20 Fla. L. Weekly Supp. 665a
Online Reference: FLWSUPP 2007MOREInsurance — Personal injury protection — Discovery — Interrogatories — Documents — Insurer is entitled to discovery related to medical provider’s MRI procedures, including lease agreements and Medicare and Medicaid reimbursements — Fact that documents pertaining to lawsuits to which provider is party are public records is not proper basis for discovery objection — Where provider has burden to prove that care rendered and amount charged were reasonable, related and necessary, information regarding amounts provider receives from other entities, billing procedures, and setting of charges is discoverable — Request for all non-privileged documents referenced in provider’s answer to interrogatories is not overbroad
BEACHES OPEN MRI OF JACKSONVILLE, as assignee of COREEN MOREHOUSE, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 4th Judicial Circuit in and for Duval County. Case No. 16-2012-SC-2965, Division CC-N. January 23, 2013. Honorable Gary P. Flower, Judge. Counsel: Melissa Lewis, Gordon & Doner, P.A., Palm Beach Gardens, for Plaintiff. David M. Gagnon and Gina A. Peretti, Taylor, Day, Grimm, Boyd and Johnson, Jacksonville, for Defendant.
ORDER GRANTING STATE FARM’S MOTION TOCOMPEL BETTER DISCOVERY RESPONSES
THIS CAUSE having come before the Court on Defendant’s Motion to Compel Better Discovery Responses, and the Court having reviewed the relevant pleadings and case law submitted by the Defendant, having heard the argument of counsel, and being otherwise fully advised in the premises, finds that State Farm’s Motion to Compel is GRANTED. Plaintiff, Beaches Open MRI of Jacksonville, a/a/o Coreen Morehouse (“Plaintiff” or “Beaches Open MRI”) must fully, honestly, and comprehensively respond to each Interrogatory and produce all documents responsive to each Production Request propounded by State Farm within 20 days from the date of entry of this Order, except for the document request withdrawn at oral, argument relating to contracts or agreements between the Plaintiff and Medicare, Medicaid, Worker’s Compensation, PPO, HMO, or private insurance carriers.
FACTUAL BACKGROUND
This action arises out of a dispute between Beaches Open MRI and State Farm regarding the payment of PIP benefits for treatment rendered to Coreen Morehouse. State Farm asserted as a defense that it paid Beaches Open MRI as a reasonable amount for the services rendered according to the terms of the subject policy and Florida law. On October 8, 2012, State Farm served Plaintiff with its Request to Produce and its first set of Interrogatories. On November 7, 2012, Plaintiff responded to State Farm’s Request to Produce. Plaintiff objected to each and every Request, except for one. Further, Plaintiff did not produce a single document. On November 13, 2012, Plaintiff answered State Farm’s Interrogatories. Plaintiff objected to 15 of the 19 Interrogatories propounded by State Farm. On November 16, 2012, State Farm filed a Motion to Compel better discovery responses. On January 16, 2013, this Court held a hearing on State Farm’s Motion to Compel and heard the arguments of counsel for Plaintiff and counsel for State Farm.
ANALYSIS
Fla, R. Civ. P. 1.280(b)(1), provides:
Parties may obtain discovery regarding any matter, not privileged, that is relevant to the subject matter of the pending action whether it relates to the claim or defense of the party seeking discovery or the claim or defense of any other party, including the existence, description, nature, custody, condition, and location of any books, documents, or other tangible things and the identity and location of persons having knowledge of any discoverable matter.
Additionally, the rule provides, “[i]t is not ground for objection that the information sought will be inadmissible at the trial if the information sought appears reasonably calculated to lead to the discovery of admissible evidence.” Fla. R. Civ. P. 1.280(b)(1). The Supreme Court has held, based on Rule 1.280, that “the concept of relevancy is broader in the discovery context than in the trial context. . . . Thus, a party may be permitted to discover relevant evidence that would be inadmissible at trial so long as it may lead to the discovery of admissible evidence.” Amente v. Newman, 653 So. 2d 1030, 1032 (Fla. 1995) [20 Fla. L. Weekly S172a]. This is clearly a broad, liberal standard. See Allstate Ins. Co. v. Boecher, 733 So. 2d 993, 995 (Fla. 1999) [24 Fla. L. Weekly S187a]; Metabolite Intern., Inc. v. Holster, 888 So. 2d 140, 141 (Fla. 1st DCA 2004) [29 Fla. L. Weekly D2682c] (finding that the trial judge has “broad discretion” in applying the liberal construction of the discovery rules). Moreover, it is well-settled under Florida law that complete disclosure in matters of discovery is favored. See, e.g., ACandS, Inc. v. Askew, 597 So. 2d 895, 898 (Fla. 1st DCA 1992).
