Court Opinion

ID: 9946907
Source: CourtListenerOpinion
Date Created: 2024-03-01 18:01:47.456481+00
Date Added: 2024-06-11T14:25:43.010528
License: Public Domain

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

                                             [DO NOT PUBLISH]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: 2 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 un-
       der 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 is-
       sue 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 re-
       lied 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 subject-

       matter-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 ac-
       tion may be brought . . . by a participant or beneficiary . . . to re-
       cover 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 fu-
       ture 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.” Ves-
       sels 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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       4                           Opinion of the Court                          22-14187

               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 lan-
       guage in a plan is unambiguous, the anti-assignment language is
       enforceable. Id. We have rejected arguments that state laws lim-
       iting 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 pub-
       lished 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). How-
       ever, we enforce as valid “unambiguous anti-assignment provi-
       sion[s] in an ERISA-governed welfare benefit plan.” Physicians Mul-
       tispecialty, 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 entitle-
       ment 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-assign-
       ment 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. Physi-
       cians 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-assign-
       ment 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 provi-
       sions 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 hold-
       ings . . . [a]nd any ‘answers’ to questions neither presented nor de-
       cided 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 prec-
       edent 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 Multi-
       specialty 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 anal-
       ysis 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 ad-
       dresses 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 unambig-
       uous anti-assignment provisions in ERISA-governed welfare bene-
       fit 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.