IN THE UNITED STATES COURT OF APPEALS

FOR THE FIFTH CIRCUIT

No. 15-20614

Summary Calendar

ROMANO WOODS DIALYSIS CENTER,

Plaintiff-Appellant,

v.

ADMIRAL LINEN SERVICE, INCORPORATED; GROUP & PENSION 

ADMINISTRATORS, INCORPORATED; THE PHIA GROUP, L.L.C.,

Defendants-Appellees.

Appeal from the United States District Court

for the Southern District of Texas

USDC 4:14-CV-1125

Before STEWART, Chief Judge, and OWEN and COSTA, Circuit Judges.

PER CURIAM:*

In this Employment Retirement Income Security Act (“ERISA”) case, the 

district court granted summary judgment in favor of Defendants-Appellees. 

The district court then denied Plaintiff-Appellant’s motion for reconsideration 

and granted Defendants-Appellees’ motion for attorney’s fees and costs. 

Plaintiff-Appellant appeals herein. We affirm.

 

* Pursuant to 5TH CIR. R. 47.5, the court has determined that this opinion should not 

be published and is not precedent except under the limited circumstances set forth in 5TH 

CIR. R. 47.5.4.

United States Court of Appeals

Fifth Circuit

FILED

June 30, 2016

Lyle W. Cayce

Clerk

 Case: 15-20614 Document: 00513574120 Page: 1 Date Filed: 06/30/2016
No. 15-20614

2

I.

Plaintiff-Appellant Romano Woods Dialysis Center (“Romano”) is a 

medical provider of dialysis treatments. Starting in 2012, Romano began 

providing dialysis treatments to Leanna Guggenmos (“Leanna”), an employee 

of Defendant-Appellee Admiral Linen Service, Inc. (“Admiral”). Leanna is 

covered by Admiral’s Welfare Benefit Plan (the “Plan”). Admiral is the Plan 

Administrator and Defendant-Appellee Group & Pension Administrators, Inc. 

(“GPA”) is the Claims Administrator. GPA contracted in late 2012 with 

Specialty Care Management LLC (“Specialty”) to assist with processing 

reimbursement claims for dialysis treatments, including Leanna’s treatments. 

After providing multiple dialysis treatments to Leanna, Romano filed 

suit in 2014 against Defendants-Appellees asserting ERISA claims for 

benefits, breach of fiduciary duty, and interference with ERISA rights. See 29 

U.S.C. § 1132(a)(1)(B). Romano claimed, inter alia, that Leanna was entitled 

to reimbursement for all unpaid medical expenses – as billed by Romano –

incurred as part of her dialysis treatments, an amount totaling approximately 

$1,363,344.00. Defendants-Appellees countered that, under the terms of the 

Plan as confirmed by their communications with Romano prior to beginning 

Leanna’s dialysis treatments, reimbursement was based on the Medicare rules 

and reimbursement rates. As such, with one limited exception,1 125% of the 

applicable Medicare rate had been paid to Romano under the terms of the Plan. 

II.

Upon considering both parties’ cross-motions for summary judgment, the 

district court rendered summary judgment in favor of Defendants-Appellees 

and dismissed Romano’s claims with prejudice. Additionally, the district court 

 

1 The record indicates that, pursuant to a separate and limited Single Case 

Agreement, the parties agreed that Defendants-Appellees would reimburse Romano at a rate 

of 65% of the billed charges for claims incurred between June 25, 2012, and October 31, 2012. 

 Case: 15-20614 Document: 00513574120 Page: 2 Date Filed: 06/30/2016
No. 15-20614

3

granted Defendants-Appellees’ subsequent motion for attorney’s fees and costs 

in the amount of $209,350.13, pursuant to 29 U.S.C. § 1132(g)(1). 

In separate memorandums providing its reasons for judgment, the 

district court noted that the plain language of the Plan provides that dialysis 

charges may be subject to Medicare rules and reimbursement rates – an 

amount which Admiral exceeded in reimbursing Romano. Accordingly, 

Admiral’s reimbursement to Romano in the amount of 125% of the applicable 

Medicare rate was not arbitrary, capricious or an abuse of discretion. 

Additionally, the district court concluded that a conflict of interest 

existed as a result of Admiral being both the Plan Sponsor and Plan 

Administrator; however, the conflict was of minimal importance in 

determining whether Admiral’s interpretation of the Plan was arbitrary and 

capricious. It reasoned that Admiral’s decision to hire Specialty as its Claims 

Administrator – a third party with no pecuniary interest – indicated that 

Admiral took active steps to reduce its own potential conflict and to promote 

an accurate administration of Leanna’s claims. Specialty reviewed the 

applicable paperwork and recommended payment to Romano in the amount of 

125% of the applicable Medicare rate and Admiral paid Romano accordingly. 

