22 Fla. L. Weekly Supp. 155a
Online Reference: FLWSUPP 2201BLACInsurance — Personal injury protection — Discovery — Because medical provider’s negotiated insurance and reimbursement contracts and reimbursement data are necessary to dispute reasonableness of provider’s charges, provider’s trade secret objections do not bar discovery so long as court take measures to ensure confidentiality — Confidentiality measures are specified
MEDPAPER, LLC A/A/O Al IMAGING CENTERS, LLC (A/A/O SYLVIA BLACKSHIRE), Plaintiff, vs. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 13-323 COCE 56. July 2, 2014. Linda R. Pratt, Judge. Counsel: Russell Lazega and James Underwood, Florida Advocates; and Ronald Hock, In-house counsel for A1 Imaging Centers, for Plaintiffs. Brett J. Roth and David Bender, Matt Hellman, P.A., Plantation, for Defendants.
AMENDED ORDER ON DEFENDANT’S MOTIONTO OVERRULE PLAINTIFF’S OBJECTIONS TODEFENDANT’S INTERROGATORIES NUMBERS 7, 8, 9AND 13; AND MOTION TO OVERRULE PLAINTIFF’SOBJECTIONS TO DEFENDANT’S REQUESTTO PRODUCE NUMBERS 1, 4, 9, AND 10AND ORDER ON PLAINTIFF’S ORETENUS MOTION TO CONSOLIDATE DISCOVERYAS TO THE ABOVE MOTIONS FOR ALL CASESBETWEEN THE SAME PARTIES ANDTHEIR RELATED ENTITIES IN THIS DIVISION
THIS CAUSE having come to be heard on June 13, 2014 before the Court on Defendant’s Motion To Overrule Plaintiff’s Objections to Defendant’s Interrogatories Number 7, 8, and 9 and Defendant’s Motion to Overrule Plaintiff’s Objections to Defendant’s request to Produce Numbers 1, 4, 9, and 10, and on Plaintiff’s Ore Tenus Motion to Consolidate Discovery as to the Above Motions for all cases between the same parties and their related entities in this Division, and the Court having heard argument of counsel, having reviewed relevant legal authority and being sufficiently advised in the premises, finds as follows:
BACKGROUND
This lawsuit arises out of a breach of contract action for Personal Injury Protection (“PIP”) Benefits regarding MRI services rendered by the Al Imaging Centers, LLC to Sylvia Blackshire. After the services were rendered, but prior to the initiation of this lawsuit Al Imaging Centers, LLC transferred its rights to collect for the MRI services at issue to its sister corporation Medpaper, LLC. Medpaper then brought this action against State Farm seeking additional funds for the MRI services provided by Al Imaging Centers. The issue remains whether the medical services provided by the Plaintiff were reasonable in price.
Defendant propounded discovery upon Plaintiff including interrogatories and a request to produce seeking documents and information relating to Plaintiff’s reimbursement contracts and the amounts Plaintiff has agreed to accept and has accepted for the same CPT code(s) at issue. In response, Plaintiff raised various objections to the aforementioned requests and interrogatories. Defendant was unsatisfied with Plaintiff’s responses and filed its Motion to overrule Plaintiff’s objections. On April 8, 2014, after hearing, the Court overruled Plaintiff’s objections to Defendant’s Interrogatories 7, 8 and 9 and overruled Plaintiff’s objections to Requests to Produce numbers 1, 4, and 9, and ordered the parties to negotiate a confidentiality agreement in good faith in order to protect and preserve Plaintiff’s claimed trade secrets. The parties were unable to reach an agreement and Plaintiff requested that this Court rehear the matter at a global hearing to cover all cases between these same parties and their related entities with litigation before this division. Currently there are over 75 cases pending before this division between these same parties or their related entities in which the reasonableness of pricing for MRI services provided by Al Imaging Centers are at issue. The Court having granted Plaintiff’s request for a global hearing, which occurred on June 13, 2014 now issues this uniform discovery order which shall apply to all cases before this division and listed in Exhibit A attached to this Order.
