11 Fla. L. Weekly Supp. 49c
Insurance — Personal injury protection — Claim for magnetic resonance imaging services by plaintiff which performed technical component of MRI and paid radiologist to perform interpretive component of MRI — Fee-splitting — Patient brokering — Relationship between plaintiff and radiologist is not unlawful brokering or fee-splitting
ACK-TEN GROUP LL d/b/a SEACREST OPEN MRI (Hazel Thompson), Plaintiff, v. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 15th Judicial Circuit in and for Palm Beach County. Case No. 2003CC005563RL. October 24, 2003. Nancy Perez, Judge. Counsel: Gary Marks, Marks & Fleischer P.A., Ft. Lauderdale. Joseph G. Murasko, N. Palm Beach.
ORDER
THIS MATTER having come before the Court on the Plaintiff and Defendant’s Motion for Summary Judgment with both sides represented by counsel.
In Defendant’s Motion for Summary Judgment, Defendant argued Plaintiff is not entitled to receive no fault benefits because Plaintiff is not a medical provider under the Statute and is engaged in illegal fee splitting and brokering activities in violation of F.S. §§458.331, 627.736 and 817.505.
In Plaintiff’s Motion for Summary Judgment, Plaintiff argued that Defendant denied benefits because the global billing of the technical and interpretive aspects of the magnetic resonance imaging (MRI) service was improper.
The stipulated facts submitted by both parties are as follows: Hazel Thompson received medicare care for bodily injuries relating to the operation of a motor vehicle. Ms. Thompson was insured by Defendant. She received medical care including an MRI. The procedure was performed by Plaintiffs with Dr. Kleinman, a board certified radiologist associated with Boca Radiology conducting the interpretations of the scan. Boca Radiology is an independent contractor which reviews MRI scans for Plaintiff.
Plaintiff owns or leases 100% of the equipment. Plaintiff pays Boca Radiology for the services at the same rate regardless of the method of payment by the patient. Contractually Boca Radiology and Plaintiff agreed to provide the billing for the interpretive aspect of the scans. Plaintiff as in this case bills the appropriate entity.
Here, Plaintiff submitted the bill to Defendant who denied the bill on the basis that the code used was global and thus improperly billed.
Defendant’s answer denied the debt claiming eleven affirmative defenses. These defenses have been withdrawn except for these issues. Defendant cited to Medical Management Group of Orlando v. State Farm, 811 So.2d 705 (Fla. 5th Dist. 2002) and Federated National Insurance Co. v. Physicians Charter Services, 788 So.2d 403 (Fla. 3rd Dist. 2001) to support their contention that the relationship between Plaintiff and Boca Radiology is fee-splitting and therefore illegal under F.S. §817.505, 458.431 and 627.732.
Plaintiff’s contention is that the change in the law in 2003 is indicative of the legislative intent that global billing is not illegal citing Burgos v. State, 765 So.2d 967 (Fla. 4th Dist. 2000); Lowry v. Parole & Probation Commission, 473 So.2d 1248 (Fla. 1985) [whereby the court found the subsequent amendment of a statute may be used to ascertain the legislative intent behind an earlier version of statute.]
Upon review of the file, case law and arguments, this Court finds the relationship Plaintiff has with Boca Radiology is not brokering or fee splitting under F.S. §§627.732, 817.505 or 458.331. Boca Radiology’s services are a necessary component of the MRI scan. Plaintiff, as 100% owner or lessee of the equipment contracted with Boca Radiology for that portion of the task which was paid and thereafter billed. The Statutes authorize for these services and are therefore payable. See also, Millennium Diagnostic & Imaging Center, Inc., v. Nationwide Mutual Fire Ins. Co., Case No. 02-2083 SP 24, 11th Judicial Circuit, Judge Jeffrey Swartz, July 2, 2003). Therefore, based on the foregoing, it is
ORDERED AND ADJUDGED that Plaintiff’s Motion for Summary Judgment is granted and Defendant’s Motion for Summary Judgment is denied. The Court reserves for entry of money judgment and any other pending issues.
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