8902(m)(1)’s  text,  context, 
and purpose.  Contractual provisions for subrogation and reimburse-
ment “relate to . . . payments with respect to benefits” because subro-
gation and reimbursement rights yield just such payments.  When a 
carrier exercises its right to either reimbursement or subrogation, it 
receives  from  either  the  beneficiary  or  a  third  party  “payment”  re-
specting  the  benefits  the  carrier  had  previously  paid.    The  carrier’s 
very  provision  of  benefits  triggers  the  right  to  payment.    Congress’
use  of  the  expansive  phrase  “relate  to,”  which  “express[es]  a  broad 
pre-emptive  purpose,”  Morales  v.  Trans  World  Airlines,  Inc.,  504 
U. S.  374,  383,  weighs  against  Nevils’  effort  to  narrow  the  term
“payments”  to  exclude  payments  that  occur  “long  after”  a  carrier’s 
provision  of  benefits.    Nevils’  argument  that  Congress  intended  to
preempt only state coverage requirements, e.g., inclusion of acupunc-
ture and chiropractic services, also miscarries. 

The  statutory  context  and  purpose  reinforce  this  conclusion. 
FEHBA  concerns  “benefits  from  a  federal  health  insurance  plan  for 
federal employees that arise from a federal law.”  Bell v. Blue Cross & 
Blue  Shield  of  Okla.,  823  F. 3d  1198,  1202.    Strong  and  “distinctly 
federal interests are involved,” Empire HealthChoice Assurance, Inc. 
v. McVeigh, 547 U. S. 677, 696, in uniform administration of the pro-
gram, free from state interference, particularly in regard to coverage, 
benefits, and payments.  The Federal Government also has a signifi-
cant financial stake in subrogation and reimbursement.  Pp. 6–8.

(b)  McVeigh’s  suggestion  that  §8902(m)(1)  has  two  “plausible”
interpretations,  547  U. S.,  at  698,  Nevils  asserts,  supports  applica-
tion of the presumption against preemption here.  But the Court nev-