19 Fla. L. Weekly Supp. 131a
Online Reference: FLWSUPP 1902ADONInsurance — Personal injury protection — Discovery — Insurer’s interrogatories and requests to produce are limited as to time and scope
TOP CARE CHIROPRACTIC & REHABILITATION, INC., a/a/o JEAN FRITZNER ADONIS, Plaintiff, vs. MGA INSURANCE COMPANY, INC., Defendant. County Court, 9th Judicial Circuit in and for Orange County. Case No. 09-CC-19536-O. December 17, 2010. Honorable Antoinette Plogstedt, Judge. Counsel: Andrew Bullock, for Plaintiff. Robert M. Lyerly, Masten, Lyerly, Peterson & Denbo, LLC, Orlando, for Defendant.
ORDER ON PLAINTIFF’S OBJECTIONS TODEFENDANT’S FIRST REQUEST TO PRODUCE ANDDEFENDANT’S FIRST SET OF INTERROGATORIES
THIS CAUSE having come before this Court on August 3, 2010 on Plaintiff’s Objections to Defendant’s First Request to Produce and Defendant’s First Set of Interrogatories, and the Court having heard arguments of counsel and otherwise being fully advised in the premises:
FINDINGS OF FACT
Plaintiff filed the above-referenced action alleging a cause of action for Breach of Contract for failure to pay PIP benefits for services it purportedly provided to Defendant’s insured. On or about May 13, 2010, Defendant served its First Request to Produce and First Set of Interrogatories upon Plaintiff. On May 26, 2010, Plaintiff filed Objections to the documents requested and certain Interrogatories.
The relevant Interrogatories and objections filed by Plaintiff to Defendant’s First Set of Interrogatories are as follows:
Defendant’s Interrogatory No. 4 and Plaintiff’s Response No. 4
4. If any of the individuals listed in response to question #3 were Registered Chiropractic Assistants (hereinafter “RCA”) working at Top Care Chiropractic & Rehabilitation, Inc, Orlando, Florida location, please list the RCA’S current and prior supervising chiropractic physicians; the dates of supervision; whether the supervising chiropractic physician is employed/contracted by Plaintiff and, if so, when did the chiropractic physicians become employed/contracted by Plaintiff and when advised the appropriate State department of who was supervising the RCA.
RESPONSE:
Objection, Irrelevant, Immaterial, Overbroad, Unduly Burdensome, Harassing, Not reasonably limited as to time and scope.
Defendant’s Interrogatory No. 5 and Plaintiff’s Response No. 5
5. Please list the name, and if no longer an employee, the current address of Plaintiff’s billing custodian/coding technician/expert, for each CPT Code billed for each date of service to MGA’S claimant, and identify all authoritative treatises Plaintiff relied upon in billing MGA these codes.
RESPONSE:
Objection, Irrelevant, Immaterial, Overbroad, Unduly Burdensome, Harassing, Not reasonably limited as to time and scope; Public record.
Defendant’s Interrogatory No. 8 and Plaintiff’s Response No. 8
8. Please list any and all Federal Employer Identification Numbers used by Plaintiff and any individual/entity, on Plaintiff’s behalf, for performing services on MGA’S claimant during the last five (5) years.
RESPONSE:
Objection, Irrelevant, Immaterial, Overbroad, Unduly Burdensome.
Defendant’s Interrogatories Nos. 10 & 11 and Plaintiff’s Responses Nos. 10 & 11
10. Provide a detailed explanation as to how Plaintiff determined the usual, reasonable and/or customary charge for each of the CPT codes for the dates of service at issue. If Plaintiff relied upon a database, resource, treatise, manual, publication, periodical or other providers as a part of your explanation, identify the database, resource, treatise, manual, publication and pages utilized or provider by name and address, and include information regarding the date the information was relayed, and what information was relayed to Plaintiff.
11. State the names, addresses and the extent of the education, (giving names and addresses of all schools, colleges, universities, vocational schools, or other institution attended and the years attended), as well as stating any degrees, certifications, or licenses (other than driver’s license) of all persons who participated in setting your fee schedule or involved in the decision of which CPT code to use for CPT codes at issue.
RESPONSE:
Objection, Irrelevant, Immaterial, Overbroad, Unduly Burdensome, Harassing, Not reasonably limited as to time and scope.
Defendant’s Interrogatory No. 13 and Plaintiff’s Response No. 13
13. Please set forth the current procedural terminology (CPT) codes utilized with regard to billing for services allegedly rendered to MGA’S claimant, stating the dates of service and provide a detailed explanation as to why these CPT codes were utilized as it relates to the service provided.
RESPONSE:
Objection, Irrelevant, Immaterial, Overbroad, Unduly Burdensome, Harassing.
