High Court Struggles Over Hospital Pension Dispute
Legal Events
The Supreme Court seemed to struggle on Monday over whether some of the nation's largest hospitals should be allowed to sidestep federal laws protecting pension benefits for workers.
Justices considered the cases of three church-affiliated nonprofit hospital systems being sued for underfunding pension plans covering about 100,000 employees. But the outcome ultimately could affect the retirement benefits of roughly a million employees around the country.
The hospitals — Advocate Health Care Network, Dignity Health and Saint Peter's Healthcare System — say their pensions are "church plans" exempt from the law and have been treated as such for decades by the government agencies in charge. They want to overturn three lower court rulings against them.
Workers suing the health systems argue that Congress never meant to exempt them and say the hospitals are shirking legal safeguards that could jeopardize retirement benefits.
"I'm torn," Justices Sonia Sotomayor said at one point during the hour-long argument. "This could be read either way in my mind."
Justice Anthony Kennedy said the Internal Revenue Service issued hundreds of letters over more than 30 years approving the hospitals' actions. That shows they were "proceeding in good faith with the assurance of the IRS that what they were doing was lawful," he said.
The case could affect dozens of similar lawsuits over pension plans filed across the country.
Much of the argument focused on how to read a federal law that generally requires pension plans to be fully funded and insured. Congress amended that law in 1980 to carve out a narrow exemption for churches and other religious organizations.
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Workers’ Compensation Subrogation of Administrative Fees and Costs
When a worker covered by workers’ compensation makes a claim against a third party, the workers’ compensation insurance retains the right to subrogate against any recovery from that third party for all benefits paid to or on behalf of a claimant injured at work. When subrogating for more than basic medical and indemnity benefits, the Texas workers’ compensation subrogation statute provides that “the net amount recovered by a claimant in a third‑party action shall be used to reimburse the carrier for benefits, including medical benefits that have been paid for the compensable injury.” TX Labor Code § 417.002.
In fact, all 50 states provide for similar subrogation. However, none of them precisely outlines which payments or costs paid by a compensation carrier constitute “compensation” and can be recovered. The result is industry-wide confusion and an ongoing debate and argument with claimants’ attorneys over what can and can’t be included in a carrier’s lien for recovery purposes.
In addition to medical expenses, death benefits, funeral costs and/or indemnity benefits for lost wages and loss of earning capacity resulting from a compensable injury, workers’ compensation insurance carriers also expend considerable dollars for case management costs, medical bill audit fees, rehabilitation benefits, nurse case worker fees, and other similar fees. They also incur other expenses in conjunction with the handling and adjusting of workers’ compensation claims. Workers’ compensation carriers typically assert, of course, that, they are entitled to reimbursement for such expenditures when it recovers its workers’ compensation lien. Injured workers and their attorneys disagree.