Category Archive for "Recent News"

Matt Stephens and Jodi Runger were selected as presenters for the National Other Party Liability Group Conference, held from March 31 – April 3, 2019, at the Hyatt Regency in Savannah, Georgia. The National Other Party Liability Group is an organization of professionals who manage other party liability activities in BlueCross BlueShield health plans across the nation. They presented “Back to the Basics- Forming a Solid Subrogation Foundation.” Additionally, Matt Stephens presented “WC Procedures v. Subro Procedures” at the conference.

On November 11, 2018, Lance Oliver and Gordon Howard presented “Getting Back to Basics: Essential Tools that Help Squeeze More Juice Out of a File” at the 2018 National Association of Subrogation Professionals Conference in Orlando, FL. As part of NASP’s 20th anniversary celebration, this presentation will look back at the basic tools we may have forgotten that can make a big difference in your recoveries.

On April 18, 2018, Matt Stephens presented “How to Avoid the Head-On Collision—Steering Clear of Adverse Subrogation Laws for ERISA, FEHBA, and Medicare Advantage Plans” at the National Other Party Liability Group Conference in Scottsdale, Arizona.

MBI Energy Services, Inc. v. Robert Hoch, 2018 U.S. Dist. LEXIS 32179 (D. N.D. Feb. 28, 2018) – ROS attorneys obtained summary judgment in favor of an ERISA plan after the participant refused to reimburse the plan pursuant to the Plan’s SPD. The participant argued that the SPD was not the governing Plan document and that an Administrative Services Contract—which was silent as to reimbursement—was the governing document. The Court, however, determined that the SPD governed the Plan’s right of reimbursement. The Court then granted summary judgment in favor of the Plan and awarded the Plan the full amount sought in this matter.

On March 23, 2016, Ohio enacted O.R.C. § 2323.44, which included changes to Ohio’s subrogation laws. Under the new law, if an injured person is unable to recover the full value of the claim, the subrogated health insurer’s claim will be reduced in the same proportion as the injured person. In other words, if the covered member recovers 60% of the value of their claim, the insurer is only entitled to recovery 60% of its lien. This law only applies to multiple employer welfare arrangements, health insurers, and sickness and accident insurances authorized to do business in Ohio and whose policies are issued, delivered, or renewed on or after January 1, 2017.

On April 28, 2017, Matt Stephens and Jodi Runger presented “Reading Between the Telephone Lines: How to Argue Your Case to the Member’s Attorney” at the 2017 National Other Party Liability Group Conference in Glendale, AZ.

Regence Blueshield v. Susan Finn (E.D. Wash. June 15, 2017) – ROS attorneys obtained summary judgment in favor of an ERISA plan after the participant refused to reimburse the plan in accordance with the terms outlined in its SPD. The Participant argued that she had not received a copy of the SPD, rendering the Plan’s reimbursement provision void and unenforceable. The Court rejected the participant’s argument and held that the plan administrator’s attempts to provide participants access to the Plan documents fulfilled ERISA’s disclosure requirements. The Court enforced the terms of the SPD and awarded the Plan full reimbursement of the benefits paid on behalf of the participant.

On November 5, 2017, ROS attorneys, Lance Oliver and Gordon Howard presented, “How to Navigate the Perfect Subrogation Storm: A Detailed Case Study.” This presentation discussed the facts underlying and lessons learned in a recent federal court case pursued by our office. This case involved many treacherous issues facing subrogation professionals including preferred member issues; dealing with hostile plaintiff’s counsel; critical elements in determining what serves as the governing ERISA plan document; and how a stop-loss carrier can impact reimbursement.

CHP v. Willia Ledford, 204 F. Supp. 3d 983 (M.D. Tenn. August 29, 2016) – ROS attorneys successfully obtained reimbursement in this case involving a personal injury accident in New York. The participant refused to reimburse the Plan and asserted that the SPD was not legally binding and her third-party recovery was not subject to the Plan’s reimbursement provision. The Court determined that the SPD was the operative plan document and denied the participant’s motion to dismiss.

Lance Oliver presented, “Burdensome ERISA Document Requests and How to Respond” at the 2016 National Association of Subrogation Professionals Conference in Colorado Springs, CO.