22 Fla. L. Weekly Supp. 480b
Online Reference: FLWSUPP 2204STINNOT FINAL VERSION OF OPINION
Subsequent Changes at 22 Fla. L. Weekly Supp. 931aInsurance — Personal injury protection — Discovery — Depositions — Scope of inquiry regarding reimbursement levels in community and documents to be produced at deposition of insurer’s corporate representative
HERNANDO HMA, LLC, D/B/A BROOKSVILLE REGIONAL HOSPITAL, (ASSIGNEE OF STINNETT, BILLY), Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 5th Judicial Circuit in and for Hernando County. Case No. SC-13-188. October 24, 2014. Donald McCathran, Jr., Judge. Counsel: Robert B. Goldman, Florida Advocates, Dania Beach, for Plaintiff.
ORDER GRANTING PLAINTIFF’S MOTIONTO COMPEL DEFENDANT TO PRODUCE AREPRESENTATIVE TO TESTIFY REGARDINGREIMBURSEMENT LEVELS IN THE COMMUNITYAND TO PRODUCE A REPORT EVIDENCING THECHARGES OF OTHER HOSPITALS IN THE COMMUNITYAND REIMBURSEMENT LEVELS IN THE COMMUNITY;AND TO REQUIRE ANSWERS TO DEPOSITIONQUESTIONS CONCERNING REASONABLENESS
THIS CAUSE having come before the Court on October 20, 2014 upon the motion of the Plaintiff, HERNANDO HMA, LLC d/b/a BROOKSVILLE REGIONAL HOSPITAL (a/a/o Stinnett, Billy) (“BROOKSVILLE”) to compel STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY (“STATE FARM”) to produce a corporate representative to testify regarding reimbursement levels in the community and answer questions concerning the issue of reasonableness of charges and produce a report evidencing reimbursement levels in the community, and the Court having heard argument of counsel and being otherwise fully advised, it is hereupon
ORDERED that BROOKSVILLE’s motion is GRANTED, as follows:
1. BROOKSVILLE shall be entitled to conduct the deposition of STATE FARM’s designated corporate representative or person with the most knowledge and conduct inquiry regarding reimbursement levels in the community of Hernando County, Florida (the “Community”), as reflected by:
a. the amounts which hospitals in the Community have charged STATE FARM for performing CPT Codes J1885, J2360, 72050, 90772 and 99283 (Modifier 25), the same CPT codes that are at issue in this case (the “Relevant CPT Code Procedures”), for procedures performed during the months of October and November of 2008;
b. the amounts which STATE FARM has allowed as reasonable, approved or authorized charges for hospitals in the Community who have billed STATE FARM for the Relevant CPT Code Procedures, for procedures performed during the months of October and November of 2008; and
c. the amounts which STATE FARM has paid hospitals in the Community who have billed STATE FARM for the Relevant CPT Code Procedures, for procedures performed for procedures performed during the months of October and November of 2008.
2. BROOKSVILLE shall prepare a new notice of taking deposition, designating the topics about which BROOKSVILLE intends to inquire at the deposition.
3. The deposition of STATE FARM’s designated corporate representative or person with the most knowledge shall be coordinated and scheduled between the parties’ counsel within thirty (30) days of October 20, 2014, and shall take place within ninety (90) days of October 20, 2014.
4. No later than ten (10) days in advance of the deposition of STATE FARM’s designated corporate representative or person with the most knowledge, STATE FARM shall produce a report using Decision Point software or similar software, reflecting the following information:
a. identification of hospitals located within the Community, who have performed the Relevant CPT Code Procedures during the months of October and November of 2008, and who have billed STATE FARM for those procedures;
b. the amounts charged by hospitals within the Community, for performing the Relevant CPT Code Procedures during the months of October and November of 2008;
c. the amounts allowed by STATE FARM as reasonable, approved or authorized charges for the Relevant CPT Code Procedures performed by hospitals within the Community, performed during the months of October and November of 2008; and
d. the amounts paid by STATE FARM to hospitals located within the Community, for the Relevant CPT Code Procedures, performed during the months of October and November of 2008.
5. Neither BROOKSVILLE, its agents and/or personnel, nor BROOKSVILLE’s counsel or its agents or personnel shall distribute or otherwise use the report identified in the preceding paragraph for purposes other than this lawsuit, pending further Order of this Court.
6. BROOKSVILLE’s motion for sanctions is DENIED.
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