7 Fla. L. Weekly Supp. 542b
Insurance — Insurer’s motion for summary judgment granted as to health care provider who submitted $1,500 bill for services which were performed in his office by third party without his supervision, direction or control and for which third party billed provider $100
CHRISANTHY MAYER, Plaintiff, v. STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY, Defendant. County Court, 6th Judicial Circuit in and for Pinellas County. Case No. 99-003710-CO-041. May 8, 2000. Myra Scott McNary, Judge. Counsel: David G. Henry, Santos, Dutton, Lynott & Henry, P.A., Tampa. Peter T. Roman.
ORDER ON DEFENDANT’S MOTION FOR PARTIAL SUMMARY JUDGMENT
THIS CAUSE having come on to be heard on February 14, 2000, on Defendant, STATE FARM MUTUAL AUTOMOBILE INSURANCE COMPANY’S, Motion for Partial Summary Judgment and the court having heard argument of counsel and being fully advised in the premises, the Court therefore makes the following findings of fact:
1. That Dr. McKnight submitted a HCFA form to the Defendant indicating that he had rendered medical services to Ms. Mayer when in fact that was not the case. Rather, the subject medical services were performed by H & R Neurodiagnostic Services, Inc. (“H&R Neurodiagnostic”).
2. That it undisputed that the services performed by H & R Neurodiagnostic, although performed in Dr. McKnight’s office, were performed without Dr. McKnight’s supervision, direction or control.
3. That the services at issue were provided by H & R Neurodiagnostic staff, and that no staff of Dr. McKnight participated in the rendering of this testing.
4. That Dr. McKnight was billed by H & R Neurodiagnostic $100.00 for the services provided by H & R Neurodiagnostic.
5. That Dr. McKnight in turn billed the insurance carrier $1,250.00 and for this that he did not render any medical services as it relates to this bill.
It is therefore ORDERED AND ADJUDGED:
The Court finds as a matter of public policy that it is inappropriate for a provider to bill $1,150.00 for a service for which he was billed and paid $100.00 where he had absolutely nothing to do with the services rendered.
As a matter of public policy, the Court is of the opinion that it is fraud on the insurance carrier for the provider to bill the insurance carrier for the services at issue, given the fact that the provider neither rendered the services, supervised the services, and that no one on the doctor’s staff was involved in this testing or service.
The Court further finds that Dr. McKnight’s bill was unreasonable as a matter of law and that Defendant had reasonable proof to establish that it was not responsible for payment of said bill.
Accordingly, the Motion for Partial Summary Judgment filed by the Defendant, as to Dr. McKnight, is GRANTED.
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