Here, Plaintiff improperly based nearly all of its objections on relevance grounds,1 unilaterally attempting to limit the issues of this suit as whether State Farm was entitled to rely on permissive payments language under Florida law and the insurance policy. However, in an action for PIP benefits, Plaintiff bears the ultimate burden of proving the care rendered and the amount it charged were reasonable, related, and necessary. Derius v. Allstate Indem. Co., 723 So. 2d 271, 272 (Fla. 4th DCA 1998)[23 Fla. L. Weekly D1383a]; State Farm Mut. Auto. Ins. Co. v. Sestile, 821 So. 2d 1244, 1246 (Fla. 2d DCA 2002) [27 Fla. L. Weekly D1757a]. Thus, the issues, as framed by the pleadings and applicable case law, are whether the amount billed by Plaintiff is reasonable and whether and to what extent Plaintiff is entitled to reimbursement, These issues are fact-intensive and Plaintiff’s objections and failure to produce a single document or adequately answer the interrogatories propounded was not justified.
Interrogatories 5-9, 11, 13, and 14 and Request to Produce 1-5, 10, 17, & 18
In its Answers to Interrogatories and Response to Request to Produce, Plaintiff asserted the same boilerplate objection to 8 Interrogatories (Nos. 5-9, 11, 13, and 14) and 5 Production Requests (1-5)2: “Objection. Irrelevant and not reasonably calculated to lead to admissible evidence.”
Case law provides that State Farm is entitled to the information it sought in these Interrogatories. For example, Interrogatories 4-9 and Production Requests 1-5 relate to the MRI machines, lease agreements, and costs of providing treatment, including Medicare and Medicaid reimbursements. Florida Courts have expressly found that this information is discoverable where, as here, an MRI, service provider is seeking PIP benefits from an insurance company. As the Fourth District Court of Appeals in Kaminester explained:
Simply put, a PIP insurer has a right to learn information about an insured’s treatment and the costs of such treatment. The term “costs” would mean almost nothing if it were limited, as the provider argues, to the amount charged by the provider to its patient. The statute would in effect create a right to discover something the PIP carrier knows from the moment the claim is submitted: namely what the provider has charged for its services. The plain meaning of “costs” is obviously the expenses the provider itself incurred to charge what it has charged. PIP coverage is required of everyone who drives, but that is not a license for health care providers to charge whatever they want for their services. The right of the PIP carrier is to discover information as to what it actually cost the provider to provide the treatment or services. Consequently we have little trouble in deciding that IBK’s lease is well within the meaning of the statutory discovery provision “the costs of such treatment.”
Kaminester v. State Farm Mut. Auto. Ins. Co., 775 So. 2d 981, 985 (Fla. 4th DCA 2000) [25 Fla. L. Weekly D2705a]; see also MRI Services, Inc. v. State Farm Mut. Auto. Ins. Co., 807 So. 2d 783, 784 (Fla. 2d DCA 2002) [27 Fla. L. Weekly D458b] (“We conclude that MRI Services was correctly ordered to produce the discovery, including the lease agreement, pursuant to the statute and affirm.”). Therefore, discovery related to Plaintiff’s MRI procedures including its lease agreements, Medicare and Medicaid, billing amounts and amounts received and accepted by Plaintiff is permissible and appropriate.3 As such, Plaintiff is required to respond to Interrogatories 5-9, 11, 13, and 14 and Request to Produce 1-5, 10, 17, & 18
Interrogatory 12
Plaintiff objected to Interrogatory 12, simply stating, “Objection, public record.” Interrogatory 12 asked for lawsuits “Plaintiff is a party to identifying the defendant, plaintiff and defense attorneys, the venue where filed, the allegations, and damages claimed as owing.” This is a Supreme Court approved Interrogatory. Merely because the documents sought are public records is not a proper basis for an objection. Thus, Plaintiff is required to respond to Interrogatory 12.
Interrogatories 15-18 and Request to Produce 6, 7, 164
In response to Interrogatories 15-18 and Production Requests 6 and 7 regarding amounts Plaintiff receives from other insurers, agencies, and patients, Plaintiff responded:
Objection. Irrelevant and not reasonably calculated to lead to admissible evidence. Any comparisons to private health care, Medicare or Medicaid reimbursements are inapplicable to Florida No Fault reimbursements. Defendant has chosen to reimburse Plaintiff at the permissive limitation set forth in Florida Statute 627.736 (5)(a)(2) without considering any other sources, making what Plaintiff accepts from these other sources irrelevant to the present litigation. See, Pan Am Diagnostic Services, Inc. d/b/a Pan Am Diagnostic of Orlando v. Metropolitan Casualty Insurance Company, 19 Fla. L. Weekly Supp. 874a (17th Judicial Cir., July 11, 2012).
