18 Fla. L. Weekly Supp. 1178a
Online Reference: FLWSUPP 1811BYOU Insurance — Personal injury protection — Coverage — Non-prescription drugs — Medical provider is “dispensing practitioner” of non-prescription drugs as contemplated by workers’ compensation statute and is entitled to be compensated for dispensing drugs if he follows billing requirements of statute — However, where there is no record evidence to establish that drugs were dispensed by provider on date at issue, insurer correctly denied payment for related CPT code
BRADLEY H. YOUNG, D.C., a/a/o DONALD RICKARDS, and BRADLEY H. YOUNG, D.C., Individually, Plaintiffs, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 1st Judicial Circuit in and for Okaloosa County, Small Claims Division. Case No. 10-SC-1331-S. August 26, 2011. Jim Ward, Judge.
ORDER
THIS CAUSE having come before the Court upon the Defendant’s Motion for Reconsideration of Court’s Order Granting Plaintiff’s Motion for Summary Disposition as to CPT Code A9150, the Court having heard the arguments of the parties, and being otherwise advised in the premises hereby modifies its previous Order as it relates to CPT Code A9150 in the following manner:
The Defendant has raised two issues for reconsideration. First the Defendant argues that Bradley H. Young is not a “dispensing practitioner” for over the counter drugs and thus cannot be reimbursed under the workman’s compensation laws of the State of Florida. The Defendant’s second argument is that the evidence presented on behalf of the competing Motions for Summary Disposition does not support a finding that an over the counter drug was dispensed by Dr. Young on the visit in question.
This Court finds that Bradley Young is a “dispensing practitioner” of over the counter drugs as contemplated by the workman’s compensation statutes and rules. Thus, if he follows the billing requirements which are set forth in the rules adopted under Section 440.13, then he would be entitled to be compensated for the dispensing of those over the counter drugs.
While this Court finds that Dr. Young is a “dispensing practitioner” there is no evidence in the record of this case to establish that any over the counter drug was dispensed by Dr. Young on this occasion. The medical records which are attached to the affidavit of Denisha Torres-Lich, make no mention of the dispensing of any over the counter drug. Furthermore, Dr. Young’s affidavit, which was filed in support of his Motion for Summary Disposition, fails to include any mention of an over the counter drug nor does it contain any information regarding CPT Code A9150.
Therefore, upon reconsideration, it is hereby ORDERED:
A. The Defendant’s Motion for Summary Disposition is GRANTED as it relates to CPT Code A9150.
B. The Plaintiff’s Motion for Summary Disposition is DENIED.