CONCLUSIONS OF LAW
Plaintiff has the burden of establishing that the MRI services at issue are reasonable. See Allstate Ins. Co. v. Derius, 773 So.2d 1190 (Fla. 4th DCA 2000) 25 Fla. L. Weekly D2730a.
Fla. Stat. §627.736(5)(a)(1) defines a “reasonable” charge as follows:
In no event, however, may such a charge be in excess of the amount the person or institution customarily charges for like services or supplies. 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 [1] usual and customary charges and payments accepted by the provider involved in the dispute, and [2] reimbursement levels in the community and [3] various federal and state medical fee schedules applicable to automobile and other insurance coverages, and [4] other information relevant to the reasonableness of the reimbursement for the service, treatment, or supply.
“What a provider customarily charges or has previously accepted are important factors for determining whether a fee is reasonable”. Allstate Insurance Company v. Holy Cross Hospital, Inc., 961 So. 2d 328, 334 (Fla. 2007) [32 Fla. L. Weekly S453a]. See Also, Pembroke Pines MRI a/a/o Elixardo Ramirez v. United Auto. Ins. Co., 20 Fla. L. Weekly Supp. 629a (Fla. Broward Cty. Ct. 2013) (J. Robert W. Lee).
The Fourth District, In Columbia Hosp. (Palm Beaches) Ltd. P’ship v. Hasson, 33 So. 3d 148 (Fla. 4th DCA 2010) [35 Fla. L. Weekly D551a], also found that what a provider accepts for the same services is relevant and discoverable in a case where the reasonableness of the provider’s charges was at issue. In Columbia Hosp., the plaintiff filed an automobile negligence suit alleging that she suffered bodily injuries in connection with the accident and incurred medical expenses, including expenses for a procedure performed at the hospital. The defendants sought discovery from the hospital concerning that particular procedure, including the amount the hospital has charged patients with and without insurance, those with letters of protection, and differences in billing for litigation patients versus non-litigation patients. The hospital moved for a protective order, asserting that the information was confidential and amounted to protected trade secrets under Florida law. The defendants conceded the information was protected as trade secrets but argued that discovery of a hospital’s charges and discounts to different classes of patients, its internal cost structure, and what a health care provider accepts as payment from private non-litigation payors, was relevant for a jury to determine the reasonable charge for the procedure. The Fourth District agreed, concluding that “Defendants sufficiently explained below why they needed the information: in order to dispute, as unreasonable, the amount of medical expenses that the plaintiff will seek to recover from them, if the hospital charges non-litigation patients a lower fee for the same medical services.” Id. at 150. The Fourth District noted that [as in PIP cases] a claimant for damages for bodily injuries has the burden of proving the reasonableness of his or her medical expenses. Id. The court next addressed Columbia Hospital’s claims of trade secrecy. The trial court ordered the discovery but had simply denied the hospital’s motion for protective order without taking measures to protect the hospital’s claimed trade secrets. The Fourth District “conclude[d] that the hospital [was] entitled to relief only insofar as the trial court should have stayed the discovery until the parties had an opportunity to negotiate a confidentiality agreement. [Then] [i]n the event the parties are unable to agree, the trial court shall narrowly tailor any order requiring disclosure in such a way as to protect the hospital’s trade secret interests.” Id at 151. See also, State Farm Mutual Automobile Insurance Company v. Shands Jacksonville Medical Center, Inc., Case No. 16-2012-CA-011452-XXXX (Fla. Duval Cir. Ct. April 11, 2014) (J. Waddell A. Wallace) (In a petition for discovery under F.S. 627.736(6)(b) where the reasonableness of the provider’s charges were at issue, State Farm sought discovery of the provider’s 37 managed care/insurance payer contracts and the Court overruled the provider’s objections, including trade secrecy, ordering the production of the provider’s contracts subject to a contemporaneously entered confidentiality order).
