Paying for care

In a contest between retail giant Wal-Mart and a Wal-Mart employee who is no longer able to work because of an automobile accident, most of the sympathy goes to the employee. That's certainly the case of Debbie Shank, who worked at the Wal-Mart in Cape Girardeau and was covered by the employee health plan. The outpouring of concern and caring has been enormous since the Aug. 21 story about her situation.

The Wal-Mart employee health plan has paid nearly $470,000 for Shank's medical bills since her mini-van was struck by a tractor-trailer rig. She receives around-the-clock care at a residential care facility. Shank sued the trucking company and received a $417,000 settlement for her future care.

To meet a legal deadline, the self-insured Wal-Mart health plan has filed a lawsuit that seeks reimbursement from Shank's settlement with the trucking company. This is a provision of the health plan -- a provision that is found in many self-insured health plans around the country. It is similar to state and federal regulations that require Medicaid and Medicare participants to repay those government programs under similar circumstances.

Whether or not the health plan's lawsuit will move forward has yet to be determined. Lawyers who handle cases like this say it is not uncommon to negotiate a settlement with health plans. Whatever the outcome, it can only be hoped that the necessity of Shank's future care will be taken into consideration. Without proceeds she received in the settlement with the trucking company, her financial future is bleak.