© 2018 Receivership Management Inc

Riverstone Capital & Nexgen Insurance Services

**  REMINDER**  Proof of Claim (POC) Deadline is JANUARY 31, 2020

All potential claimants, including Riverstone Plan Members, Employers, Providers & General Creditors should read the POC instructions and decide for themselves whether they want to file a POC.

 

UPDATE FOR MEDICAL PROVIDERS AND EMPLOYEE HEALTH PLAN PARTICIPANTS

 

Many providers are contacting our offices regarding unpaid medical claims.  All medical claims payments are to be funded by the sponsoring employer.  The employer received unpaid claims runs at the end of June 2019 and originally had until October 28, 2019 to fund these claims runs.  Under the approved plan of liquidation and as outlined on this website, employers could seek an extension of time to fund these claims runs.  The employers listed below have been granted extensions until January 31, 2020:

Admin Services Inc.

AG&Y Enterprise OWL Rexal dba OWL Western

Altscripts Specialty Pharmacy

American Chung Nam

APR Consulting

Burke Williams

Caliburger

California Technical Plating

CEMCO

City of Modesto

Cook Chayil

Davlyn Investments

Ernies Mobile Home Transport Inc.

Experior Labs

Fox Sports Grill

FPI Management

Hard Rock Casino Sioux City

JBR Marine

JC Hospitality - Hard Rock Las Vegas

Jensen Design & Survey Inc.

Kretek International

M. Frederic

Mega Fiber Inc.

MVP Leasing

Nations Reliable Lending

PayQwick Inc.

Peter C. Foy & Associates

Peterson Dean

Racing RV's

Rapid Rooster Plumbing

Regency Lighting/All Sale Electric

Semillias Sociedad

System Pavers

Talent Logistix

Teasdale Latin Foods

Triple Enterprises

US Veterans

V&L Produce

V&L Transport

Victory Foam

Vitek Mortgage Group

YMCA of Greater Long Beach

Zein Insurance

 

Employers That Have Been Confirmed to the Independent Fiduciary as Fully Funding All Health Claims (as of January 3, 2020).     (**Note** some employers have fully funded claims for one TPA (S&S or HMA) but not both.  Those employers are not listed here.  If your status has changed, check with one and/or both of your TPAs or our Office).

Access Labor

AG&Y Enterprise OWL Rexal dba OWL Western

Altura Credit Union

Amen Clinics

Arborwell

Barstow Fire Protection

Circle H Holdings

Contractors Wardrobe

DenMat Holdings

ENKI Health & Research Systems

Evergreen Home Health

Five Keys Charter School

Golden State

Graston Technique

Hatch Beauty

Lloyd Pest Control

Pine Mountain

Saint Paul Enterprises, Inc.

San Diego Transit Authority

Spicers Paper

Teamwork HR

United AG

Victory Foam

 

For those employers who have not received an extension nor have funded their unpaid claims runs, this office will be reviewing and where warranted initiating collection activities against those non-compliant employers for payment of medical benefits as provided under the health plan. 

Medical providers are advised and cautioned that under the Court’s Orders, medical providers are enjoined from collection activities on these claims that are a part of the Riverstone MEWA Plan of Liquidation. Should a medical provider attempt collection in violation of the Court’s Order, this office as well the U.S. Department of Labor may seek sanctions against medical providers for violations of a federal court order. Such remedies may include reimbursement of our costs of enforcement against the medical providers for violations of the injunction.

Riverstone Plan of Liquidation: Proof of Claim Form and Process

 

The Riverstone Approved Plan of Liquidation calls for two stages of addressing claims.  The first stage consists of sponsoring employers funding the health plan’s portion of the unpaid medical claims. This first stage is to address those medical claims of the employee/medical provider that the health plan has not paid its portion due on the health benefit. The health plan’s benefit is to be funded by the sponsoring employer.  The second stage, known as the POC Process, provides a procedure to address not only medical claims, but other claims as well against the Riverstone MEWA Plan Assets.  This second stage is largely to address the claims of:  1. Members/employees of sponsoring employers, who have funded and paid medical claim amounts that were required to be paid by the health plan; 2. Sponsoring employers who have fully paid their outstanding June 2019 unpaid medical claims runs; 3. Sponsoring employers who may have paid a portion of their June unpaid claims runs; 4. Medical providers who have claims that were not addressed by the sponsoring employer; 5. non-medical service providers/vendors who provided services to the health plan prior to February 7, 2019 and who have not been paid.