The parties in these cases raise the same issues and arguments which were presented in Columbia Hosp. and Shands, and this Court finds the analysis by those courts convincing and instructive. The discovery sought by State Farm in these cases is the same as that sought by the Defendant in Columbia Hosp. and the Petitioner in Shands. Medpaper and Al Imaging Centers raise the same objections as those raised by Columbia Hospital and Shands. Based on the above, this Court finds that requested discovery of the medical provider’s negotiated insurance and reimbursement contracts, and reimbursement data is necessary to dispute the reasonableness of the provider’s charges and that Medpaper and Al Imaging Centers objections of trade secrecy do not bar such discovery so long as the Court takes measures to ensure confidentiality. See Columbia Hosp., at 151.
Therefore for the reasons stated, the Court ORDERS as follows:
1. Medpaper, LLC shall provide complete and verified answers to Defendant’s Interrogatories numbers 7, 8 and 9 in the above styled case within 45 days of the date of this Order, subject to protections described below.
2. Medpaper, LLC shall produce all documents and records responsive to Defendant’s Requests to Produce number 1, 4, and 9, in the above styled case within 45 days of the date of this Order subject to protections described below. Plaintiff shall conduct a diligent search, including a search of computer and email systems, to ensure that those documents and records which are responsive to the requests are produced.
3. Within 45 days of the date of this Order Medpaper, LLC and A1 Imaging Centers, LLC shall provide Defendants with a copy of the medical billing report for each CPT code at issue in the cases before this division, generated using Al Imaging Centers’ billing software. The report may be further limited to dates of service ranging from January 1, 2008 to December 31, 2012, and provided in the state of Florida. In lieu of producing a broad report ranging from dates of service January 1, 2008 to December 31, 2012, Plaintiff shall have the option to produce a report containing the required information for a date range of 15 days before and 15 days after each date of service listed in the attached case list exhibit. Said report shall include the following details:
a) procedure code performed
b) date of service
c) amount billed
d) amount(s) paid
e) date of payment(s)
f) method of payment(s)
g) Payor (however this field is subject to the additional protections as outlined in ¶5 below)
4. Within 45 days of the date of this order, Medpaper, LLC and Al Imaging Centers, LLC shall provide Defendants with complete copies of each of Al Imaging Centers contracts (including any fee schedules) in effect at any point January 1, 2008 to December 31, 2012, relating to payment for MRI services in the state of Florida. (The above includes contracts/agreements with any automobile insurer, health insurers, worker’s compensation insurer, commercial insurer, federal agency, State agency, disability insurer, health maintenance organization, preferred provider organization, exclusive provider organization, and any other commercial payor with which Al Imaging Centers has contracted concerning reimbursement for MRI services in the state of Florida). Medpaper, LLC and A1 Imaging Centers, LLC may redact reimbursement rates for CPT codes not at issue in the cases before this division.
5. In place of any contracted payor name (e.g. Blue Cross, Aetna, Cigna, etc.), and individual patient names, or other information which would identify any payor for which trade secrecy or personal/individual privacy is a concern, Medpaper and/or Al Imaging Centers may redact and replace such information with some non-identifying code (Ex. HMO 1, HMO 2, PPO 1, PPO2, and Workers Compensation Carrier 1, Patient, Cash Payor, Insurance Company 1). This provision applies to both interrogatory answers and production of documents/records, and Plaintiff shall use the same code when responding to all requests.
6. State Farm has agreed to be bound by a confidentiality order, so the claim of trade secrecy is not a bar to discovery as discussed above. Since, the parties have been unable to agree on the terms of a confidentiality agreement, the Court shall enter a narrowly tailored Confidentiality Order, to be issued contemporaneously with this Order.