Plaintiff’s reliance on Pan Am is misplaced. Unlike Pan Am, here, there is an issue of fact regarding the “reasonable” amount charged for the CPT codes at issue. Since Plaintiff contends the amount paid by State Farm was unreasonable, State Farm is entitled to discover what amounts Plaintiff is accepting as reasonable from other sources. Therefore, Plaintiff is required to respond to Interrogatories 15-18 and Production Requests 6 and 7.
Interrogatory 19 and Request to Produce 9
Interrogatory 19 asked Plaintiff to explain its “billing procedures” at the time of treatment to the insured. Plaintiff objected to this response contending that “billing procedures” was vague and unclear. This Court finds that the term “billing procedures” is sufficiently clear and orders Plaintiff to Respond to this Interrogatory.
Production Request 9 asked for “all schedules indicating what fee” Plaintiff considers within the customary range and/or guidelines for the CPT codes at issue. Similar to Interrogatory 19, Plaintiff objected to this response contending that “all schedules” was vague. Yet, Plaintiff did not object to Request to Produce 12 on the same grounds, which asked for “all . . . fee schedules”. This Court finds Plaintiff’s objection to Request 9 without merit. Therefore, Plaintiff is required to respond to Production Request 9.
Request to Produce 8, 11-14
Production Requests 8 and 11-14 asked for information related to Plaintiff’s setting of charges, coding recommendations, individuals who participated in pricing schedules, and other information used to determine the amounts charged for services rendered. Plaintiff objected as follows, “Defendant has chosen to reimburse Plaintiff at the permissive limitation set forth in Florida Statute 627.736(5)(a)(2).” However, State Farm has not asserted in any pleading before this Court, that it “chose to reimburse Plaintiff at the permissive limitation” set forth in the statute. Plaintiff’s objection attempts to unilaterally limit the issues in this litigation to whether State Farm was entitled to rely on permissive payments language under Florida law and the insurance policy. In an action for PIP benefits, Plaintiff bears the ultimate burden of proving the care rendered and the amount it charged were reasonable, related, and necessary. Derius, 723 So. 2d at 272; Sestile, 821 So. 2d at 1246. Whether the charges are reasonable, related, and necessary, necessarily involves the information subject to these discovery requests. As a result, Plaintiff is required to produce the documents requested in Production Requests 8 and 11-14.
Request to Produce 19
Request to Produce 19 sought any and all non-privileged documents used or referred to in Plaintiff’s Answers to Defendant’s Initial Interrogatories. Plaintiff responded that this Request was “overbroad”. This Court disagrees. Thus, Plaintiff must respond to Production Request 19.
It is therefore
ORDERED AND ADJUDGED:
1. State Farm’s Motion to Compel is hereby Granted.
2. Plaintiff is required to fully, honestly, and comprehensively respond to each Interrogatory and produce all documents responsive to each Production Request propounded by State Farm within 20 days from the date of entry of this Order, except for the document request withdrawn at oral argument relating to contracts or agreements between the Plaintiff and Medicare, Medicaid, Worker’s Compensation, PPO, HMO, or private insurance carriers.
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1Notably, none of Plaintiff’s objections relate to claims of privilege or confidentiality, with the exception of Response No. 18 to State Farm’s Request for Production.
2Additionally, the Responses to Requests 10, 17, and 18 contained similar relevance objections.
3Similarly, Interrogatories 11, 13, and 14, and Requests 10, 17, and 18 are relevant as they ask for information related to billing: Interrogatory 11 asks for the name of the person responsible for billing on the date of service at issue, which is directly relevant to the amount charged for treatment rendered; Interrogatory 13 asks for billing companies and third party vendors utilized by Plaintiff; and Interrogatory 14 asks for all documents utilized in determining billable amounts for medical services rendered by the Plaintiff. Similarly, Production Requests 10, 17, and 18 relate to documents regarding billing and billing procedures. These items are directly relevant to whether the charges for the treatment were reasonable and whether Plaintiff is entitled to reimbursement.
4Request 16 related to contracts or agreements between the Plaintiff and Medicare, Medicaid, Worker’s Compensation, PPO, HMO, or private insurance carriers. At the January 16, 2013 hearing on State Farm’s Motion to Compel, State Farm withdrew Request 16; as a result, Request 16 is not addressed herein.
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