Defendant’s Interrogatory No. 20 and Plaintiff’s Response No. 20
20. Please identify present or former shareholders, officers and directors in the company, stating for each their name, current address and phone number, the capacity in which they serve or have an investment interest, the percentage of shares controlled or owned; the period of time each served as an officer, director or shareholder; the names of all other corporations in which the officer, director or shareholder serves as a shareholder in excess of five (5) percent and the nature and extent of such interest; when and the amount said shareholder(s) sold/transferred his/her shares and the person to whom said shares were sold/transferred.
RESPONSE:
Objection, Irrelevant, Immaterial, Overbroad, Unduly Burdensome, Harassing, Not reasonably limited as to time and scope; Public record.
Defendant’s Interrogatory No. 22 and Plaintiff’s Response No. 22
22. Please provide a listing of any and all fictitious names owned by the Plaintiff and the date upon which Plaintiff registered the fictitious name with the State of Florida.
RESPONSE:
Objection, as Interrogatories exceeds 30 including subparts.
Defendant’s Interrogatories Nos. 23-25 and Plaintiff’s Responses Nos. 23-25
23. Please identify the names and addresses of any person or entity that has shared in the profits and/or losses for Plaintiff from inception.
24. Please identify the name and address of any office where Plaintiff has or had a bank account, savings account, money market or other financial account since December 8, 2007.
25. If you made any objections within your responses to Defendant’s First Interrogatories or Defendant’s First Request to Produce, please provide the legal basis supporting these objections (i.e. Privilege Log).
RESPONSE:
Objection, as Interrogatories exceeds 30 including subparts; Irrelevant, Immaterial, Overbroad, Unduly Burdensome, Harassing, Not reasonably limited as to time and scope.
As it relates to Interrogatories number 23 through 25, Plaintiff’s only objection at the hearing was that the Requests exceeded the number allowed by applicable Florida Rules Civil Procedure. Defendant made an Ore Tenus for Leave to File Additional Interrogatories and have those Interrogatories deemed filed during the hearing. Plaintiff voiced no other objections to Interrogatories number 23 through 25.
Despite the objections raised in the responses, Plaintiff’s only objections to Interrogatories number 4, 9, 14 and 15 at the hearing were that the requests were not sufficiently limited in time and/or scope. More specifically, Plaintiff objected based on the fact that the services at issued were provided during 2007 and 2008, and any discovery before or after those dates were irrelevant to the present litigation.
The requests and objections to Defendant’s First Request to Produce to Plaintiff are as follows:
Defendant’s Requests Nos. 1-8 and Plaintiff’s Responses Nos. 1-8
1. Copies of any documents identifying any and all shareholders of, and any individual and/or entity with an ownership interest in, TOP CARE CHIROPRACTIC & REHABILITATION, INC., including names, business addresses, and telephone numbers for each individual and/or entity identified.
2. Any and all information regarding the dates of acquisition and percentage of ownership for any individual and/or entity with an ownership interest in TOP CARE CHIROPRACTIC & REHABILITATION, INC., regardless of how small the ownership interest is or when acquired. Please include a copy of the IRS Form 8594 (Asset Acquisition Statement) of both the buyer and seller regarding.
3. Copy of Transfer and Change of Ownership Notice (CHOW) provided to AHCA and proof that this notice was forwarded to AHCA sixty (60) days prior to any transfer of ownership.
4. Copies of any and all contracts for the purchase of stock and/or ownership interest in TOP CARE CHIROPRACTIC & REHABILITATION, INC. regardless as to if the contract is still pending.
5. Copies of any and all documents identifying any person and/or entity that owns, or has any financial interest in, any equipment within TOP CARE CHIROPRACTIC & REHABILITATION, INC. including names, business addresses, telephone numbers and start and end date of ownership interest of each individual and/or entity.
6. Copies of any and all documents previously forwarded to any government agency, medical board, state/county administrative agency, federal government or lending institution that declared or outlined the ownership of this clinic since the formation of the corporation and procurement of the federal tax identification number.
7. If TOP CARE CHIROPRACTIC & REHABILITATION, INC. shares facilities and/or equipment and/or services with any other individual/entity, documents identifying the individual/entity by name, their business addresses and telephone numbers and provide copies of any contracts, agreements, leases, memos of understanding or any other documents pertaining to that arrangement.
8. Please identify any billing company, Medical Director, physician, marketing company, medical management company, and/or coding company utilized by TOP CARE CHIROPRACTIC & REHABILITATION, INC. during the last three (3) years, including names, business addresses and telephone numbers for each individual/entity.