__________________EXHIBIT A
| Style | Case Number |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Burrell, Articia) | 13-00325 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Sylvestre, Lesly) | 13-00318 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Sinclair, Gloria A.) | 13-00254 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Fernandez, Jacqueline) | 13-00306 COCE 56 |
| MedPaper, LLC, as assignee of Al Imaging Centers, LLC, (a/a/o Valmond, Guerold) | 13-00313 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Mojica-Valdez, Arturo) | 13-00328 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Binder, Jeffrey) | 13-00326 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Szymanski, Mary Ann) | 12-23553 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o O’Connor, Barry) | 13-00329 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Cruz, Susan) | 13-00338 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Chenail, Trisha) | 13-00236 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Welch, Alexandra) | 13-00226 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Villalobos, Jessica) | 13-00229 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Cox, Henry M.) | 13-00339 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Smith, Tiffany) | 12-23527 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Teixeira, Crystal) | 12-23554 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Morgan, Amber) | 12-23677 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Schumacher, Lynn) | 13-00214 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Wines, Mary) | 13-00225 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Villanueva, Guillermina) | 13-00227 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Jackson, James) | 13-00244 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Gibson, Stephanie) | 13-00245 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Torsanko, Grace) | 13-00250 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Stocks, Peter) | 13-00255 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Hall, Robert 2) | 13-00263 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Fish, Angela) | 13-00267 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Bartlett, Thomas) | 13-00320 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Mathlin, Allan) | 13-00340 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Colon, Belinda) | 13-00341 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Ludwig, Derek) | 13-00342 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Valentin, Brenda) | 13-00248 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Stefanko, Edward) | 12-23530 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Swartz, Karin) | 12-23531 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Timmons, Angelique) | 12-23555 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Vega, Peter) | 12-23557 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Keller, Noris) | 12-23558 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Green, Micheal) | 12-23559 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Marmo, Matthew) | 12-23670 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Samuels, Kendall) | 13-00294 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Esperance, Richard) | 13-00336 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Silverman, Dale) | 13-00210 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Shepard, Briana) | 13-00212 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Santos, Berta) | 13-00216 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Orlosky, Judith) | 13-00222 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Coleman, Valerie) | 13-00238 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Lippe, Gregg) | 13-00297 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Jones, Akeem) | 13-00299 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Castelar, Josephine) | 13-00309 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Zamor, Joseph) | 13-00314 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Bethea, Valerie) | 13-00321 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Blackshire, Sylvia) | 13-00323 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Mehaffie, Kimberly | 13-00327 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Fells, Altonia) | 13-00335 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Lopez, Efrain) | 13-00343 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Weintraub, Caren) | 11-27669 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Trento, Alexandra) | 11-27671 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Stachurski, Sonia S.) | 11-27673 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Truman, Charles R.) | 11-27660 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Samuels, Gennean) | 11-27933 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Rojas, Eberto) | 11-27655 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Philius, Roselore P.) | 11-27658 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Orozco, Humbert) | 11-27667 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Nemeth-Smith, Margaret) | 11-27676 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Benbow, Patrice) | 11-27690 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Becerra, Gabriel) | 11-27693 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Balbino, Magno) | 11-27697 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Bailey, Vincent) | 11-27700 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Bien-Aime, Gina) | 11-27709 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Garraud, Chantal) | 11-27717 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Phillips, Catherine M.) | 11-27930 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Mincey, Africa K.) | 11-27945 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Bienaime, Celendieu) | 11-27947 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Powell, Douglas D.) | 11-27949 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Martes, Lourdes) | 11-27951 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Ortiz, Derrick) | 11-27988 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Kim, Ray H.) | 11-28002 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Mills, Ramsey) | 11-28005 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Gordon, Thelma) | 11-28007 COCE 56 |
__________________CONFIDENTIALITY ORDER
This Confidentiality Order is entered in conjunction with the Court’s Order regarding Defendant’s request for discovery of potentially trade secret and confidential information from the Plaintiffs, Medpaper, LLC, and Al Imaging Centers, LLC, which includes negotiated insurance and reimbursement contracts, and reimbursement data. To the extent that any documents or information is ordered to be produced by Medpaper, LLC, or Al Imaging Centers, LLC by this Court, and it is hereby, ORDERED as follows:
1. Designation of Material as “CONFIDENTIAL”:
Plaintiff shall specifically identify any such documents(s), or portion of such document(s), including deposition testimony (if any) discussing this same type of information, for which it seeks protection by marking such records as “CONFIDENTIAL”. Any health care payor contracts, and reimbursement / charge reports produced pursuant to this order shall be presumed confidential and subject to this order. Within 30 days of receipt of any deposition transcript Plaintiff shall notify Defendant in writing of the page and lines of any testimony for which it seeks protection as trade secret.
