Issue link: https://viewer.e-digitaledition.com/i/72776
PHYSICIANS ALL RIGHT, TITLE AND INTEREST IN ALL BENEFITS PAYABLE FOR THE HEALTHCARE RENDERED, WHICH ARE PROVIDED IN ANY AND ALL INSURANCE POLICIES AND HEALTH BENEFIT PLANS FROM WHICH I AM ENTITLED SERVICES OR I AM ENTITLED TO RECOVER. I UNDERSTAND THAT ANY PAYMENT RECEIVED FROM THESE POLICIES AND/OR PLANS WILL BE APPLIED TO THE AMOUNT THAT I HAVE AGREED TO PAY FOR SERVICES RENDERED DURING THIS ADMISSION, AS FURTHER DESCRIBED IN SECTION 2. The court made much of the fact that the assignment did not refer specifically to "fiduciary duties." Instead, the assignment referred to rights, title and interest to "benef its payable for the healthcare rendered." North Cypress Medical Center argued that the plain language of the assignment demonstrated that it had standing to sue under ERISA for breach of fiduciary duties because a breach of fiduciary duty is within the scope of an "administrative remedy, claim and/or lawsuit." The court rejected this argu- ment, holding that "the assignment at issue in this case is not an express and knowing assignment of fiduciary duty claims. Therefore, North Cypress does not have derivative standing to assert these claims. … In sum, because North Cypress' patients did not expressly and knowingly assign the right to assert ERISA fiduciary duty claims to North Cypress, it lacks standing to assert the claims." The court dismissed the claims with prejudice. Given today's world of shrinking reimbursements, many physicians may find themselves seeking redress at the courthouse. Don't allow an insufficient assignment of benefits form to destroy your chances of recovery. We recom- mend that you review your assignment of benefits form now and ensure that it contains everything necessary to preserve your rights to seek full reimbursement from the insurance company. Additionally, keep in mind that, as case law in this area continues to develop, further updates and reviews may be necessary. Ensuring that your assignment of benefits form is up to par is the best medicine for the non- participating provider. Debra W. Biehle is a member of the Health Law group at Strasburger & Price, LLP. To receive a sample assignment of benefits form that addresses the deficiencies some courts have highlighted, contact her in the Houston office at (713) 951-5615, or contact Cynthia Grimes in the San Antonio office of Strasburger Price Oppenheimer Blend at (210) 250-6003. s The BEST Today For Your LIFE Tomorrow Treatment and Patient Services Medical Oncology, Hematology Radiation Oncology Gynecologic Oncology Out-patient Chemotherapy Out-patient Radiation Therapy Minimally Invasive Robot-Assisted Surgery PET Imaging, CT Imaging Ultrasound Bone Densitometry Clinical Trials Genetic Testing/Counseling Retail Pharmacy In-house Laboratory Treatment and Management of Hematological Disorders Thrombosis and Anticoagulation Center LDL Lipidpheresis, Plasmapheresis CANCER CARE CENTERS of South Texas www.CancerCareSouthTexas.com Downtown-210-224-6531 Medical Center-210-595-5300 Northeast-210-656-7177 Southeast-210-337-4494 Stone Oak-210-545-6972 San Antonio Fredericksburg-830-990-0255 Floresville-210-242-6506 Hondo-210-595-5300 Westover Hills-210-245-2000 Boerne-830-249-1429 New Braunfels-830-643-1762 Seguin-830-643-1762 Uvalde-830-278-2469 Jourdanton-830-769-5259 Kerrville-830-792-3434 Marble Falls-830-693-4075