21 Fla. L. Weekly Supp. 697a
Online Reference: FLWSUPP 2107NARVInsurance — Discovery — Depositions — In deposition of insurer’s designated representative, medical provider is entitled to inquire about payments made to other similar providers in same geographical area for CPT codes at issue
AXIS CHIROPRACTIC & REHAB CENTER, INC. (assignee of Narvaez, Sissy), Plaintiff, v. STATE FARM FIRE AND CASUALTY COMPANY, Defendant. County Court, 13th Judicial Circuit in and for Hillsborough County, Civil Division. Case No. 13-CC-009059. February 8, 2014. Christopher C. Nash, Judge. Counsel: Robert B. Goldman, Florida Advocates, Dania Beach, for Plaintiff.
ORDER GRANTING DEFENDANT’S MOTIONFOR RECONSIDERATION, AND GRANTINGIN PART, AND DENYING IN PART, DEFENDANT’SMOTION FOR PROTECTIVE ORDER
THIS MATTER came before the Court on January 28, 2014, upon the Defendant’s Motion for Reconsideration of the Court’s October 3, 2013 Order Denying Defendant’s Motion for Protective Order with regard to paragraph 5 of the Designated Topics of Plaintiff’s Notice of Taking Rule 1.310(b)(6) corporate deposition, and the Court having heard argument of counsel and being otherwise fully advised, it is hereby
ORDERED as follows:
1. The Defendant’s Motion for Reconsideration is GRANTED.
2. The Defendant’s Motion for Protective Order is DENIED in part, and GRANTED in part, as set forth herein.
3. Sec. 627.736(5)(a)(1), Fla. Stat. provides, in pertinent part, that “with respect to a determination of whether a charge for a particular service, treatment or otherwise is reasonable, consideration may be given to evidence of . . . reimbursement levels in the community.”
4. Plaintiff has advised of its intention to depose State Farm’s Corporate Representative and inquire into amounts which State Farm has paid other providers in the same geographical area as the Plaintiff for the same CPT codes that are at issue in this case, as well as the methodology, basis, facts and calculations used by State Farm in determining the amounts to pay those providers.
5. The Court finds that the information sought by the Plaintiff appears reasonably calculated to lead to the discovery of admissible evidence, as it specifically relates to the factors set forth in Sec. 627.736(5)(a)(1), Fla. Stat., and therefore meets the standard for discoverable information, pursuant to Rule 1.280(b)(1), Fla.R.Civ.P.
6. The Court finds that State Farm’s payments to “other providers” shall mean payments to other Chiropractors or Chiropractic Facilities (collectively, “Chiropractors”)
7. The Court finds that “the same geographical area as the Plaintiff” shall mean Hillsborough County and Pinellas County, Florida.
8. The Court finds that the relevant and reasonable time frame for the inquiry into amounts which State Farm has paid other Chiropractors in Hillsborough County and Pinellas County shall be from July 1, 2008 through September 30, 2008.
9. Plaintiff shall modify paragraph 5 of its proposed topics, as follows:
– Amounts which State Farm has paid other Chiropractors in Hillsborough County and Pinellas County, Florida, for the same CPT codes that are at issue in this case, from July 1, 2008 through September 30, 2008, as well as the methodology, basis, facts and calculations used by State Farm in determining the amounts to pay those providers.
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