2. Permitted Use by Recipients:
“CONFIDENTIAL” information pursuant to the terms of this order may be used and/or disclosed by Defendant and counsel only for the limited purposed of the defense, prosecution, and settlement of this action and any related proceeding/litigation in this division between the same parties (or their related entities, e.g. Medpaper, LLC, A1 Imaging Centers, LLC, Consolidated Healthcare Services, LLC, State Farm Mutual Automobile Insurance Company, State Farm Fire & Casualty Company, and State Farm General Insurance Company (See attached case list in Exhibit A)), including any appeals.
3. Permitted Recipients:
Disclosure in accordance with this Order may only be made to the following categories of individuals:
a. The Court in this and any related proceeding, including the Court’s staff, and clerks offices.
b. Court reporters or videographers, if any, provided that such individuals not retain copies of any such documents produced by the Plaintiffs.
c. Counsel for the parties, in cases in this division, including their employed legal assistants, paralegals, and any support staff only for the purposes stated above,
d. No more than three (3) designated employees of the Defendants for the purposes stated above.
e. Consulting or testifying experts, including their clerical assistants and support staff.
f. Jurors in this any and any related proceeding/litigation.
g. Testifying witnesses in this any and any related proceeding//litigation to which such disclosure is necessary.
4. Agreements to be Bound:
Other than the Court, the Court’s and Clerk’s staff, Jurors, each person identified in the paragraphs to whom CONFIDENTIAL information may be disclosed, specifically including employees of the Defendant and its related entities and employees of its consulting or testifying experts, shall execute an acknowledgment and shall agree to be bound by this order before such CONFIDENTIAL material is disclosed. Such acknowledgment shall include a statement that the person to whom disclosure is to be made agrees to abide by this Order and consents to being subject to sanctions, including but not limited to contempt from this Court if such person violates the terms of this order. Copies of any executed agreements to be bound shall be given to Plaintiff’s counsel prior to disclosure to any particular individual.
5. Duty of Permitted Recipients:
That Permitted Recipients shall take all necessary and lawful action to prevent disclosure of materials designated as CONFIDENTIAL to any other person except as permitted by the terms of this Order.
6. Filing of protected documents under seal:
The parties may file under seal, as necessary, pleadings, exhibits, discovery or other documents which include or reference to CONFIDENTIAL information without need for separate order to seal the record being entered by this Court. Such documents to be filed under seal in this case shall be clearly marked and state; “CONFIDENTIAL INFORMATION; FILED UNDER SEAL PER COURT ORDER DATED _____/_____/_____, CASE NO.: ______________”.
7. Challenges to Designation:
The Defendant may, upon proper motion, challenge whether or not any document or testimony designated as “CONFIDENTIAL” is entitled to protection under this order.
8. Duration:
This Order shall survive the conclusion of this proceeding and remain in full force and effect until vacated or modified by further order of this Court or by written agreement of the parties. This Court shall retain jurisdiction to modify or enforce this Order.
