13 Fla. L. Weekly Supp. 257a
Torts — Conversion — Insurance — Personal injury protection — Coverage — Medical provider — Unregistered clinic — If clinic fails to register, it may not collect PIP benefits for services rendered, and insurer who mistakenly pays for such services may assert claim for reimbursement — Provider’s argument that insurer is impermissibly attempting to assert a private cause of action under applicable registration statute is not supported by case law or statutory authority — Accepting allegations in complaint as true, plaintiff has alleged cause of action for compensatory damages and conversion — Motion to dismiss denied
STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Plaintiff, vs. DIAGNOSTIC OUTPATIENT CENTERS, INC., Defendant. Circuit Court, 6th Judicial Circuit in and for Pinellas County. Case No. 05-005659-CI-15. January 4, 2006. Brandt C. Downey, III, Judge. Counsel: J. Michael Huey and Vikki R. Shirley, Tallahassee, for Plaintiff. David B. Kampf, Ramey, Ramey & Kampf, P.A., Tampa, for Defendant.
ORDER DENYING DEFENDANT’S MOTION TO DISMISS
THIS CAUSE came before the Court on the Defendant’s Motion to Dismiss at a hearing on November 22, 2005 at which time the Court requested a copy of the hearing transcript and took the matter under advisement. The Court has reviewed the Court file, the hearing transcript, the submitted case law and listened to the arguments of counsel. The Court being fully advised in the premises, finds as follows:
Plaintiff, State Farm Mutual Automobile Insurance Company (“State Farm”) filed a two count complaint against Diagnostic Outpatient Centers, Inc. (“DOCS”) for compensatory damages and conversion seeking recovery of approximately $47,516.55. State Farm alleges that it paid the money to DOCS in reimbursement for medical care rendered by DOCS to various State Farm insureds. Such charges were paid by State Farm on behalf of its insureds pursuant to mandatory personal injury protection coverage provided in State Farm automobile insurance policies. Although State Farm does not dispute that the services in question were rendered by DOCS, it alleges that DOCS was not entitled to payment since it had failed to properly register, as it was then required pursuant to § 456.0375, Florida Statutes (repealed in 2003). The charges and payments in question related to services rendered from October 1, 2001 through May 7, 2002. DOCS seeks dismissal with prejudice contending that State Farm may not assert a private cause of action under section 456.0375, Florida Statutes.
In reviewing a motion to dismiss for failure to state a cause of action, a trial court is restricted to a consideration of the well-pled allegations of the complaint. It must accept those allegations as true and then determine if the complaint states a valid claim for relief. A trial court has no authority to look beyond the complaint by considering the sufficiency of the evidence which either party is likely to produce, or any affirmative defense raised by the defendant. Holland v. Anheuser Busch, Inc., 643 So.2d 621, 623 (Fla. 2d DCA 1994); Brocato v. Health Option, Inc., 811 So.2d 827 (Fla. 2nd DCA 2002).
Motorists in Florida are protected by the Florida Motor Vehicle No-Fault laws. §§ 627.730-627.7405, Florida Statutes. The No-Fault Law was intended to provide a minimum level of insurance benefits, including personal injury protection (“PIP”) medical benefits, to individuals injured in automobile accidents, without regard to fault. Warren v. State Farm Mut. Auto. Ins. Co., 899 So.2d 1090, 1095 (Fla. 2005). “As a result, each motor vehicle owner or registrant required to be licensed in Florida is required to carry a minimum amount of personal injury protection, or PIP insurance, for the benefit of the owner and other designees. Section 627.736, Florida Statutes, sets forth required PIP benefits, which are triggered if a loss is reasonable, necessary, and related to a motor vehicle accident.” Id.
