County Civil Court: INSURANCE – PIP benefits – effective date of section 627.736(5)(b)(5), MRI billing and payment practices, is June 19, 2001 – appellant is unable to show beyond all reasonable doubt that this statute conflicts with some designation provision of the constitution – Legislature had a legitimate purpose for providing a separate method for MRI billing and payment practices – Order affirmed.  Gainesville Open MRI Center, Inc. v. Allstate Insurance Company, No. 03-0980CI-88B (Fla. 6th Cir. App. Ct. April 6, 2004). 

 

 

IN THE CIRCUIT COURT FOR THE SIXTH JUDICIAL CIRCUIT

IN AND FOR PINELLAS COUNTY, FLORIDA

APPELLATE DIVISION

 

GAINESVILLE OPEN MRI CENTER, INC.,

on behalf of Justin Sipe,

                        Appellant,

 

vs.                                                                                               Appeal No. 03-0980CI-88B

                                                                                                   UCN522003AP000980XXXXCV

ALLSTATE INSURANCE COMPANY,

                        Appellee.

_________________________________________/

 

Opinion filed _______________________

 

Appeal from Final Judgment

Pinellas County Court

County Judge Henry Andringa

 

Angela M. Stone, Esquire

Attorney for Appellant

 

Charles W. Hall, Esquire

Peter J. Valeta, Esquire

Attorneys for Appellee

 

 

ORDER AND OPINION

 

            THIS CAUSE came before the Court on appeal, filed by Gainesville Open MRI Center, Inc. (Gainesville), on behalf of Justin Sipe (Sipe), from the Final Judgment, entered November 18, 2002, in favor of Allstate Insurance Company (Allstate).  Upon review of the briefs, the record and being otherwise fully advised, the Court affirms the trial court’s ruling as set forth below.

            The underlying action arose from an automobile accident, on September 13, 2000, involving Sipe, who was covered under an insurance policy issued by Allstate that provided Personal Injury Protection (PIP) benefits.  Sipe sought medical treatment for his injuries.  On March 22, 2002, Gainesville filed a Complaint against Allstate alleging that Allstate had failed to pay for reasonable expenses incurred by Sipe, specifically for an MRI provided by Gainesville on August 24, 2001.  Gainesville submitted its charges of $1,200.00 to Allstate for payment.  In determining the amount to be paid to Gainesville, Allstate applied the newly enacted fee schedule pursuant to Senate Bill 1092, as codified in Laws of Florida 2001-271.  Allstate paid Gainesville $863.78, leaving a balance due of $336.22.

            Both parties filed competing Motions for Summary Judgment and a Joint Stipulation of Facts providing that the only issue for the trial court to determine was the effective date of Florida Statutes, § 627.736(5)(b)(5).  The trial court found that the effective date of the statute was June 19, 2001, and entered Final Judgment in favor of Allstate.  Upon stipulation of the parties, the trial court certified the following question as one of great public importance:  “whether the 2001 amendment to Section 627.736(5)(b)(5), Florida Statutes, enacted in Chapter 2001-271, became effective on June 19, 2001, the date that the act was signed by the Governor or on October 1, 2001, the date referenced in Section 11(3), Laws of Florida Chapter 2001-271?”  By Order of the Court, entered January 16, 2003, the Second District Court of Appeal declined to exercise its jurisdiction to review the certified question.

            On appeal before this Court, Gainesville raises four issues:  (1) must a statute be considered in its entirety when interpreting one section of it; (2) does a trial court have to consider a memorandum which interprets a statute, when the memorandum was written by a department that is not charged with enforcing the statute in question; (3) is it unconstitutional to interpret a statute to implement a price control for one type of diagnostic testing, but no other types of diagnostic testing, without a rational basis for doing so; and, (4) is it reversible error for a trial court to consider unauthenticated documents in ruling on a Motion for Summary Judgment. 

