HANOVER PARK, Ill., Feb 1, 2016 /PRNewswire/ -- Supreme Court Montanile decision on January 20, 2016 limits an ERISA plan rights to subrogation lien recovery, but this decision also ensures potentially trillions of dollars in plan assets recovery for all self-insured ERISA plans nationwide from all across plan overpayment recoupment and offsets by the plan TPA's, as the Supreme court ruled: "[t]his rule applied to equitable liens by agreement as well as other types of equitable liens".
On January 30, 2016, ERISAclaim.com announced its 2016 self-insured ERISA plan assets auditing and recovery projects under the Supreme Court Montanile decision, to demystify this SC Montanile decision's $Trillions impact in healthcare overpayment recoupments or offsets market in $Billions or $Trillions from $3.5 trillion in national health expenditure, because (1) the Supreme Court Montanile decision also limits and prohibits a self-insured plan TPA's from offsetting or converting the self-insured plan claims payment into its own fully-insured account for any alleged overpayment from the TPA's fully-insured plans, by claiming for equitable relief under ERISA §502(a)(3); (2) the entire auto or personal injury subrogation lien recovery market is relatively ignorable as compared to the healthcare $Billions or $Trillions overpayment recoupments or offsets market with $3.5 trillion in national health expenditure.
ERISAclaim.com's 2016 self-insured ERISA plan assets auditing and recovery projects are open to all large and median self-insured ERISA plans, in order (a) to brainstorm, assess and realize the immediate true economic values in the Supreme Court Montanile decision; (b) to immediately audit the plan assets for any possible conversion, embezzlement from the plan TPA's across plan overpayment recoupment or offset; (c) to immediately recover or restore the plan assets under the Supreme Court Montanile decision as required under ERISA statutory duties.
Supreme Court case info: Robert v. Board of Trustees of the National Elevator Industry Health Benefit Plan, case #: 14-723, January 20, 2016
Supreme Court link for a PDF copy: http://www.supremecourt.gov/opinions/15pdf/14-723_1bn2.
"It's a well-known fact from the federal court documents and in healthcare industry news that $Billions of ERISA plan claims payments from self-insured plans could have been recouped or offset by self-insured plan TPA's for the TPA's fully-insured accounts. This Supreme Court Montanile decision may have limited a plan's right in a small PI subrogation lien market but fundamentally and significantly protected all self-insured plans for $Billions or $Trillions from self-dealing in across plan offset by self-insured plan co-fiduciary TPA's, aka, embezzlement ATM operations," says Dr. Jin Zhou, president of ERISAclaim.com, a national expert on ERISA appeals and compliance, and an ERISA "Special Collection Agent", as recently ordered by a Federal Bankruptcy Court for a bankrupt hospital system in Texas.
According to the Court Documents, the Supreme Court ruled:
- "Plan fiduciaries are limited by §502(a)(3) to filing suits "to obtain ... equitable relief."
- "[A]s here, an equitable lien by agreement, only against specifically identified funds that remained in the defendant's possession or against traceable items that the defendant purchased with the funds."
- "If a defendant dissipated the entire fund on items, the lien was eliminated and the plaintiff could not attach the defendant's general assets instead."
- "The Board's arguments in favor of the enforcement of an equitable lien against general assets are unsuccessful. does not contain an exception to the general asset-tracing requirement for equitable liens by agreement."
- "In sum, at equity, a plaintiff ordinarily could not enforce any type of equitable lien if the defendant once possessed a separate, identifiable fund to which the lien attached, but then dissipated it all. The plaintiff could not attach the defendant's general assets instead because those assets were not part of the specific thing to which the lien attached."
- "This rule applied to equitable liens by agreement as well as other types of equitable liens."
"It's a no-brainer now that, after the Supreme Court Montanile decision, an alleged overpayment lien from a fully-insured plan cannot attach to a different self-insured plan fund or claims payment, and it's an ERISA common sense that a TPA for a self-insured plan is absolutely barred from converting claims payment of plan assets from the self-insured plan to pay for an alleged overpayment lien and retain all recovery for its own fully-insured account, as a self-dealing and embezzlement," says Dr. Zhou.
"Now, it's a simple question, after the Supreme Court Montanile decision, if a self-insured plan fiduciary shall take immediate corrective actions now as a first, or wait until last, with a DOL audit alert. Ironically, this is also true in this case for the Respondent: Montanile decision also protects the Board of Trustees of the National Elevator Industry Health Benefit Plan from any across plan or patient offset embezzlement if applicable," added Dr. Zhou.
To find out more about 2016 self-insured ERISA plan assets auditing and recovery projects from ERISAclaim.com: http://erisaclaim.com/Embezzlement_Recovery.
Located in a Chicago suburb in Illinois, for over 15 years, ERISAclaim.com is the only ERISA & PPACA consulting, publishing and website resource for healthcare providers in the country. ERISAclaim.com offers free webinars, basic and advanced educational seminars and on-site claims specialist certification programs for ERISA plans, fiduciary TPA's, doctors, hospitals and commercial companies, as well as numerous pending national ERISA class action litigation support. Dr. Jin Zhou is regarded as the industry "Godfather of ERISA claims" for healthcare providers.
For any questions, please contact Dr. Jin Zhou, president of ERISAclaim.com, at 630-808-7237.