In Re W. A. Griffin

Whether the anti-assignment provision in the health benefit plan apply to W. A. Griffin, MD (“Dr. Griffin”), a Georgia provider, who obtained a written assignment of benefit from her patient in accordance with Georgia State mandatory assignment of benefit law (Georgia § 33-24-54). Anti-assignment and anti-alienation provisions contained in employer sponsored group health benefit plans subject to the Employee Retirement Investment Security Act of 1974 (“ERISA”) are usually not applicable to an assignee who is the provider of the services which the plans are maintained to furnish. Dr. Griffin provided health services to Patient K.R., an individual covered by the Savannah River Nuclear Solutions, LLC, employer-sponsored group health benefit plan (“Savannah River Nuclear Plan”), and Patient K. R. executed a written assignment benefit to Dr. Griffin that states this assignment is a “direct legal assignment of [Patient K.R/s] rights and benefits under” the Plan. The District Court and the Eleventh Circuit have repeatedly stated that the language “rights and benefits” does not cover rights to statutory penalties and/or breaches of fiduciary duty claims and that Dr. Griffin does not have a valid assignment of benefit, because the state assignment law is pre-empted by ERISA.