Rathbun v. HEALTH NET OF NORTHEAST, INC., 133 Conn. App. 202

Connecticut participates in the Medicaid program; DSS administers it and awards contracts for managed care.
The department assigned to Health Net all rights to third‑party recoveries for medical costs paid for members.
The contract required Health Net to pursue third‑party recoveries and allowed assignment to subcontractors/network providers.
Rawlings pursued third‑party recoveries when members were injured; Rathbun’s settlement paid Health Net $2,982.93 for medical costs.
Kay' Anah Brayboy's death led Health Net to seek reimbursement for $13,541.45 paid for her care; Brayboy’s counsel later withdrew and then Brayboy’s new counsel was notified.
Plaintiffs filed a putative class action; the trial court granted Health Net summary judgment on a declaratory judgment count; on appeal, Health Net’s ability to recover was challenged but affirmed.

Issue	Plaintiff's Argument	Defendant's Argument	Held
Whether § 17b-265 authorizes subrogation claims against Medicaid enrollees/recipients?	Rathbun/Brayboy contend subrogation may be pursued only against third parties, not enrollees.	Health Net argues department’s subrogation rights were assigned to it and allow recovery from enrollees via settlement/judgment.	Yes; defendant may recover from plaintiffs under § 17b-265.

Westchester Fire Ins. Co. v. Allstate Ins. Co., 236 Conn. 362 (1996) (insurer may be subrogated and seek recovery after paying a claim)
Amica Mut. Ins. Co. v. Barton, 1 Conn.App. 569 (1984) (subrogation rights extend to reimbursement from insured upon settlements)
Sargeant v. Local 478 Health Benefits & Ins. Fund, 746 F.Supp. 241 (D.Conn. 1990) (insurer’s subrogation rights include recovery from insured funds obtained from third party)
State v. Peters, 287 Conn. 82 (2010) (department may pursue direct third‑party reimbursement or liens as permitted by statute)
Brown & Brown, Inc. v. Blumenthal, 297 Conn. 710 (2010) (statutory interpretation guides subrogation rights and assignment)