14 Fla. L. Weekly Supp. 576a
Insurance — Personal injury protection — Claim forms — Signature of medical provider — Requirements of box 31 of HCFA form are met where provider’s name is typed or facsimile signature is stamped in box — Question certified whether statute requires actual handwritten signature of medical provider in Box 31 of HCFA form
AMERICAN MED-CARE CENTERS, Plaintiff, vs. PROGRESSIVE AMERICAN INSURANCE COMPANY, Defendant. County Court, 15th Judicial Circuit, Civil Division, in and for Palm Beach County. Case No. 502006SC9466XXXX, Division RB. March 30, 2007. Ted Booras, Judge. Counsel: Heather Wallace, West Palm Beach. Mark Januschewski, Boynton Beach.
ORDER ON DEFENDANT’S MOTION FOR SUMMARY JUDGMENT
THIS CAUSE having come before the Court upon Defendant’s Motion for Summary Judgment, the Court having heard argument and being fully advised in the premises, finds as follows:
This case involves a claim for personal injury protection (PIP) benefits. Defendant, in their Motion for Summary Judgment, argued that they were not put on proper notice of Plaintiff’s claim for PIP benefits because Plaintiff failed to properly complete the Health Insurance Claim Form (HCFA) as required by section 627.736(5)(d), when they submitted their bills to Defendant for payment. Specifically, Defendant argued that Plaintiff, medical provider, failed to sign Box 31 of the HCFA forms. The Court finds that in the instant case Box 31 was in fact not signed.
Plaintiff, on the other hand, argued that they complied with section 627.736(5)(d), by stamping the name of the medical provider in Box 31 of the HCFA form and that this method complies with the signature requirement. The Court finds that in the instant case Box 31 contained the name of the medical provider clearly typed or stamped.
At issue is whether section 627.736(5)(d), actually requires Box 31 of the HCFA forms to be signed by the medical provider. Section 627.736(5)(d), states in part that:
All statements and bills for medical services rendered by any physician, hospital, clinic, or other person or institution shall be submitted to the insurer on a properly completed Centers for Medicare and Medicaid Services (CMS) 1500 form, UB 92 forms, or any other standard form approved by the office or adopted by the commission for purposes of this paragraph. . . . All providers other than hospitals shall include on the applicable claim form the professional license number of the provider in the line or space provided for “Signature of Physician or Supplier, Including Degrees or Credentials.”
Several Florida courts have ruled that section 627.736(5)(d), does not have a specific requirement that Box 31 of the HCFA forms be signed by the medical provider. United Automobile Insurance Company v. Medical Specialists and Diagnostic Services, 11 Fla. L. Weekly Supp. 508 (Fla. 9th Jud. Cir. 03/04/04) (“There is no provision under Section 627.736 that specifically requires the signature of the provider or physician, or the inclusion of credentials or degrees on the Form.”); All County Medical Center v. State Farm Mutual Automobile Insurance Company, 13 Fla. L. Weekly Supp. 184 (Fla. Broward Cty. Ct. 12/19/05); The Aries Insurance Company v. First Chiropractic Clinic, 12 Fla. L. Weekly Supp. 637 (Fla. 13th Jud. Cir. 04/25/05) (“. . . the relevant version of §627.736(5)(d) does not expressly require a healthcare provider’s signature on notices to insurance companies. . .”); Old Masters Medical v. Progressive Auto Pro Insurance, 12 Fla. L. Weekly Supp. 163 (Fla. Broward Cty. Ct. 09/22/04 ) (“The Court concludes that Box 31 of each of the HCFA’s at issue is not deficient. The fact that none of the HCFAs contain the treating provider’s signature in Box 31 does not render the HCFAs in violation of section 627.736(5)(d). Florida Statutes (2002).”); and, Florida MRI, Inc. v. Progressive Express Insurance, 13 Fla. L. Weekly Supp. 190 (Fla. Broward Cty. Ct. 09/16/05).
Likewise, another court held that a provider’s failure to sign Box 31 of the HCFA forms was not defective as long as the medical provider’s name appears in Box 31. Garcia v. United Automobile Insurance Company, 12 Fla. L. Weekly Supp. 888 (Fla. Broward Cty. Ct. 07/14/05) (stamped facsimile signature).
Only one county court ruled that Box 31 of the HCFA forms must contain the signature and identity of the medical provider. Miami Medical Group v. Progressive Southeastern Insurance Company, 11 Fla. L. Weekly Supp. 246 (Fla. Miami Cty. Ct. 01/14/04) (“The signature of the physician or supplier on the HCFA 1500 is an integral part of establishing a covered loss, as it authenticates the claim information by specifying the named individual who is providing services and otherwise attesting that the services have actually been rendered is required. This is not optional. . . . Accordingly, Box 31 of the HCFA 1500 must contain the identity and signature of the Physician or Supplier as well as the date signed and the failure of Plaintiff to do so is fatal to their claim . . .”).
Notwithstanding this one case, after reviewing section 627.736(5)(d), the Court first finds that, as a matter of law, there in no specific requirement that Box 31 of the HCFA forms be signed at all.
The Court further finds herein that, as a matter of law, that the requirements of Box 31, of the HCFA forms, are satisfied where a medical provider’s name is provided therein by typing or stamping a facsimile signature.
IT IS THEREFORE ORDERED AND ADJUDGED that Defendant’s Motion for Summary Judgment is hereby DENIED.
However, this Court recognizes that the challenge raised herein, being one of statutory construction, could ultimately affect a good majority of PIP cases. Therefore, this Court does hereby certify the following as a question of great public importance:
Does section 627.736(5)(d) require that the actual handwritten signature of the medical provider be included in Box 31 of the HCFA form in order for an insured to be put on notice of the provider’s claim for PIP benefits, or is the typed or stamped name of the medical provider provided sufficient to comply with the statute?