As a result, the conflict of interest created by Admiral serving as both the Plan 

Sponsor and the Plan Administrator was minimal.

Finally, upon analyzing Defendants-Appellees’ “Motion for Attorneys’ 

Fees and Costs” under Bowen2 and Johnson,3 the district court awarded 

reasonable and necessary attorney’s fees in the amount of $209,350.13, to be 

recovered from Romano. In its reasons for judgment with respect to the award 

of attorney’s fees, the district court placed particular emphasis on Romano’s 

 

2 Iron Workers Local No. 272 v. Bowen, 624 F.2d 1255, 1266 (5th Cir. 1980).

3 Johnson v. GA Highway Express, Inc., 488 F.2d 714, 717-19 (5th Cir. 1974).

 Case: 15-20614 Document: 00513574120 Page: 3 Date Filed: 06/30/2016
No. 15-20614

4

“bad faith” in filing suit against Defendants-Appellees, in light of the plain 

language of the Plan clearly stating that dialysis charges may be subject to 

Medicare rules and reimbursement rates.4

Romano appeals the district court’s award of summary judgment in favor 

of Defendants-Appellees and its award of attorney’s fees and costs. 

On appeal, Romano argues that Defendants-Appellees’ interpretation of 

the Plan – which they used to reimburse Romano based on Medicare rates –

was legally wrong, that their interpretation of the Plan was tainted by a 

conflict of interest, and that the district court abused its discretion in awarding 

attorney’s fees against Romano.

Should this court affirm the district court’s summary judgment, 

Defendants-Appellees request that they be awarded additional attorney’s fees 

and costs incurred after June 30, 2015, in defending this appeal. 

III.

“We review the district court’s judgment on cross motions for summary 

judgment de novo, addressing each party’s motion independently, viewing the 

evidence and inferences in the light most favorable to the nonmoving party.”

See Morgan v. Plano Ind. Sch. Dist., 589 F.3d 740, 745 (5th Cir. 2009) (citation 

omitted). We “affirm only if there is no genuine issue of material fact and the 

party is entitled to prevail as a matter of law.” Id. (citation omitted). Where 

“the language of an ERISA benefits plan grants the plan administrator 

discretionary authority to interpret the plan and determine eligibility for 

benefits, the plan administrator’s denial of benefits is reviewed for an abuse of 

discretion.” Hagen v. Aetna Ins. Co., 808 F.3d 1022, 1026 (2015) (citation 

omitted). We also review a district court’s award of attorney’s fees for abuse of 

 

4 Defendants-Appellees also contend that Romano was advised prior to beginning

Leanna’s treatments that its dialysis charges may be subject to Medicare rules and 

reimbursement rates. 

 Case: 15-20614 Document: 00513574120 Page: 4 Date Filed: 06/30/2016
No. 15-20614

5

discretion. See Salley v. E.I. DuPont de Nemours & Co., 966 F.2d 1011, 1016 

(5th Cir. 1992) (citation omitted).

IV.

After considering the parties’ arguments as briefed on appeal, and after 

reviewing the record, the applicable law, and the district court’s judgment,

memorandums and orders, we affirm the district court’s summary judgment in 

favor of Defendants-Appellees and adopt its analysis in full. 

Courts have held that the ERISA fee-shifting provision entitles parties 

to attorney’s fees incurred on appeal. See Prod. & Maint. Emps. Local 504 v. 

Roadmaster Corp., 954 F.2d 1397, 1407 (7th Cir. 1992); see also Nachwalter v. 

Christie, 805 F.2d 956, 961 (11th Cir. 1986) (collecting cases). This court’s 

precedent has similarly allowed for awards of attorney’s fees for both trial and 

appellate work. See Norris v. Hartmarx Specialty Stores, Inc., 913 F.2d 253, 

257 (5th Cir. 1990). Accordingly, we award Defendants-Appellees attorney’s

fees for this appeal and we remand to allow the district court to determine the 

amount of attorney’s fees to be granted to Defendants-Appellees for their

appellate work.

The judgment is AFFIRMED. This matter is REMANDED for the 

limited purpose of calculating an award of attorney’s fees incurred on appeal.

 Case: 15-20614 Document: 00513574120 Page: 5 Date Filed: 06/30/2016