21 Fla. L. Weekly Supp. 1051a
Online Reference: FLWSUPP 2110MISTInsurance — Personal injury protection — Discovery — Medical provider ordered to produce bills submitted to and payments made by Medicare, any Florida workers’ compensation insurer, and any health insurer for CPT codes at issue, and any contract entered into with those entities — Provider is ordered to produce bills submitted to and payments made by private pay customers for CPT codes at issue
BETTER CARE CHIROPRACTIC CENTER, LLC a/a/o LOUIS MISTILIEN, Plaintiff, v. STATE FARM FIRE AND CASUALTY COMPANY, Defendant.County Court, 9th Judicial Circuit in and for Orange County. Case No. 2012-SC-004607-O. May 15, 2014. Honorable Andrew L. Cameron, Judge. Counsel: Florida Advocates, Dania Beach, for Plaintiff. Matthew J. Corker, Conroy, Simberg, Ganon, Krevans, Abel, Lurvey, Morrow & Schefer, PA, Orlando, for Defendant.
ORDER ON PLAINTIFF’S MOTION FOR PROTECTIVE ORDER
THIS CAUSE, having come on to be heard in Plaintiff’s Motion for Protective Order and Objections to Defendant’s Notice of Taking Deposition Duces Tecum on May 7, 2014, and the Court having reviewed the Court’s file, the submissions of the respective parties, having heard argument of counsel, and being otherwise fully informed in the premises, finds as follows:
1. This matter is a claim for personal injury protection (“P.I.P.”) benefits initiated by plaintiff involving a multitude of CPT codes submitted to State Farm by Plaintiff seeking payment for services rendered to State Farm’s insured, Louis Mistilien.
2. Subsequent to the filing of the instant lawsuit, Defendant sought to depose the corporate representative with the most knowledge of billing of Better Care Chiropractic Center, LLC.
3. Defendant served plaintiff’s counsel with a copy of its notice of taking deposition and annexed a duces tecum to same.
4. The duces tecum directed Plaintiff’s designated corporate representative to appear for deposition and to have with her/him at that time, inter alia, the following:
1. All CMS 1500 billing submissions for the CPT code or codes in dispute for any patient (you may redact patient information) which you have submitted to first Coast Service Options Inc. and/or the Centers for Medicare and Medicaid Services for the time period of one year pre-dating the date of the services in dispute to the present date.
2. Any document which evidences any payments you have received from Medicare (Centers for Medicare and Medicaid Services and/or First Coast Service Options, Inc) for the CPT code or codes in dispute for a period of one year preceding the dates of service in dispute to the current date;
3. All bills submitted for the CPT code or codes which is/are the subject of your complaint which you submitted to any Florida Workers’ Compensation insurer, Third Party Administrator or employer of the patient (you may redact patient identifying information) for the period of one year preceding the dates of service in dispute until the current time.
4. Any document evidence the payment amounts received for each bill submission referenced in request #3 above for the period of one year predating the dates of service in dispute until the current time.
5. All billing submissions to any health insurer or their Third Party Administrator of fiscal intermediary for the CPT code or codes which is/are in dispute for the period of one year predating the dates of service in dispute until the current time;
6. A copy of the document evidencing payment (whether through check, electronic submission or otherwise) relating to each CPT code submission referenced in Request number 5 above.
7. A copy of all contracts entered into between your company and any insurer, Third Party Administrator, employer, workers’ compensation provider or any governmental agency in effect for the years 2009, 2010, 2011 and 2012. This request specifically includes, but is not limited to, any contracted for reimbursement schedules for the CPT codes which are the subject of your complaint.
8. A copy of your retainer agreement with your lawyer in this case.
9. A copy of all bills for charges for the CPT code or codes in dispute that you provided to any private pay customer (person with no insurance) for the year predating the date of service in dispute to the current time (you may redact patient identifying information).
10. Any document which is evidence of the amounts paid by every private pay customer who you charged for the same CPT code or codes in dispute in this matter related to the corresponding bills referenced in Request number 9 above.
5. Counsel for Plaintiff contended that Plaintiff does not maintain or have any contracts with any of the entities identified in items numbered 1 through 4 of the duces tecum.
6. Counsel for Defendant argued that pursuant to Plaintiff’s own website page, Plaintiff accepts payments from the entities so identified in items numbered 1 through 4 of the duces tecum.
7. The Court finds that the information sought to be provided and produced at deposition in items numbered 1 through 4 of the duces tecum, are relevant, and if the Plaintiff did accept payments from said entities indentified in the duces tecum during the time frame encompassing the dates of service at issue in this dispute, that Plaintiff’s objections to production of the billing submissions and payment receipts from those entities is overruled and plaintiff shall have with her/him and produce copies of those billing submissions and payment receipts to and from those entities for a period encompassing 6 months predating the dates of service at issue in this matter through and including 6 months following the dates of service at issue in this matter.
8. As to items numbered 5 and 6 of the duces tecum, Plaintiff’s objections to same are overruled and Plaintiff shall produce and have at the deposition all documents requested therein for a period of 6 months predating the dates of service at issue in this matter through and including 6 months following the dates of service at issue in this matter.
9. As to item number 7 of the duces tecum, Plaintiff’s objection to the items requested therein is overruled and Plaintiff is to produce and have at the deposition the contracts entered into between Plaintiff and any insurer, third-party administrator, employer workers’ compensation provider and any governmental agency in effect for the years 2008, 2009 and 2010.
10. As to items numbered 9 and 10 of the duces tecum, Plaintiff’s objections thereto are overruled Plaintiff shall produce and have at the deposition all documents requested therein for a period of 6 months predating the dates of service at issue in this matter through and including 6 months following the dates of service at issue in this matter.
11. Defendant agreed to withdraw items numbered 25, 26 and 27 from the duces tecum.
12. Plaintiff reserved its right to produce a burdensome affidavit as to the production of the documents sought in the duces tecum. The Court agrees that Plaintiff has such a right, however, directs the parties to address that issue before the Court should it arise and such issue must be addressed prior to the commencement of any deposition of the plaintiff’s corporate representative.
13. Consequently, this Court hereby finds that Plaintiff’s Motion for Protective Order is hereby GRANTED in part and DENIED in part, consistent with the foregoing rulings.
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