First DCA Defines Scope of Enforcement Provision Available to Insurers Under PIP
In Shands Jacksonville Medical Center, Inc. v. State Farm Mutual Automobile Ins. Co., Case No. 2D14-2001 (Fla. 1st DCA 2015), the 1st DCA overturned the trial court’s discovery order, because it was an abuse of discretion and exceeded the scope of discovery allowable under sections 627.736(6)(b) and (c), F.S., which is part of the PIP law. State Farm had paid Shands for medical services provided to 29 insureds, after which, State Farm requested information regarding the treatment invoices. Shands sent State Farm a variety of documents. However, Shands did not comply with State Farm’s request for confidential contracts between Shands and 37 health insurers, which contain negotiated discount rates from its regular charges with those third parties. In the case below, State Farm requested those contracts, and theright to depose certain Shands employees. The trial court ordered Shands to produce the contracts and a corporate representative for deposition.
The appellate court held, in reversing the order:
[W]e disagree with the trial court’s conclusion that the “discovery of facts” referred to in section 627.736(6)(c), … allows discovery under the entirety of section 627.736, including the types of evidence that may be considered when determining the reasonable reimbursement rate for medical bills presented for treatment referred to in section 627.736(5)9a). Rather, we hold that this reference to discovery applies only to the types of information a healthcare provider is required to provide as delineated in section 627.736(6).
Also, the 1st DCA certified conflict with Kaminester v. State Farm Mutual Automobile Ins. Co., 775 So.2d 981 (Fla. 4th DCA 2000), to the extent that “it holds that the ‘discovery of facts’ referred to in section 627.736(6)(c), Florida Statutes, means that the discovery methods provided for in the Florida Rules of Civil Procedure are available to insurers that institute proceedings pursuant to that statute.”