            In addressing the first two issues, the Court finds that the Third District Court of Appeal, in the case of State Farm Mutual Automobile Insurance Company v. West Gables Open MRI Services, Inc., 846 So.2d 538 (Fla. 3d DCA 2003), has squarely held that the effective date of section 627.736(5)(b)(5) is June 19, 2001.  As stated above, the Second District Court of Appeal declined to exercise its jurisdiction to review the identical issue and there are no other appellate court decisions on point.  Hence, this Court is obligated to follow the Third District’s West Gables holding in affirming the trial court’s Final Judgment.  See Chapman v. Pinellas County, 423 So.2d 578, 580 (Fla. 2d DCA 1982)(holding that the trial court is obligated to follow decisions of other District Courts of Appeal in the state in the absence of conflicting authority and where the appellate court in its own district has not decided the issue).  Further, in evaluating the fourth issue, the Court finds that to the extent to trial court relied on unauthenticated documents in making its decision, it is harmless error in view of the West Gables decision.  See Chrysler v. Dept. of Professional Regulation, 627 So.2d 31, 35 (Fla. 1st DCA 1993)(stating that an error is harmful where there is a reasonable probability that a different result would have been reached but for the error committed).

            In reviewing the merits of the third issue, the Court finds that Gainesville did argue that section 627.736(5)(b) was unconstitutional in its Memorandum of Law filed in support of its Motion for Summary Judgment.  However, this Court’s review is specifically limited to section 627.736(5)(b)(5), the subject of the underlying proceedings and this appeal.  Without citing to any supporting authority, Gainesville makes the general argument that the imposition of price controls for MRI services deprives medical providers of the right to freely enter into contracts with those who are in need of such services and that the statutory scheme fails to treat all providers of such services equally.  However, upon review of the statute and applicable law, the Court finds that Gainesville has failed to meet its burden of showing “beyond all reasonable doubt the statute conflicts with some designated provision of the constitution.”  See State Farm Mutual Automobile Insurance v. Warren, 805 So.2d 1074, 1077 (Fla. 5th DCA 2002).

            As recognized by the Fifth District Court of Appeal in Warren in evaluating a related PIP statute, section 627.736(5)(b), a “statutory classification need only bear some reasonable relationship to the achievement of a legitimate state purpose.”  Id.  The Court agrees with Allstate’s argument, which is premised on Warren, that the fee schedule set forth in section 627.736(5)(b)(5) is designed to prevent MRI billing abuses, which in turn lowers the costs upon which insurers base PIP premiums, ultimately benefiting insurance consumers.  Additionally, as observed by the Third District in West Gables, charges for MRI services stand alone in section 627.736(5)(b)(5), while subsections (1)-(4) provide for allowable amounts and fee schedules for other types of services.  See West Gables, 846 So.2d at 540, footnote 2 (finding no disharmony in 627.736(5)(b)(1)-(5)).  As MRI services are unique, the Court finds that the Legislature had a legitimate state purpose for providing a separate method for MRI billing and payment practices.  Compare with Warren, 805 So.2d at 1077 (finding that the Legislature had a legitimate state purpose for distinguishing between services provided by medical providers and services provided by hospital emergency departments and ambulance providers). Therefore, even though the effective date for other types of services encompassed under section 627.736(5)(b) is October 1, 2001, the Court cannot conclude that this difference deprives Gainesville of equal protection under the Florida Constitution.

 

            Therefore, it is,

            ORDERED AND ADJUDGED that the Final Judgment is affirmed.

            DONE AND ORDERED in Chambers, at St. Petersburg, Pinellas County, Florida this ________ day of April 2004. 

 

 

 

 

                                                                        ___________________________________

                                                                        DAVID A. DEMERS

                                                                        Circuit Judge, Appellate Division

 

 

 

 

 

 

 

 

Copies furnished to:

 

Judge Henry J. Andringa

 

Angela M. Stone, Esquire

1234 9th Street North

St. Petersburg, FL  33705

 

Charles W. Hall, Esquire

501 First Avenue North, Suite 900

St. Petersburg, FL  33701

 

Peter J. Valeta, Esquire

150 N. Michigan Avenue, Suite 2500

Chicago, IL 60601