 

Below is the POC Form and the POC Definitions and Instructions

POC Form

POC Definitions and Instructions

The deadline to submit the form is January 31, 2020. The form and supporting documentation must be submitted by mail to:

Riverstone MEWA Health Plan

c/o RMI

510 Hospital Drive, Suite 490

Madison, TN 37115

 

Should you want proof of our receipt, you should mail your materials certified mail, return receipt requested.

 

If you have questions, you may email your questions to rmoore@receivermgmt.com.  Please note in the subject line  “Riverstone POC Process”

Plan of Liquidation Update and upcoming October 28, 2019 Deadline

 

Many employers are reporting significant success in paying their unpaid claims runs and this is great news for their employees!  Nearly 50% of the sponsoring employers in the Riverstone MEWA reported their progress to the Independent Fiduciary on August 15, 2019.

 

As set forth in the Revised Orderly Plan of Liquidation that was approved by the U.S. District Court on May 9, 2019, employers are to have completed their negotiations/payments of claims listed on their June 14 and June 28, 2019 unpaid claims run. Many employers are in the last stages of negotiations and questions have arisen on gaining extra time to complete these efforts.  The approved Revised Plan of Orderly Liquidation provides as follows: The Independent Fiduciary will discuss in good faith the date by which the Sponsoring Employer is to have completed the payment/funding of the claims or negotiated claims and the date upon which further reports, if applicable are due, but said deadline will not be beyond October 28, 2019, absent specific allowance from the Independent Fiduciary.

 

To gain this allowance, the Independent Fiduciary requests that employers make a written request for an extension (e-mailed to Robert E. Moore, Jr. at rmoore@receivermgmt.com  with “Riverstone” in the subject line) setting forth, in detail, the reasons for the requested extension, the requested extension date and a statement that, in good faith, the employer believes that the extension will result in the complete payment/funding of all remaining unpaid medical invoices.

 

In considering a request for an extension of the October 28, 2019 deadline, the Independent Fiduciary will consider the number and amounts of a Sponsoring Employer’s unpaid medical invoices and the efforts demonstrated by the Sponsoring Employer to address those unpaid medical invoices, as well as related matters (Approved Revised Orderly Plan of Liquidation at fn. 6).  Amongst those “related matters” are (1) that the Sponsoring Employer is actively engaged, either directly or through a third party, in contacting/negotiating with the relevant medical provider(s), (2) that those efforts have yielded/are yielding specific results, (3) that the Sponsoring Employer is committed to continuing efforts to address the remaining outstanding unpaid medical invoices, and (4) that the Sponsoring Employer reasonably anticipates that the continuation of those efforts (during any extended period) will result in payment/funding of the remaining outstanding unpaid medical invoices.  The Independent Fiduciary will also consider any unique issue that the Sponsoring Employer asserts has hindered its ability to have paid/funded all unpaid medical invoices by the October 28, 2019 deadline.

 

Many employers are reporting that providers are either not responding to efforts to negotiate or are refusing to negotiate.  Providers are not required to negotiate; however the Independent Fiduciary believes the Court will not be sympathetic to providers who seek to gain more than what the Plan Document provides.  To be clear, the employer is only responsible to fund the adjudicated payable amount as set forth under the Plan Document, regardless of whether the medical provider participated in negotiations.  Failure of a provider to negotiate is not an excuse to not fund the unpaid claims runs from June 14 and June 28, 2019.

Instructions to Employers on Progress Reports

 

As a part of the court approved Revised Plan of Liquidation, Sponsoring employers of health plans in the Riverstone MEWA are to report their progress in the negotiation/payment of the claims that were listed on the June 14, 2019 and June 28, 2019 claims runs.  Those progress reports are to be made to Mr. Rob Moore at Receivership Management Inc., the Independent Fiduciary.  The progress reports should consist of the following:

 

1. A narrative report of the sponsoring employers activities and efforts to resolve the claims on their claims runs signed by an officer of the sponsoring employer.

