12 Fla. L. Weekly Supp. 1036a
Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Fee-splitting — Patient brokering — Global billing by medical provider which performed technical component of MRI but contracted with independent radiologist to perform professional component — Where provider billed $250 for professional component of MRI services, and only professional services rendered were by independent radiologist who charged provider $50, payment sought by provider would result in fee-splitting and patient brokering — Remand with instructions to enter judgment in favor of insurer
PROGRESSIVE EXPRESS INSURANCE COMPANY, Appellant, vs. RADIOLOGY B & SERVICES, INC., Appellee. Circuit Court, 17th Judicial Circuit (Appellate) in and for Broward County. Case No. 04-8687 (12). L.T. Case No. 02-14193 (56). August 5, 2005. Counsel: Douglas Stein, J. Keith Ramsey, Miami, for Appellant. Steven Lander, Ft. Lauderdale, and Steven Goldsmith, for Appellee.
OPINION
(DORIAN DAMOORGIAN, J.) THIS CAUSE is before the Court on direct appeal from a final judgment in favor of Appellee. For the reasons stated below, the judgment of the County Court is Reversed.
On or about April 4, 2002, Robert Carter was involved in a motor vehicle accident. Mr. Carter had personal injury protection insurance coverage (“PIP”) with Progressive Insurance Company (“Progressive”). On May 23, 2003, Mr. Carter was referred to Radiology B & Services, Inc. (“Radiology”) for a magnetic resonance imaging (“MRI”) study. Radiology took MRI images of Mr. Carter’s spine and then sent the images to Dr. Robert Rivera, an independent contractor, to read and interpret the MRI films and render a report. Pursuant to an agreement with Radiology, Dr. Rivera was compensated $50.00 for reading the films. Radiology submitted its bill to Progressive Express Insurance Company (“Progressive”) for $250.00. Progressive denied the claim because Radiology was not the entity which rendered the services to its insured and its bill amounted to fee splitting contrary to §817.505, Florida Statutes.
Radiology filed a complaint in the County Court against Progressive under an assignment of benefits from Carter for the unpaid bill. Progressive moved for summary judgment, arguing, inter alia, that Radiology was not entitled to payment because the act of sending the films to an independent contractor was patient brokering and a fee-splitting arrangement in violation of §817.505, Fla. Stat. The trial court denied Progressive’s motion, and judgment was ultimately entered in favor of Radiology. This timely appeal follows.
The standard of review of this judgment is de novo, as the appeal is restricted to issues of law. Lowe v. Broward County, 766 So.2d 1199 (Fla. 4th DCA 2000).
Section 817.505, Fla. Stat., provides:
(1) It is unlawful for any person…to:
(b) Solicit, or receive any commission, bonus, rebate, kickback, or bribe, directly or indirectly, in cash or in kind, or engage in any split-fee arrangement, in any form whatsoever, in return for referring patients or patronage to a health care provide or health care facility.
It is undisputed that Radiology billed $250.00 for the professional component of the MRI services. It is further undisputed that the only professional services rendered were by Dr. Rivera and he charged $50.00 for those services. The payment sought by Radiology would result in fee splitting for the MRI service, with Radiology receiving $200.00 and Dr. Rivera receiving $50.00. In effect, Radiology would be receiving a referral fee of $200.00 per MRI study for brokering this patient to Dr. Rivera. Any such fee arrangement is against the public policy of this state and is specifically prohibited by §817.505, Fla. Stat.
Accordingly, the trial court erred by denying Progressive’s motion for summary judgment and entering judgment in favor of Radiology. This Court’s disposition on this issue renders appellant’s remaining issues on appeal moot.
Accordingly, it is hereby
ORDERED AND ADJUDGED that the final judgment in favor of Radiology B & Services, Inc., is RESERVED. This matter is REMANDED to the County Court with directions to enter judgment in favor of Progressive Express Insurance Company.
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