March 15, 2016

GBI Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2016 NY Slip Op 50329(U))

Headnote

The main issue in this case was whether State Farm Mutual Automobile Insurance Co. had properly used the workers' compensation fee schedule applicable to chiropractors who render the same services as acupuncturists to reimburse GBI Acupuncture, P.C. for the acupuncture services it had rendered. The court considered the argument from GBI Acupuncture, P.C. that State Farm failed to establish that its fee schedule reductions were proper. However, the court disagreed with GBI Acupuncture, P.C. and found that State Farm had demonstrated that it had fully paid GBI Acupuncture, P.C. for the services at issue in accordance with the workers' compensation fee schedule for acupuncture services performed by chiropractors. As a result, the court affirmed the order granting State Farm's motion for summary judgment dismissing the complaint.

Reported in New York Official Reports at GBI Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2016 NY Slip Op 50329(U))

GBI Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co. (2016 NY Slip Op 50329(U)) [*1]

GBI Acupuncture, P.C. v State Farm Mut. Auto. Ins. Co.

2016 NY Slip Op 50329(U) [50 Misc 3d 148(A)]

Decided on March 15, 2016

Appellate Term, Second Department

Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.

This opinion is uncorrected and will not be published in the printed Official Reports.

Decided on March 15, 2016

SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS

PRESENT: : PESCE, P.J., ALIOTTA and ELLIOT, JJ.
2013-1477 K C

GBI Acupuncture, P.C., as Assignee of Brenetta Selver, Appellant,
against
State Farm Mutual Automobile Ins. Co., Respondent.

Appeal from an order of the Civil Court of the City of New York, Kings County (Robin S. Garson, J.), entered April 30, 2013. The order granted defendant’s motion for summary judgment dismissing the complaint.

ORDERED that the order is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, defendant moved for summary judgment dismissing the complaint, arguing that it had properly used the workers’ compensation fee schedule applicable to chiropractors who render the same services as acupuncturists to reimburse plaintiff for the acupuncture services plaintiff had rendered. The Civil Court granted defendant’s motion.

Plaintiff argues on appeal, as it did in the Civil Court, that defendant failed to establish that its fee schedule reductions were proper. We disagree and find that defendant demonstrated that it had fully paid plaintiff for the services at issue in accordance with the workers’ compensation fee schedule for acupuncture services performed by chiropractors (see Great Wall Acupuncture, P.C. v Geico Ins. Co., 26 Misc 3d 23 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2009]).

Accordingly, the order is affirmed.

Pesce, P.J., Aliotta and Elliot, JJ., concur.

Decision Date: March 15, 2016