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Nature of Suit Code: 791
Nature of Suit: Employee Retirement Income Security Act (ERISA)
Cause of Action: 

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[DO NOT PUBLISH]

In the

United States Court of Appeals

For the Eleventh Circuit

____________________

No. 22-14187

Non-Argument Calendar

____________________

W. A. GRIFFIN, MD,

Plaintiff-Appellant,

versus

BLUE CROSS BLUE SHIELD HEALTHCARE PLAN OF 

GEORGIA, INC., 

TRUIST FINANCIAL CORPORATION, 

CRESTLINE HOTELS & RESORTS, LLC, 

THE WILLIAM CARTER COMPANY,

LABORATORY CORP. OF AMERICA HOLDINGS, et. al, 

Defendants-Appellees.

____________________

USCA11 Case: 22-14187 Document: 81-1 Date Filed: 03/01/2024 Page: 1 of 7
2 Opinion of the Court 22-14187

Appeal from the United States District Court

for the Northern District of Georgia

D.C. Docket No. 1:22-cv-00085-SEG

____________________

Before ROSENBAUM, GRANT, and BLACK, Circuit Judges.

PER CURIAM:

W. A. Griffin, M.D., proceeding pro se, appeals an order of 

the district court dismissing her claims, and granting summary 

judgment against her, on her claims of breach of fiduciary duty under the Employee Retirement Income Security Act of 1974 (ERISA) 

against various health care providers. The district court concluded 

that, under this Court’s precedent: (1) all of the patient plans at issue contained valid anti-assignment provisions; (2) ERISA permits, 

as a matter of federal common law, such provisions regardless of 

any state laws to the contrary; and (3) Griffin lacked statutory 

standing to bring her suit because she was not a beneficiary under 

her patients’ plans.1 Griffin asserts the district court improperly relied on our precedents to reject her suit as a matter of law, because 

they are at odds with two Supreme Court cases—Metropolitan Life 

Insurance Co. v. Massachusetts, 471 U.S. 724 (1985), and Kentucky 

1 “[T]he ‘standing’ at issue here is not the standing label given to the subjectmatter-jurisdictional doctrine,” but rather the statutory right to sue under 

ERISA. Physicians Multispecialty Grp. v. Health Care Plan of Horton Homes, Inc., 

371 F.3d 1291, 1293 (11th Cir. 2004).

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22-14187 Opinion of the Court 3

Association of Health Plans, Inc. v. Miller, 538 U.S. 329 (2003).2 After 

review,3 we affirm the district court. 

ERISA “sets the minimum standards for employee benefits 

plans.” Griffin v. Coca-Cola Refreshments USA, Inc., 989 F.3d 923, 931

(11th Cir. 2021) (Griffin I) (citing 29 U.S.C. §§ 1001, 1002). ERISA 

creates a federal cause of action for recovery of benefits under 

ERISA-governed plans. See 29 U.S.C. § 1132(a)(1)(B) (“A civil action may be brought . . . by a participant or beneficiary . . . to recover benefits due to him under the terms of his plan, to enforce 

his rights under the terms of the plan, or to clarify his rights to future benefits under the terms of the plan[.]”). ERISA also allows 

participants to bring actions against plan fiduciaries for breaches of 

fiduciary duty. 29 U.S.C. §§ 1104, 1132(a).

2 To the extent Griffin raised an issue relating to Rutledge v. Pharmaceutical Care 

Management Association, 141 S. Ct. 474 (2020), in the district court, she has 

waived that issue or argument on appeal by affirmatively disclaiming it in her 

initial brief. See United States v. Campbell, 26 F.4th 860, 872 (11th Cir. 2022) (en 

banc) (stating “waiver is the intentional relinquishment or abandonment of a 

known right,” and “if a party affirmatively and intentionally relinquishes an 

issue, then courts must respect that decision”).

3 We review de novo a district court’s dismissal of a complaint for failure to 

state a claim, accepting the allegations in the complaint as true and construing 

them in the light most favorable to the plaintiff. Leib v. Hillsborough Cnty. Pub. 

Transp. Comm’n, 558 F.3d 1301, 1305 (11th Cir. 2009). We also review a district 

court’s order granting summary judgment de novo, “viewing all the evidence, 

and drawing all reasonable inferences, in favor of the non-moving party.” Vessels v. Atlanta Indep. Sch. Sys., 408 F.3d 763, 767 (11th Cir. 2005). “We review 

de novo questions of law, including questions of statutory interpretation.” SEC 

v. Graham, 823 F.3d 1357, 1360 (11th Cir. 2016).

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To maintain an action under ERISA, however, a plaintiff 

must have a cause of action to sue under the statute. Griffin I, 989 

F.3d at 931. “ERISA limits the right to sue for plan participants, 

plan beneficiaries, plan fiduciaries, and the Secretary of Labor.” Id. 

at 932 (citing 28 U.S.C. § 1132(a)). “Healthcare providers . . . are 

generally not participants or beneficiaries under ERISA,” but “an 

assignee may obtain derivative standing for payment of medical 

benefits through a written assignment from a plan participant or 

beneficiary.” Id. (internal quotation marks and citations omitted). 

