Document ID: ./input/supremecourt_opinions/opinions/16pdf/16-149_6jfm.pdf
Page Number: 7.0

4 

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

Opinion of the Court 

with OPM, see App. to Pet. for Cert. 129a–130a, Coventry
asserted a lien for $6,592.24 against part of the settlement 
proceeds  to  cover  medical  bills  it  had  paid.    Nevils  I,  418 
S. W. 3d,  at  453.    Nevils  repaid  that  amount,  thereby 
satisfying the lien.  Ibid. 

Nevils  then  filed  this  class  action  against  Coventry  in
Missouri state court, alleging that Coventry had unlawfully 
obtained reimbursement.  Ibid.  Nevils premised his claim 
on  Missouri  law,  which  does  not  permit  subrogation  or
reimbursement  in  this  context,  see,  e.g.,  Benton  House, 
LLC  v.  Cook  &  Younts  Ins.,  Inc.,  249  S. W. 3d  878,  881– 
882 (Mo. App. 2008).  Coventry countered that §8902(m)(1) 
makes subrogation and reimbursement clauses in FEHBA 
contracts enforceable notwithstanding state law.  The trial 
court  granted  summary  judgment  in  Coventry’s  favor, 
Nevils  v.  Group  Health  Plan,  Inc.,  No.  11SL–CC00535 
(Cir.  Ct.,  St. Louis  Cty.,  Mo.,  May  21,  2012),  App.  to  Pet. 
for  Cert.  28a,  32a,  and  the  Missouri  Court  of  Appeals
affirmed,  Nevils  v.  Group  Health  Plan,  Inc.,  2012  WL 
6689542, *5 (Dec. 26, 2012). 

The  Missouri  Supreme  Court  reversed.    Nevils  I,  418 
S. W. 3d,  at  457.    That  court  began  with  “the  assumption 
that the historic police powers of the States [are] not to be 
superseded  by  . . .  Federal  Act  unless  that  [is]  the  clear
and  manifest  purpose  of  Congress.”    Id.,  at  454  (quoting 
Cipollone v. Liggett Group, Inc., 505 U. S. 504, 516 (1992)) 
(alterations  in  original).  Finding  §8902(m)(1)  susceptible 
to  diverse  “plausible  readings,”  the  court  invoked  a  “pre-
sumption against preemption” to conclude that the federal
statute’s  preemptive  scope  excluded  subrogation  and 
reimbursement.  418 S. W. 3d, at 455. 

Judge  Wilson,  joined  by  Judge  Breckenridge,  concurred 
in  the  judgment.  Id.,  at  457.    Observing  that  “it  defies
logic  to  insist  that  benefit  repayment  terms  do  not  relate
to  the  nature  or  extent  of  Nevils’  benefits,”  id.,  at  460 
(emphasis  deleted),  Judge  Wilson  concluded  that  “Con-