11 Fla. L. Weekly Supp. 584a
Insurance — Personal injury protection — Discovery — Depositions — Expert witness fee — Physician — Plaintiff medical provider is not entitled to deposition fee, but deposition will be limited to provider’s role as fact witness, bills at issue, and services rendered — Documents — Requests for insurer to produce gain sharing plan and communications with anyone who conducted investigation for insurer into validity or reliability of database used to reduce or deny medical bills are denied — Request for documents regarding payments made to owner of database in state is granted for period of one year preceding dates of service at issue, but requests for other information on database usage and function are denied
PETER J. GODLESKI, M.D., P.A. d/b/a CENTRAL FLORIDA ORTHOPAEDIC & NEUROLOGY SPECIALISTS (Laguerre), Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 18th Judicial Circuit in and for Seminole County. Case No. 03-SC-2976. April 20, 2004. Carmine M. Bravo, Judge. Counsel: George Milev, Adams, Blackwell & Diaco, P.A., Tampa. V. Rand Saltsgaver.
ORDER
THIS CAUSE having come before the Court on Plaintiff’s Motion to Compel Production of Documents Sought in Plaintiff’s 4th Request to Produce, Plaintiff’s Motion to Enlarge Number of Interrogatories to be Served Upon the Defendant, Plaintiff’s Motion for Partial Protective Order as to the Deposition of Peter Godleski, Plaintiff’s Motion to Compel Documents Sought in Plaintiff’s 3rd Request to Produce, Plaintiff’s Motion to Set or Compel Payment of Expert Witness fee to Peter J. Godleski, MD, Plaintiff’s Motion to Compel Answers to Deposition Questions, and Defendant’s Motion to Compel Deposition of Dr. Peter J. Godleski Without Expert Witness Fee on February 3, 2004, the Court having heard arguments by counsels for Plaintiff and Defendant and otherwise being fully advised in the premises, hereby
FIND, ORDER AND ADJUDGE:
1. Defendant’s Motion to Compel Deposition of Dr. Peter J. Godleski Without Expert Witness Fee is GRANTED.
2. Plaintiff’s Motion to Set or Compel Payment of Expert Witness fee to Peter J. Godleski, MD, is DENIED without prejudice.
3. On September 17, 2003 Plaintiff propounded its 3rd Request to Produce asking for:
1. Defendant’s “gain sharing” plan or program (Plaintiff agrees to entry of a confidentiality order prior to production of the documents).
2. All communications received from anyone who conducted any investigation for the defendant into the validity and/or reliability of the Mitchell Medical database used by the defendant to reduce or deny payment to the Plaintiff for its care and treatment of the insured (plaintiff agrees to entry of a protective order prohibiting dissemination of the requested documents to anyone outside this litigation).
4. Plaintiff’s Motion to Compel Documents Sought in Plaintiff’s 3rd Request to Produce is DENIED.
5. On October 8, 2003 Plaintiff propounded its 4th Request to Produce asking for:
1. All reports, documents, materials, or anything that can be reduced to writing which show the amount of money saved by the defendant during the last three years by utilizing the Mitchell Medical database program in Florida PIP claims.
2. All reports, documents, materials, or anything that can be reduced to writing which show payments made by the defendant to Mitchell Medical for the last three years.
3. All reports, documents, materials, or anything that can be reduced to writing which enables the defendant to track its monetary savings for the last three years by utilizing the services of Mitchell Medical in Florida PIP cases.
4. The specific zip codes included in the Mitchell Medical database utilized to decide that the healthcare services provided by the plaintiff in this case would not be paid at the rate billed by the plaintiff.
5. The specific CPT codes included in the Mitchell Medical database utilized to decide that the healthcare services provided by the plaintiff would not be paid at the rate billed by the plaintiff.
6. Any and all documentation, correspondence, electronic mail memoranda, brochures, audio or video tapes, or electronic medium regarding the factual basis by which the defendant created or procured the Mitchell Medical database program utilized to make a determination as to the reasonableness of the cost of the healthcare services provided by the plaintiff in this case, including the number of and type of healthcare providers that form the basis for the statistical model used, the specific boundaries of the geographical region and the training and qualifications of medical providers included in the survey or statistical model.
7. Any and all reports, documents, notes, electronic mail, manuals, guidelines, procedural manuals, or anything that can be reduced to writing which show how any information gathered from HCFA, Champus, Medicare, Medicaid, and/or any worker’s compensation carriers was used, either directly or indirectly, in determining the reasonableness of the cost of the healthcare services provided by the plaintiff in this case.
8. The “regional inflation factors” if any, which were incorporated into the Mitchell Medical database program utilized to decide that the healthcare services provided by the plaintiff would not be paid at the rate billed by the plaintiff.
9. Any and all reports, documents, electronic mail, seminar notes, memos, governmental data, healthcare finance administration data, electronic data, or anything that can be reduced to writing which was utilized in the development and maintenance of the statistical model used to determine the appropriate or reasonable charge for healthcare services provided to personal injury protection claimants in Florida, including the process for creating the statistical model; composition, and results of any surveys used to create the statistical model; and the basis of, or guidelines for determining or creating the geographical boundaries of any region used to determine the amount of fees to be paid to any healthcare providers for services rendered to personal injury protection claimants in Florida.
6. Plaintiff’s Motion to Compel Production of Documents Sought in Plaintiff’s 4th Request to Produce is GRANTED in part.
7. Defendant shall produce to Plaintiff within 30 days the documents in existence and in Defendant’s possession regarding payments made to Mitchell Medical in the State of Florida for the year preceding the dates of service at issue.
8. The Court reserves ruling as to the rest of Plaintiff’s Motion to Compel Production of Documents Sought in Plaintiff’s 4th Request to Produce.
9. Plaintiff’s Motion to Enlarge Number of Interrogatories to be Served Upon the Defendant is GRANTED.
10. Plaintiff can propound Ten (10) additional interrogatories including sub-parts to be determined by Plaintiff.
11. Plaintiff’s Motion for Partial Protective Order as to the Deposition of Peter Godleski is GRANTED.
12. The deposition of Dr. Godleski shall be limited to Dr. Godleski’s role as a fact witness in this case, to the bills at issue and services rendered.
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