23 Fla. L. Weekly Supp. 639b
Online Reference: FLWSUPP 2306CABRInsurance — Personal injury protection — Discovery — Insurer is not entitled to discover agreements reflecting amounts accepted by medical provider as reimbursement from any payor, but must produce matrix reflecting amounts accepted for CPT codes at issue for six months surrounding dates of service and identifying payors by category and number — Provider need not produce documents evidencing amount, method of payment, and date of any patient’s 20% co-payment for CPT codes at issue
XTREME CHIROPRACTIC & REHAB, INC. (a/a/o CABRERA, JACK), Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 12-3610 COCE54. October 13, 2015. Stephen J. Zaccor, Judge. Counsel: Robert B. Goldman, Florida Advocates, Dania Beach, for Plaintiff.
ORDER ON DEFENDANT’S MOTION TOCOMPEL BETTER ANSWERS AND OVERRULEOBJECTIONS TO REQUEST TO PRODUCE
THIS CAUSE came before the Court on October 7, 2015 upon Defendant’s Motion to Compel Better Answers and Overrule Objections to request numbers 1, 6 and 13 of its Request for Production. The Court having considered the motion, the discovery requests and responses thereto and having heard argument of counsel, it is hereupon
ORDERED that the motion to compel is GRANTED in part and DENIED in part, and the objections are SUSTAINED in part and OVERRULED in part, as follows:
Request No. 1 — All agreements between You and any Payor in effect from six months before the first date of service through six months after the last date of service regarding the amount You charged and accepted for the Procedure Codes at issue.
Plaintiff’s Response to Request No. 1 —
Plaintiff objects to producing documents responsive to request no. 1 on the grounds that such documents are neither relevant nor reasonably calculated to lead to the discovery of admissible evidence regarding the reasonableness of Plaintiff’s charges for providing the relevant CPT Code Procedures (97010, 97012, 97016, 97035, 97110, 97112, 97124, 98940, 99203, 99213 and G0283) during the period of treatment (June 25, 2008 – October 27, 2008), nor are such documents relevant or reasonably calculated to lead to the discovery of admissible evidence regarding the relatedness or medical necessity of the treatment provided. See, e.g., Millenium Radiology, LLC d/b/a Millenium Open MRI (a/a/o Roberto Diaz) v. United Automobile Ins. Co., 22 Fla. L. Weekly Supp. 1100a (Broward County, Judge Stephen J. Zaccor, March 27, 2015) (“Negotiated contract rates, i.e., HMOs and PPOs are not relevant unless the insurer and provider in suit have entered into such a contract”). The requested documents are further objectionable, as they constitute or otherwise contain confidential, business proprietary and trade secret information. See Tri-County Accident Clinic (a/a/o Spencer Kermisch) v. State Farm Mutual Automobile Ins. Co., 22 Fla. L. Weekly Supp. 644a (Broward County, J. Martin Dishowitz, Oct. 30, 2014) Quantum Imaging Holdings (Gerome Baptelmy) v. United Automobile Ins. Co., 22 Fla. L. Weekly Supp. 142a, (Broward Cty, J. Peter Skolnik, June 17, 2014); Palms MRI Diagnostic Imaging Centers (a/a/o Frank Sirker) v. State Farm Mutual Automobile Ins. Co., 21 Fla. L. Weekly Supp. 1069a, (Broward County, Judge Louis Schiff, May 19, 2014); Gables MRA (a/a/o Teresa Morales) v. United Automobile Ins. Co., 22 Fla. L. Weekly Supp. 627a, (Miami-Dade County, J. Gloria Gonzalez-Meyer, August 10, 2012); Physicians Medical Center Jax, Inc. (a/a/o Janice Primiano) v. State Farm Mutual Automobile Ins. Co., 22 Fla. L. Weekly Supp. 706a (Duval County, Judge Eleni Derke, October 21, 2014); Physicians Medical Center Jax, Inc. (a/a/o Debra Royal) v. State Farm Mutual Automobile Ins. Co., 22 Fla. L. Weekly Supp. 456a (Duval County, Judge Scott Mitchell, Oct. 9, 2014); D. Badolato d/b/a Premier Urgent Care (a/a/o Gwendolyn Floyd) v. State Farm Mutual Automobile Ins. Co., 22 Fla. L. Weekly Supp. 399a, (Brevard County, Judge Majeed, Feb. 25, 2014).