RESPONSE:
Objection, Irrelevant, Immaterial, Overbroad, Unduly Burdensome, Harassing, Not reasonably limited as to time and scope; Public record.
Defendant’s Requests Nos. 10-15 and Plaintiff’s Responses Nos. 10-15
10. Records as to who owned/rented/leased [Editor’s Note: Address Omitted], Orlando, Florida, 32839, for the last 3 years, including but not limited to copies of all agreements/contracts pertaining thereto.
11. The 2007 full corporate tax return, including all schedules and footnotes, for TOP CARE CHIROPRACTIC & REHABILITATION, INC. (The actual monetary figures may be redacted off same.)
12. Proof of all authorized signers on corporate bank accounts. (The account number may be redacted off same.)
13. Tangible property tax filings confirming the medical equipment owned and operated by TOP CARE CHIROPRACTIC & REHABILITATION, INC. to provide the services billed.
14. Current premise liability policy with proof of purchase for the clinic located at [Editor’s Note: Address Omitted], Orlando, Florida, 32839.
15. Please provide a copy of the complete Pre-Suit Demand Letter submitted in this case.
RESPONSE:
Objection, Irrelevant, Immaterial, Overbroad, Unduly Burdensome, Harassing, Not reasonably limited as to time and scope; Public record.
Defendant’s Request No. 28 and Plaintiff’s Response No. 28
28. All letters of protection from any insured, their attorney, to you, your P.A., or any other party having financial interest in the outcome of any pending litigation, including but not limited to, commercial factors, accounts receivable, collection services or commercial finance companies.
RESPONSE:
Objection, Irrelevant, Immaterial, Overbroad, Unduly Burdensome, Harassing, Not reasonably limited as to time and scope; Violation of HIPPA.
Defendant’s Request No. 29 and Plaintiff’s Response No. 29
29. All records, documents and/or materials of whatever nature regarding any and all charges, claims, and/or complaints made by the Department of Professional Regulation, Agency for Health Care Administration, or any other regulatory entity, regarding the issue of over billing, the reasonableness of your fees and the qualification of the person performing the services.
RESPONSE:
Objection, Irrelevant, Immaterial, Overbroad, Unduly Burdensome, Harassing, Not reasonably limited as to time and scope.
Defendant’s Request No. 31 and Plaintiff’s Response No. 31
31. A copy of your wage and hour Quarterly Report (redacted for social security number and amount of compensation) for each quarter wherein MGA’S claimant, Jean Fritzner Adonis, received goods or service from Plaintiff.
RESPONSE:
Objection, Irrelevant, Immaterial, Overbroad, Unduly Burdensome, Harassing, Not reasonably limited as to time and scope; Invasion of Privacy.
Defendant’s Requests Nos. 34-43 and Plaintiff’s Responses Nos. 34-43
33. Time Cards, schedules or anything to indicate the hours worked on each day by anyone who rendered service to MGA’S claimant, Jean Fritzner Adonis, during the time period the bills were generated.
34. Any submissions to any governmental entity or agency that allowed Plaintiff to lawfully perform services on MGA’S claimant, Jean Fritzner Adonis, including but not limited to submissions to ACHA, FDA, Department of Health, Bureau of Radiology Control, etc.
35. All clinic submissions to the Department of Health Care Administration regarding clinic licensure/clinic registration.
36. A computer printout and the raw data that show all CPT codes billed for all patients for each date MGA’S claimant, Jean Fritzner Adonis.
37. All correspondence, memos, letters, documents and materials of whatever nature between you and other doctors, medical providers, the American Medical Association, and/or any other group, society or organization regarding billing amounts, billing procedures and fees for each service rendered to MGA’S claimant, Jean Fritzner Adonis.
38. All documents and/or materials of whatever nature you have in your possession regarding companies that are in the business of reviewing charges for medical services and/or treatment for insurance carrier.
39. All correspondence, memos, letters, documents and/or materials of whatever nature between you and other doctors and/or medical providers regarding companies that are in the business of reviewing charges for medical services and/or treatment for insurance carriers.
40. All memos, guidelines and/or instructions your employees, agents and/or accountant which were given regarding the procedures to be followed when billing, the codes to be used, and the fees to be charged.
41. All seminar materials and other documentation of whatever nature you have regarding billing and billing procedures in cases involving personal injury protection claims and/or a doctor’s or medical provider’s compliance with Florida Statute §627.736(5).
42. All records documents and/or materials of whatever nature you have in your possession regarding any audits that have been performed on your billing records and/or billing procedures. (Redacted to conceal the patient’s identifying information.)
43. All documents and/or materials you have received during seminars, workshops and meetings of whatever nature that address the issue of billing and billing procedures.
