Document ID: ./input/supremecourt_opinions/opinions/16pdf/16-149_6jfm.pdf
Page Number: 1

(Slip Opinion) 

OCTOBER  TERM,  2016 

1 

Syllabus 

NOTE:  Where  it  is  feasible,  a  syllabus  (headnote)  will  be  released,  as  is
being  done  in  connection  with  this  case,  at  the  time  the  opinion  is  issued.
The  syllabus  constitutes  no  part  of  the  opinion  of  the  Court  but  has  been
prepared  by  the  Reporter  of  Decisions  for  the  convenience  of  the  reader. 
See United States v. Detroit Timber & Lumber Co., 200 U. S. 321, 337. 

SUPREME COURT OF THE UNITED STATES 

Syllabus 

COVENTRY HEALTH CARE OF MISSOURI, INC., FKA 
GROUP HEALTH PLAN, INC. v. NEVILS 

CERTIORARI TO THE SUPREME COURT OF MISSOURI 

No. 16–149.  Argued March 1, 2017—Decided April 18, 2017 

The Federal Employees Health Benefits Act of 1959 (FEHBA) authoriz-
es  the  Office  of  Personnel  Management  (OPM)  to  contract  with  pri-
vate  carriers  for  federal  employees’  health  insurance.    5  U. S. C. 
§8902(a),  (d).
  FEHBA  contains  an  express-preemption  provision,
§8902(m)(1), which states that the “terms of any contract under this
chapter which relate to the nature, provision, or extent of coverage or 
benefits (including payments with respect to benefits) shall supersede
and preempt any State or local law . . . which relates to health insur-
ance or plans.”

OPM’s contracts have long required private carriers to seek subro-
gation  and  reimbursement.    Accordingly,  OPM’s  regulations  make  a 
carrier’s “right to pursue and receive subrogation and reimbursement 
recoveries . . . a condition of and a limitation on the nature of benefits 
or benefit payments and on the provision of benefits under the plan’s 
coverage.”  5 CFR §890.106(b)(1).  In 2015, OPM published a new rule 
confirming  that  a  carrier’s  subrogation  and  reimbursement  rights
and  responsibilities  “relate  to  the  nature,  provision,  and  extent  of
coverage  or  benefits  (including  payments  with  respect  to  benefits)
within  the  meaning  of ”  §8902(m)(1),  and  “are . . .  effective  notwith-
standing any state or local law, or any regulation issued thereunder,
which relates to health insurance or plans.”  §890.106(h). 

Respondent Jodie Nevils was insured under a FEHBA plan offered 
by petitioner Coventry Health Care of Missouri.  When Nevils was in-
jured in an automobile accident, Coventry paid his medical expenses. 
Coventry subsequently asserted a lien against part of the settlement
Nevils recovered from the driver who caused his injuries.  Nevils sat-
isfied the lien, then filed a class action in Missouri state court, alleg-
ing  that,  under  Missouri  law,  which  does  not  permit  subrogation  or