Ruling
Plaintiff need not produce agreements between Plaintiff and any Payor regarding the amount Plaintiff charged and accepted for the Procedure Codes at issue. However Plaintiff shall provide a matrix reflecting the amounts Plaintiff charged and the amounts Plaintiff accepted for those Procedure Codes from Payors with which Plaintiff had agreements during the year 2008, identifying the Payors by category and number (i.e., HMO #1, HMO #2, PPO #1, PPO #2, etc.). Plaintiff shall produce the matrix within sixty (60) days from the date of this Order.
Request No. 6 — To the extent that You were paid by any Payor an amount less than the amounts You have charged for Procedure Codes at issue in this case, produce all documents reflecting the different amounts that You were paid from each such Payor from three months before the first date of service through one month after the first date of service.
Plaintiff’s Response to Request No. 6
Plaintiff objects to producing documents responsive to request no. 6 for the same reasons set forth in response to Request No. 1 above. In addition to those reasons, the request is further objectionable as over broad, unduly burdensome, vexatious, harassing and expensive. Pursuant to the relevant PIP statute applicable to this case, where PIP insurers are required to pay 80% of a reasonable charge, ALL PIP insurers’ payments would be less than the amounts Plaintiff charged for the procedure codes at issue in this case (97010, 97012, 97016, 97035, 97110, 97112, 97124, 98940, 99203, 99213 and G0283). Plaintiff does not have the capability to electronically retrieve the information requested, which would necessarily entail Plaintiff reviewing literally hundreds of files in order to retrieve and print/copy the responsive documents, after which Plaintiff would be required to redact confidential patient information data. This exercise would require 2-3 weeks of full time effort. Plaintiff is simply unable to devote such resources to such an undertaking.
Ruling
The matrix to be produced in response to request no. 1 shall be deemed responsive to request no. 6.
Request No. 13 — All documents evidencing the amount, method of payment and date received of any patient’s 20% co-payment for the Procedure Codes at issue from 6 months before the first date of service through 6 months from the last date of service.
Plaintiff’s Response to Request No. 13
Plaintiff objects to producing documents responsive to request no. 13 on the grounds that such documents are neither relevant nor reasonably calculated to lead to the discovery of admissible evidence regarding the reasonableness of Plaintiff’s charges for providing the relevant CPT Code Procedures (97010, 97012, 97016, 97035, 97110, 97112, 97124, 98940, 99203, 99213 and G0283) during the period of treatment (June 25, 2008 – October 27, 2008), nor are such documents relevant or reasonably calculated to lead to the discovery of admissible evidence regarding the relatedness or medical necessity of the treatment provided. See, e.g., Health Diagnostics of Miami, LLC d/b/a Stand-Up MRI of Miami (a/a/o Tawana Dixon) v. State Farm Mutual Automobile Ins. Co., 22 Fla. L. Weekly Supp. 1097b (Broward County, Judge John D. Fry, March 20, 2015) (information as to collection and receipt of the named assignor/patient’s 20% co-payment for the services at issue is “neither relevant to the subject matter of the pending action, nor reasonably calculated to lead to the discovery of admissible evidence”); Tri-County Accident Clinic, LLC (a/a/o Spencer Kermisch) v. State Farm Mutual Automobile Ins. Co., 22 Fla. L. Weekly Supp. 644a (Broward County, Judge Martin Dishowitz, October 30, 2014) (this category “bears no relationship to the issues raised in this case as framed by the pleadings”); Physicians Medical Center, Jax., Inc. (a/a/o Janice Bowman) v. Star Casualty Ins. Co., 23 Fla. L. Weekly Supp. 54a (Duval County, Judge Mose L. Floyd, Jan. 27, 2015) (“whether Plaintiff has collected co-payments or deductibles from other patients is similarly irrelevant as to the determination of whether the Plaintiff’s charges are reasonable”); Pompano Beach Pain & Rehabilitation, Inc. (a/a/o Felix Guzman) v. State Farm Mutual Automobile Ins. Co., 22 Fla. L. Weekly Supp. 375a (Miami-Dade County, Judge Lawrence D. King, Sept. 30, 2014) (“whether Plaintiff has collected co-payments or deductibles from other patients is similarly irrelevant and immaterial as to the determination of whether Plaintiff’s charges are reasonable”)
Ruling
The motion to compel a better answer is DENIED and Plaintiff’s objection is SUSTAINED. Plaintiff need not produce documents evidencing the amount, method of payment and date received of any patient’s 20% co-payment for the Procedure Codes at issue.