Partly in order to ensure that such medical services were provided by qualified licensed providers, in 2001 Florida enacted section 456.0375, Florida Statutes. (Effective March 1, 2004, the legislature repealed § 456.0375, Florida Statutes. However, a new statutory registration was enacted to replace § 456.0375.). During the time period at issue herein, section 456.0375, Florida Statutes required that “[e]very clinic, as defined in [the statute], must register, and must at all times maintain a valid registration, with the Department of Health.” § 456.0375(2)(a), Florida Statutes. The statute provided for numerous civil and criminal penalties for a clinic that failed to comply. § 456.0375(4)(a)-(e), Florida Statutes. Pursuant to section 4(a), a non-compliant clinic may not recover payment for services rendered. In fact, the statute specifically provides that any such charges are unlawful and “therefore noncompensable and unenforceable.” § 456.0375(4)(a), Florida Statutes.
As noted above, State Farm alleges that it is entitled to damages and reimbursement of payments mistakenly made to DOCS when it was in non-compliance with the registration statute. DOCS counters that State Farm does not have standing to assert a private cause of action under § 456.0375, Florida Statutes. DOCS argument is novel and appears to be one of first impression.
Recently, the Third District Court of Appeal addressed the issue of whether a clinic could recover fees for services rendered during the period of time during which it failed to register in accordance with the statute. Active Spine Centers, LLC v. State Farm Fire and Cas. Co., 911 So.2d 241 (Fla. 3rd DCA 2005). In upholding the decision of the trial court which had granted summary judgment in favor of the insurer, the Court summarized the lower court’s findings:
State Farm argued that any treatment allegedly rendered by the clinic during the relevant time period “was illegal because of [the clinic’s] failure to satisfy the Licensing Statute” and that “the clear language of the Registration statute and the legislative intent behind the Statute provide no support for [the clinic’s] position.” After a hearing on the parties’ motions, the trial court entered summary judgment in State Farm’s favor, reasoning that the clinic violated the registration statute, and that as a result of the violation, the services the clinic provided during the period of the violation were not lawfully rendered. Because the services were not lawfully rendered, State Farm was not obligated to pay the clinic for the services under State Farm policies or Florida’s PIP statute (section 627.736(5)(a), Fla. Stat. (2005), requires State Farm to pay only for “lawfully” rendered treatment).
Id. at 243. Moreover, the District Court noted that preventing an unregistered clinic from recovering such fees fulfilled the legislative intent behind the statute. Id.
In the present matter, DOCS takes a slightly different approach, arguing that State Farm is impermissibly attempting to assert a private cause of action under section 456.0375, Florida Statutes. While this argument is ingenious, it is not supported by the case law or statutory authority.
The plain language of the statute specifically deals with effect of the clinic’s failure to register on its ability to recover fees for services rendered. This provision would be rendered superfluous if it could not be enforced by the party responsible for payment of those charges. It is a common tenent of statutory construction that an interpretation that renders a provision useless should not be applied. State v. Goode, 830 So.2d 817, 824 (Fla.2002); Hechtman v. Nations Title Ins. of New York, 840 So.2d 993, 996 (Fla.2003) (“It is an elementary principle of statutory construction that significance and effect must be given to every word, phrase, sentence, and part of the statute if possible and words in a statute should not be construed as mere surplusage.”). As noted by the Third District, the statutory language is clear, if a clinic fails to register, it may not collect payment for services rendered. The Court notes that if an insurer is entitled to withhold payment from a non registered clinic, then it is axiomatic that an insurer who mistakenly pays for such services may assert a claim for the reimbursement of such funds.
Finally, a plain reading of the Complaint reveals that Plaintiff is asserting a cause of action for conversion. Plaintiff is not seeking to enforce the statute through a private cause of action. Rather, it is alleging conversion and seeking return of funds based on the theory that Defendant improperly charged State Farm and accepted payment for unlawful services, due to its failure to properly register. Accordingly, accepting the allegations in the Complaint as true, the Court finds that Plaintiff has alleged a cause of action for compensatory damages and conversion.
WHEREFORE it is hereby
ORDERED AND ADJUDGED that the Defendants’ Motion to Dismiss is DENIED.
