ROIG Managing Partner Wins Suit on Summary Judgment

May 12, 2016

Michael A. Rosenberg, managing partner of ROIG Lawyers, successfully argued that a healthcare clinic wholly owned by a licensed massage therapist does not qualify for any exemptions under state law and therefore must obtain a Health Care Clinic license to receive reimbursement.

Rosenberg was granted summary judgment on a lawsuit he filed on behalf of Imperial Fire and Casualty. Rosenberg’s motion argued that Imperial did not have to pay Finlay Diagnostic Center for services performed there because Finlay could not lawfully collect personal injury protection (PIP) benefits.

Imperial issued a policy to Hector Maury that covered the benefits of two patients injured in an automobile accident. Finlay, a medical healthcare clinic, treated the two patients and then sought reimbursement from Imperial for the services.

Rosenberg argued that Finlay was not eligible to collect PIP benefits. Finlay was not licensed as a healthcare clinic but had obtained a Certificate of Exemption from the Agency for Health Care Administration (AHCA) in 2010. Finlay was exempted at that time because it was wholly owned by a licensed massage therapist. In 2012, however, the Florida Legislature repealed AHCA exemptions for massage therapists and other practitioners, meaning they could no longer bill for PIP services unless a new exemption in the PIP statutes was met.

The Miami-Dade Circuit judge ruled that Finlay was a clinic wholly owned by a licensed massage therapist that did not qualify for any state exemptions. Finlay never obtained a Health Care Clinic license, so the court ruled the charges submitted for Imperial are unlawful. Thus the court granted the Motion for Summary Judgment in favor of Imperial.