However, “[w]e have held that ‘an unambiguous anti-assignment 

provision in an ERISA-governed welfare benefit plan is valid and 

enforceable’ against healthcare providers.” Id. (quoting Physicians 

Multispecialty Grp. v. Health Care Plan of Horton Homes, Inc., 371 F.3d 

1291, 1296 (11th Cir. 2004)). Thus, where anti-assignment language in a plan is unambiguous, the anti-assignment language is 

enforceable. Id. We have rejected arguments that state laws limiting anti-assignment provisions alter the preceding, since ERISA 

“broadly preempt[s] state law relating to employee benefit plans.” 

Id. at 931.

The district court did not err in dismissing Griffin’s claims 

and granting summary judgment against her. We have repeatedly 

rejected identical or nearly identical arguments by Griffin in published and unpublished opinions.4 Healthcare providers generally 

4 As the district court noted, this is consistent with this Court’s handling of 

Griffin’s claims in unpublished cases as well. See, e.g., Griffin v. Gen. Mills, Inc., 

634 F. App’x 281 (holding Griffin lacked statutory standing to sue); Griffin v. 

FOCUS Brands, Inc., 635 F. App’x 796 (11th Cir. 2015) (same); Griffin v. S. Co. 

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22-14187 Opinion of the Court 5

may not sue under ERISA, but an assignee may obtain a derivative

cause of action. Griffin I, 989 F.3d at 932; 28 U.S.C. § 1132(a). However, we enforce as valid “unambiguous anti-assignment provision[s] in an ERISA-governed welfare benefit plan.” Physicians Multispecialty, 371 F.3d at 1296; Griffin I, 989 F.3d at 932. And here 

there are valid unambiguous anti-assignment provisions in each 

plan document, so the district court did not err in finding those 

provisions barred Griffin’s patients from assigning their entitlement to plan benefits to her. Physicians Multispecialty, 371 F.3d at 

1296; Griffin I, 989 F.3d at 934. 

Griffin’s arguments—which are premised on her contention 

that ERISA does not preempt state laws that prohibit anti-assignment clauses—are directly contrary to our holdings in Physicians 

Multispecialty and Griffin I, where we held that ERISA permits, as a 

matter of federal common law, anti-assignment provisions. Physicians Multispecialty, 371 F.3d at 1295-96; Griffin I, 989 F.3d at 933. 

Further, the relevant questions that were answered in Physicians 

Multispecialty and Griffin I—i.e., whether unambiguous anti-assignment provisions in ERISA-governed welfare benefit plans are valid 

and enforceable against healthcare providers and whether ERISA 

preempts state laws that purport to limit anti-assignment provisions in this respect—were not mere “assumptions,” see United 

Servs., 635 F. App’x 789 (11th Cir. 2015) (same); Griffin v. Habitat for Humanity 

Int’l, Inc., 641 F. App’x 927 (11th Cir. 2016) (same); Griffin v. SunTrust Bank, 

Inc., 648 F. App’x 962 (11th Cir. 2016) (same); Griffin v. Health Sys. Mgmt., 635 

F. App’x 768 (holding Griffin failed to state a claim); Griffin v. Verizon Commc’n, 

641 F. App’x 869 (same). 

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6 Opinion of the Court 22-14187

States v. Penn, 63 F.4th 1305, 1310 (11th Cir.) (citations omitted), 

cert. denied, 144 S. Ct. 398 (2023) (stating “assumptions are not holdings . . . [a]nd any ‘answers’ to questions neither presented nor decided are not precedent”), they were holdings, answering the same 

questions as presented here, see Physicians Multispecialty, 371 F.3d 

at 1295-96; Griffin I, 989 F.3d at 933. 

Thus, Griffin’s arguments are foreclosed by the prior panel 

precedent rule. Griffin I, 989 F.3d at 934 (stating under our prior 

panel precedent rule, a prior panel’s holding is binding unless it has 

been overruled or abrogated by the Supreme Court or by this 

Court sitting en banc); Smith v. GTE Corp., 236 F.3d 1292, 1303 (11th 

Cir. 2001) (explaining there is no exception to the prior panel precedent rule based upon an “overlooked reason” or “perceived defect 

in the prior panel’s reasoning or analysis as it relates to the law in 

existence at that time”). This is true here, where the Supreme 

Court’s 1985 decision in Metropolitan Life and its 2003 decision in 

Miller—the cases that Griffin argues overruled Physicians Multispecialty and Griffin I—predate the latter cases, which were decided 

in 2004 and 2021, respectively. Smith, 236 F.3d at 1303. 

In any event, neither Metropolitan Life nor Miller support 

Griffin’s position. Specifically, Metropolitan Life “set forth the analysis for determining whether a state law is an insurance regulation” 

that might be excepted from ERISA preemption under ERISA’s 

“saving clause.” Smith v. Jefferson Pilot Life Ins. Co., 14 F.3d 562, 569 

(11th Cir. 1994) (citing Metropolitan Life, 471 U.S. at 743). Miller addresses the same question. See Alexandra H. v. Oxford Health Ins. 

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22-14187 Opinion of the Court 7

Co., 833 F.3d 1299, 1316-17 (11th Cir. 2016) (citing Miller, 538 U.S. 

at 342). Neither case addresses the specific issues presented here, 

and, as discussed above, we have already concluded that unambiguous anti-assignment provisions in ERISA-governed welfare benefit plans are valid and enforceable against healthcare providers and 

ERISA preempts state laws that purport to limit anti-assignment 

provisions in this respect. Physicians Multispecialty, 371 F.3d at 

1295-96; Griffin I, 989 F.3d at 933. 

For these reasons, the district court did not err in rejecting

Griffin’s claims. We affirm. 

AFFIRMED.

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