21 Fla. L. Weekly Supp. 583a
Online Reference: FLWSUPP 2106BUSHInsurance — Personal injury protection — Discovery — Depositions — In deposition of insurer’s designated representative, medical provider is entitled to inquire about reimbursement levels in community as reflected by amounts insurer has paid other diagnostic imaging providers in county for CPT codes at issue — Insurer is required to bring entire PIP claim file and underwriting file to deposition and to produce random samplings of explanations of review showing amounts insurer paid to other providers
ACK-TEN GROUP, LLC D/B/A SEACREST OPEN MRI OF DELRAY BEACH (Patient: Natalya Bushneva), Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 15th Judicial Circuit in and for Palm Beach County, Civil Division. Case No. 502012SC007591SBRS. February 27, 2014. Edward A. Garrison, Judge. Counsel: Robert Goldman, Florida Advocates, Dania Beach, for Plaintiff.
ORDER OVERRULING DEFENDANT’S OBJECTIONSAND DENYING DEFENDANT’S MOTION FORPROTECTIVE ORDER AS TO PLAINTIFF’S NOTICEOF RULE 1.310(B)(6) DEPOSITION
THIS MATTER came before the Court on February 27, 2014 upon Defendant STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY’s Objections and Motion for Protective Order as to Plaintiff’s Notice of Taking Deposition Duces Tecum, and the Court having considered Defendant’s Objections and Motion for Protective Order, having heard argument of counsel and being otherwise fully advised, it is
ORDERED as follows:
1. Defendant’s objections to paragraph 5 of the designated topics of the Fla.R.Civ.P. 1.310(B)(6) deposition of Defendant’s designated representative is OVERRULED and the motion for protective order is DENIED.
2. Plaintiff is entitled to inquire of STATE FARM’s designated representative as to reimbursement levels in the community, as reflected by the amounts which STATE FARM has paid other diagnostic imaging providers in Palm Beach County, Florida, for the same CPT Code(s) at issue in this case, during the period of time from December 1, 2007 through December 31, 2007 and during the period of time from 10 days prior to Natalya Bushneva’s MRI at Plaintiff’s facility until 10 days after her MRI at Plaintiff’s facility.
3. Defendant’s objections to Duces Tecum paragraphs 2, 3, 8 and 9 are OVERRULED and the motion for protective order is DENIED.
4. Defendant shall bring its entire PIP claim file to the Fla.R.Civ.P. 1.310(B)(6) deposition of Defendant’s designated representative. Any objection of privilege may be raised at the deposition and Defendant does not waive any privilege by bringing its entire PIP claim file to the deposition.
5. Defendant shall bring its underwriting file to the Fla.R.Civ.P. 1.310(B)(6) deposition of Defendant’s designated representative.
6. Defendant shall bring a random sampling of at least ten (10) Explanations of Review, reflecting reimbursement levels in the community of Palm Beach County, Florida, showing amounts which STATE FARM has paid other diagnostic imaging providers in Palm Beach County, Florida, for the same CPT Code(s) at issue in this case, during the period of time from December 1, 2007 through December 31, 2007.
7. Defendant shall bring a random sampling of at least five (5) Explanations of Review, reflecting reimbursement levels in the community of Palm Beach County, Florida, showing amounts which STATE FARM has paid other diagnostic imaging providers in Palm Beach County, Florida, for the same CPT Code(s) at issue in this case, for the 10 day period prior to Natalya Bushneva’s MRI at Plaintiff’s facility.
8. Defendant shall bring a random sampling of at least five (5) Explanations of Review, reflecting reimbursement levels in the community of Palm Beach County, Florida, showing amounts which STATE FARM has paid other diagnostic imaging providers in Palm Beach County, Florida, for the same CPT Code(s) at issue in this case, for the 10 day period after Natalya Bushneva’s MRI at Plaintiff’s facility.
9. Defendant shall bring a random sampling of at least ten (10) bills and/or Explanations of Review, reflecting usual and customary charges in the community of Palm Beach County, Florida, showing amounts charged by other diagnostic imaging providers in Palm Beach County, Florida, for the same CPT Code(s) at issue in this case, during the month and year on which Natalya Bushneva’s MRI was performed at Plaintiff’s facility.
10. Defendant may redact confidential patient information from any Explanations of Review and bills produced at the Fla.R.Civ.P. 1.310(B)(6) deposition of Defendant’s designated representative.
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