__________________EXHIBIT A
| Style | Case Number |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Burrell, Articia) | 13-00325 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Sylvestre, Lesly) | 13-00318 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Sinclair, Gloria A.) | 13-00254 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Fernandez, Jacqueline) | 13-00306 COCE 56 |
| MedPaper, LLC, as assignee of Al Imaging Centers, LLC, (a/a/o Valmond, Guerold) | 13-00313 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Mojica-Valdez, Arturo) | 13-00328 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Binder, Jeffrey) | 13-00326 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Szymanski, Mary Ann) | 12-23553 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o O’Connor, Barry) | 13-00329 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Cruz, Susan) | 13-00338 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Chenail, Trisha) | 13-00236 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Welch, Alexandra) | 13-00226 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Villalobos, Jessica) | 13-00229 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Cox, Henry M.) | 13-00339 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Smith, Tiffany) | 12-23527 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Teixeira, Crystal) | 12-23554 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Morgan, Amber) | 12-23677 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Schumacher, Lynn) | 13-00214 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Wines, Mary) | 13-00225 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Villanueva, Guillermina) | 13-00227 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Jackson, James) | 13-00244 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Gibson, Stephanie) | 13-00245 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Torsanko, Grace) | 13-00250 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Stocks, Peter) | 13-00255 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Hall, Robert 2) | 13-00263 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Fish, Angela) | 13-00267 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Bartlett, Thomas) | 13-00320 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Mathlin, Allan) | 13-00340 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Colon, Belinda) | 13-00341 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Ludwig, Derek) | 13-00342 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Valentin, Brenda) | 13-00248 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Stefanko, Edward) | 12-23530 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Swartz, Karin) | 12-23531 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Timmons, Angelique) | 12-23555 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Vega, Peter) | 12-23557 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Keller, Noris) | 12-23558 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Green, Micheal) | 12-23559 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Marmo, Matthew) | 12-23670 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Samuels, Kendall) | 13-00294 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Esperance, Richard) | 13-00336 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Silverman, Dale) | 13-00210 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Shepard, Briana) | 13-00212 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Santos, Berta) | 13-00216 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Orlosky, Judith) | 13-00222 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Coleman, Valerie) | 13-00238 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Lippe, Gregg) | 13-00297 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Jones, Akeem) | 13-00299 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Castelar, Josephine) | 13-00309 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Zamor, Joseph) | 13-00314 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Bethea, Valerie) | 13-00321 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Blackshire, Sylvia) | 13-00323 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Mehaffie, Kimberly | 13-00327 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Fells, Altonia) | 13-00335 COCE 56 |
| MedPaper, LLC, as assignee of A1 Imaging Centers, LLC, (a/a/o Lopez, Efrain) | 13-00343 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Weintraub, Caren) | 11-27669 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Trento, Alexandra) | 11-27671 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Stachurski, Sonia S.) | 11-27673 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Truman, Charles R.) | 11-27660 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Samuels, Gennean) | 11-27933 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Rojas, Eberto) | 11-27655 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Philius, Roselore P.) | 11-27658 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Orozco, Humbert) | 11-27667 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Nemeth-Smith, Margaret) | 11-27676 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Benbow, Patrice) | 11-27690 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Becerra, Gabriel) | 11-27693 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Balbino, Magno) | 11-27697 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Bailey, Vincent) | 11-27700 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Bien-Aime, Gina) | 11-27709 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Garraud, Chantal) | 11-27717 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Phillips, Catherine M.) | 11-27930 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Mincey, Africa K.) | 11-27945 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Bienaime, Celendieu) | 11-27947 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Powell, Douglas D.) | 11-27949 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Martes, Lourdes) | 11-27951 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Ortiz, Derrick) | 11-27988 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Kim, Ray H.) | 11-28002 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Mills, Ramsey) | 11-28005 COCE 56 |
| A1 Imaging Centers, LLC, (a/a/o Gordon, Thelma) | 11-28007 COCE 56 |
* * *