2. A copy of each of the claims runs received noting on the claims run whether each claim is: a)pending, b)negotiated and paid, or c)paid.

 

These progress reports may be emailed to Mr. Moore at rmoore@receivermgmt.com referencing in the Subject line: Riverstone Progress Report.  Because these claims runs contain protected health information, you may wish to send them through a secure portal to Mr. Moore.  If you do not have a secure portal, please advise Mr. Moore at the email address above and a dropbox link will be forwarded to you.

 

Should you wish to fax the reports the fax number is 615-373-4336

Should you wish to mail the reports mail to:

Mr. Robert Moore, Jr.

Receivership Management Inc.

510 Hospital Drive, Suite 490

Madison, TN 37115

 

REMEMBER YOUR FIRST REPORT IS DUE TO MR. MOORE ON AUGUST 15, 2019. 

Information Regarding the Approved Plan of Liquidation

 

Notice of Actions Regarding Liquidation of Riverstone-NexGen MEWA

Revised Orderly Plan of Liquidation

Order Granting Independent Fiduciary's Motion to Approve Revised Plan of Liquidation

The Template Letter and Release Form linked below is to be used by employers or their agents when they have reached a negotiated agreement with the medical provider to accept payment by the employer of an amount less than what is owed by the Riverstone MEWA Health Plan. THIS COMPLETED RELEASE CONTAINING THE SIGNATURE OF THE MEDICAL PROVIDER AND THE EMPLOYER SHOULD BE SUBMITTED BY THE EMPLOYER TO THE INDEPENDENT FIDUCIARY ALONG WITH THE PROOF OF CLAIM FORM WHEN THE EMPLOYER IS SEEKING REIMBURSEMENT FOR AMOUNTS IT HAS PAID ON BEHALF OF THE RIVERSTONE MEWA HEALTH PLAN. FAILURE TO SUBMIT COMPLETED RELEASE FORMS ALONG WITH A COMPLETED PROOF OF CLAIM FORM MAY RESULT IN NO CREDIT FOR THE PAYMENT OF THE

Template Letter to Provider with Terms of Payment and Release.pdf

Information and Court Filings Concerning the Proposed Orderly Plan of Liquidation

Motion
Exhibit A
Exhibit B
Exhibit C
Proposed Order Granting Motion to Approve the Plan of Liquidation

Department of Labor Notice of No Objection to Proposed Orderly Plan of Liquidation

Order of Default Against Riverstone Capital LLC, Order Deferring Approval of the IF Orderly Plan of Liquidation

Important news about Plan Termination

Redacted Consent Judgment and Order Acknowledging Plan Termination and Setting Date for Independent Fiduciary to Submit an Orderly Plan of Liquidation

Notice of Benefit Plan Termination

Notice to the Federal Court of Termination

RMoore Declaration

General Information

Riverstone Capital MEWA Notice to All Participating Plans and Sponsoring Employers 

U.S. Department of Labor Brokers and Consultants Cease and Desist Order

 

Court Information

U.S. Department of Labor Complaint

Order Granting in Part the Department of Labor’s Application for Temporary Restraining Order

Redacted Amended Temporary Restraining Order

 

On February  7, 2019, the U.S. District Court for the Central District of California, as a part of its Temporary Restraining Order under the provisions of the All Writs Act, 28 U.S.C. § 1651 enjoined and stayed all proceedings against participants, beneficiaries, the Riverstone MEWA Plan, employer plans participating in the Riverstone MEWA Plan, and plan assets.  The Court’s Order stays all federal and state court proceedings, including collections actions, against participants and beneficiaries for unpaid medical claims.

Urgent health claims with date of service February 7,2019 forward until further orders of the Court will be paid, including prescription drug costs, under the terms of the Plan. Questions regarding the current status of the plan may be directed to 615-370-0051 or emailed to rmoore@receivermgmt.com. Please reference in the subject "Riverstone"