On April 16, 2014, Roig Lawyers Partner, and Board Certified Trial Attorney, Jeff Tutan presented at the Medical Claims Defense Network Conference in Orlando, Florida. Jeff Tutan, head of the firm’s trial practice group, discussed his recent success at jury trial in a case involving a medical provider’s claim for reimbursement for “mobile x-ray” services. During the round table presentation, Attorney Tutan discussed how he, partner Jessica Martin, and senior associate attorney Jenna Hackman, successfully defended such a case involving these increasingly prevalent medical services.
For more information, contact attorney Jeff Tutan at email@example.com.
Plaintiff Milo Diagnostic Center filed suit against Defendant State Farm to recover PIP benefits for mobile x-rays provided to Pedro Barreto, a State Farm insured. According to Florida PIP Statute Section 627.732(2) (2006), only medically necessary services are covered. “Medical necessity” is defined as those services that a prudent physician would provide in a manner that is in accordance with generally accepted standards, clinically appropriate, and not primarily for the convenience of the patient or medical provider.
In a motion for summary judgment, State Farm argued against the medical necessity of such mobile x-rays in this case. State Farm presented evidence in the form of a deposition of a Department of Health expert that, pursuant to the Florida Administrative Code, mobile x-ray equipment is only to be used where it is impractical to transfer the patient to a stationary radiographic location. The reason for this caution is that the use of mobile machines results in increased radiation to the patient and inferior quality films. State Farm also relied upon an affidavit of a chiropractic doctor attesting that the use of mobile x-rays on Barreto was not medically necessary.
On November 12, 2013, Judge Jason E. Dimitris granted Defendant State Farm’s Motion for Summary Judgment regarding Medical Necessity. Judge Dimitris expressed the Court’s concern about the increased radiation exposure and poor quality films. Milo did not file a written response, but did appear at oral argument. Judge Dimitris held that since Milo did not produce counter-evidence sufficient to create a genuine issue of fact concerning the medical necessity for the use of mobile x-rays in this case, State Farm’s motion for summary judgment was granted and final judgment in the case was entered.
Click on the link to read the Judge’s order in Milo Diagnostic Center, Inc. vs. State Farm Fire & Casualty Co., No. 07-30146 SP 23 (4) (Fla. Miami-Dade Cty. Ct. 2013).
Contact partner Jessica Z. Martin via email or at 954-462-0330 to discuss any questions about the case.