December 19, 2014

Health Needles Acupuncture, P.C. v GEICO Ins. Co. (2014 NY Slip Op 51864(U))

Headnote

The court considered a dispute between Health Needles Acupuncture, P.C. and GEICO Ins. Co. regarding the reimbursement for acupuncture services rendered by Health Needles. The main issue was whether GEICO properly used the workers' compensation fee schedule applicable to chiropractors to reimburse Health Needles for the services rendered. The court held that GEICO had demonstrated that it had fully paid Health Needles for the services at issue in accordance with the workers' compensation fee schedule for acupuncture services performed by chiropractors, and affirmed the lower court's decision to grant summary judgment to GEICO and deny Health Needles' motion for summary judgment on most of the claims.

Reported in New York Official Reports at Health Needles Acupuncture, P.C. v GEICO Ins. Co. (2014 NY Slip Op 51864(U))

Health Needles Acupuncture, P.C. v GEICO Ins. Co. (2014 NY Slip Op 51864(U)) [*1]

Health Needles Acupuncture, P.C. v GEICO Ins. Co.

2014 NY Slip Op 51864(U) [46 Misc 3d 134(A)]

Decided on December 19, 2014

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This opinion is uncorrected and will not be published in the printed Official Reports.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 December 19, 2014

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

PRESENT: : PESCE, P.J., ALIOTTA and SOLOMON, JJ.
2012-2071 Q C

Health Needles Acupuncture, P.C. as Assignee of GERRY WELCH, Appellant, December 19, 2014
against
GEICO Ins. Co., Respondent.

Appeal from an order of the Civil Court of the City of New York, Queens County (Barry A. Schwartz, J.), entered August 15, 2012. The order, insofar as appealed from, denied plaintiff’s motion for summary judgment, except for the branch of the motion seeking summary judgment on so much of the complaint as sought to recover upon a claim for services rendered on October 7, 2009, and granted defendant’s cross motion for summary judgment dismissing the complaint except for the branch of the cross motion seeking summary judgment dismissing so much of the complaint as sought to recover upon the aforesaid claim.

ORDERED that the order, insofar as appealed from, is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff moved for summary judgment, and defendant cross-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 the branch of plaintiff’s motion seeking summary judgment on a claim for reimbursement for an initial evaluation on October 7, 2009, denied the remaining branches of plaintiff’s motion, denied the branch of defendant’s cross motion seeking to dismiss so much of the complaint as sought to recover for the initial evaluation on October 7, 2009, and granted the remaining branches of defendant’s cross motion for summary judgment dismissing the complaint.

On appeal, plaintiff argues 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, 11th & 13th Jud Dists 2009]).

Accordingly, the order, insofar as appealed from, is affirmed.

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

Decision Date: December 19, 2014