11 Fla. L. Weekly Supp. 476b
Insurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered treatment — Where chiropractor referred insured to plaintiff diagnostic company for nerve conduction testing, plaintiff is located at same address as chiropractor’s office and is wholly owned by chiropractor, plaintiff owns no diagnostic testing equipment and did not conduct testing, but instead contracted with another diagnostic company to provide equipment and technician to perform test and physician to interpret test, and plaintiff and diagnostic company performing test had agreement by which plaintiff was to receive 51% of amount charged for testing, plaintiff and other diagnostic company violated statutory prohibitions against split-fee arrangements, kickbacks, and commissions — Insurer is absolved of liability for treatment not lawfully rendered, and summary judgment is entered in its favor
VERO DIAGNOSTICS, INC., (Patricia Ducap), Plaintiff, vs. ALLSTATE INSURANCE COMPANY, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 02-13821 COCE(54). March 1, 2004. Lisa G. Trachman, Judge. Counsel: Amir Fleisher, for Plaintiff. Harriett L. Uris, Tolgyesi, Katz, Hankin & Katz, P.A., for Defendant.
FINAL SUMMARY JUDGMENT IN FAVOR OF DEFENDANT ALLSTATE INSURANCE COMPANY
THIS CAUSE having come before this Court for hearing on January 21, 2004 on Defendant’s, Allstate Insurance Company, Motion for Final Summary Judgment, and the Court having reviewed the file, including all record evidence submitted, supporting documents and this Court having heard argument of counsel and being otherwise fully advised in the premises, it is hereupon,
ORDERED AND ADJUDGED that the Defendant, Allstate Insurance Company’s, Motion for Summary Judgment is hereby granted, based on the following:
1. Allstate Insurance Company’s insured, Patricia Ducap, was involved in an automobile accident on January 25, 2002.
2. Following the subject automobile accident, Patricia Ducap began receiving chiropractic treatment from Dr. Charles Weston.
3. Dr. Charles Weston referred Patricia Ducap to his company, Plaintiff Vero Diagnostics, Inc. for nerve conduction testing.
4. Plaintiff Vero Diagnostics, Inc. in turn contracted with Southeast Diagnostics, Inc. to perform the nerve conduction testing on Patricia Ducap at Dr. Charles Weston’s office.
5. Dr. Charles Weston is the sole owner, President and sole employee of Plaintiff Vero Diagnostics, Inc.
6. Plaintiff Vero Diagnostics, Inc. has the same physical address as Dr. Charles Weston, D.C.’s office.
7. Plaintiff Vero Diagnostics, Inc. owns no diagnostic testing equipment.
8. Southeast Diagnostics, Inc. provided the technician and the equipment used to perform the nerve conduction studies on Patricia Ducap. Also, Southeast Diagnostics, Inc. provided the physician that interpreted the studies.
9. Neither Dr. Charles Weston nor Plaintiff Vero Diagnostics, Inc. performed any part of the nerve conduction testing.
10. Southeast Diagnostics, Inc. and Plaintiff Vero Diagnostics, Inc. are separate and distinct corporations.
11. Southeast Diagnostics, Inc. and Vero Diagnostics, Inc. had a financial agreement by which Vero Diagnostics, Inc. was to receive 51% of the amount charged for the nerve conduction testing referred by Dr. Charles Weston and performed at Dr. Charles Weston’s office, and
12. Southeast Diagnostics, Inc. agreed to accept 49% of the amount charged to Allstate Insurance Company for the nerve conduction studies performed on Patricia Ducap.
Based on the above, this Court finds that the Plaintiff, Vero Diagnostics, Inc. and Southeast Diagnostics, Inc. violated Florida Statute §817.505.
Florida Statute §817.505 (2001) provides: It is unlawful for any person . . . to: (b) solicit or receive any commission, bonus, rebate, kickback or bribe, directly or indirectly, in cash or in kind, or engage in any split fee arrangement, in any form whatsoever, in return for referring patients or patronage to a health care provider or health care facility . . . (emphasis added).
Additionally, Plaintiffs, Vero Diagnostics, Inc. and Southeast Diagnostics, Inc. violated Florida Statute §455.657.
Florida Statute §455.657 (2001) provides: It is unlawful for any health care provider or any provider of health care services to offer, pay, solicit or receive a kickback, directly or indirectly, overtly or covertly, in cash or in kind, for referring or soliciting patients. (Emphasis added)
Florida Statute §627.736(5) provides in short that an insurer is only responsible for payment of lawfully rendered treatment. The Defendant, Allstate Insurance Company, is absolved of liability for payment of the charges submitted by Vero Diagnostics, Inc. in that the treatment was not lawfully rendered.
WHEREFORE, based upon the record evidence and the findings and conclusions set forth above, Final Summary Judgment is hereby entered in favor of the Defendant, Allstate Insurance Company, and it is hereby adjudged that the Plaintiff, Vero Diagnostics, Inc., take nothing by this action and the Defendant, Allstate Insurance Company, shall go hence without day.
The Court reserves jurisdiction for any Motions to Determine Taxation of Costs and/or Attorney’s Fees.
* * *