RESPONSE:
Objection, Irrelevant, Immaterial, Vague, Ambiguous, Overbroad Unduly Burdensome, Harassing, Not reasonably limited as to time and scope.
Defendant’s Requests Nos. 45-49 and Plaintiff’s Responses Nos. 45-49
45. All contracts or agreements with any individual and/or service provider employed or contracted by Plaintiff, who provided any service on MGA’S claimant, Jean Fritzner Adonis, (redacted for social security number and amount of compensation).
46. All contracts or agreements between Plaintiff and any individual, corporation or business entity who refers patients to Plaintiff.
47. All records of payments, checks, journals, etc., that reference any payment to any individual, corporation or business entity who refers patients for the last five years.
48. All records of payments, checks, journals, etc., that referenced any payment to, or from Plaintiff with regard to the referral of patients for the last five years.
49. All documents reflecting the number of referrals made by Plaintiff to any diagnostic company rendering services to MGA’S claimant, Jean Fritzner Adonis.
RESPONSE:
Objection, Irrelevant, Immaterial, Vague, Ambiguous, Overbroad, Unduly Burdensome, Harassing, Not reasonably limited as to time and scope.
Defendant’s Request No. 54 and Plaintiff’s Response No. 54
54. Any and all computer programs, records and/or computer generated documents used by your office to track the services provided to patients and/or their billing records.
RESPONSE:
Objection, Irrelevant, Immaterial, Vague, Ambiguous, Overbroad, Unduly Burdensome, Harassing.
Defendant’s Requests Nos. 55-59 and Plaintiff’s Responses Nos. 55-59
55. Your fee schedules in effect on each date of treatment of MGA’S claimant, Jean Fritzner Adonis, including all worker’s compensation, Medicare, Medicaid, PPOs, HMOs or other health insurance programs.
56. Copies of all fee schedules, including but not limited to Florida Workers’ Compensation, Medicare, Medicaid, Blue Cross/Blue Shield, CHAMPUS, any HMO or PPO or any other group’s schedules which you have accepted in the past five years.
57. All records, documents and materials or whatever nature regarding patients and/or cases where an insurance carrier has disputed the reasonableness of your fees. (You may redact the identity of the specific patient.)
58. All records, documents and materials of whatever nature you have from other doctors and/or medical providers regarding their charges for services and treatments similar to those which you provided to MGA’S claimant, Jean Fritzner Adonis, on each date of treatment.
59. Every piece of paper contained within the medical/billing file folders kept for MGA’s claimant, Jean Fritzner Adonis.
RESPONSE:
Objection, Irrelevant, Immaterial, Vague, Ambiguous, Overbroad, Unduly Burdensome, Harassing, Not reasonably limited as to time and scope.
THEREFORE, it is hereby ORDERED and ADJUDGED as follows:
1. Defendant’s Ore Tenus Motion For Leave To Serve Additional Interrogatories And To Deem The Interrogatories Previously On May 13, 2010 To Be Served is hereby GRANTED. Plaintiff’s objections to the interrogatories are OVERRULED in part and SUSTAINED in part. More specifically, the objections are sustained in part as to interrogatory requests number 7 and 8 are limited to 2007 and 2008. Interrogatories 20, 22, and 23 shall be limited to 2007 to the present. Plaintiff shall have 30 days.
2. Plaintiff’s Objections to Defendant’s First Request to Produce are overruled subject to the limitations outline below:
a. Request to Produce numbers 1 through 8 are limited to documents from 2007 and 2008;
b. Request to Produce number 11 is limited to providing the sections of the tax returns which identify the shareholders and percentage of ownership or the K-1 which identify the shareholders of the company and their percentage of ownership, whichever exist;
c. Plaintiff’s Objection to Request to Produce number 15 was withdrawn;
d. Plaintiff’s Objection to Request to Produce number 28 is limited to the claimant and not other insureds and/or patients;
e. Plaintiff’s Objection to Request to Produce number 29 is limited to the types of services provided by Plaintiff to Defendant’s insured as it relates to this matter;
f. Request number 31 is limited to the quarters where the insured was treated by the Plaintiff;
g. As to request number 33, Plaintiff shall produce some type of time card or employee log for dates the insured received treatment;
h. As to request number 55 and 56, Plaintiff shall produce fee schedules for anybody that they submitted bills to during the time period when the insured treated with Plaintiff and the CPT codes utilized by Plaintiff as it relates to the treatment of the insured; except for Medicare, Medicaid and Worker’s Compensation;
i. For requests number 13, 14, 46, 47, 48 and 57 are limited to 2007 and 2008; and
j. Except as specifically limited above, Plaintiff shall produce all documents responsive to Defendant’s First Request to Produce within 30 days of the date of this order.
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