September 13, 2012
RAZ Acupuncture, P.C. v GEICO Gen. Ins. Co. (2012 NY Slip Op 51826(U))
https://www.beynensonlaw.com/case-law/raz-acupuncture-p-c-v-geico-gen-ins-co-2012-ny-slip-op51826u/
- Decided
- September 13, 2012
- Citation
- 2012 NY Slip Op 51826(U) · 36 Misc 3d 160(A)
- Posture
- Summary judgment
- Outcome
- Insurer prevailed
- Issues
- Fee schedule
- Legal questions
- Proving a fee schedule defense (see the maps)
Posture, outcome, issues and treatment by other decisions are Beynenson Law’s classification. Treatment labels are assigned by a language model reading the citing decision; negative and appeal-history labels are checked by a second reader.
Summary
Editorial summary by Beynenson Law, not part of the court’s decision.
Reported in New York Official Reports at RAZ Acupuncture, P.C. v GEICO Gen. Ins. Co. (2012 NY Slip Op 51826(U))
| RAZ Acupuncture, P.C. v GEICO Gen. Ins. Co. |
| 2012 NY Slip Op 51826(U) [36 Misc 3d 160(A)] |
| Decided on September 13, 2012 |
| 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| This opinion is uncorrected and will not be published in the printed Official Reports. |
SUPREME COURT, APPELLATE TERM, SECOND DEPARTMENT, 2d, 11th and 13th JUDICIAL DISTRICTS
PRESENT: : PESCE, P.J., RIOS and ALIOTTA, JJ
2010-3130 K C.
against
GEICO General Ins. Co., Respondent.
Appeal from an order of the Civil Court of the City of New York, Kings County (Reginald A. Boddie, J.), entered May 18, 2010. The order, insofar as appealed from as limited by the brief, denied the branches of plaintiff’s motion seeking summary judgment as to its claims for services rendered from June 28, 2006 to September 26, 2006 and billed under procedure code 97810, and granted the branches of defendant’s cross motion seeking summary judgment dismissing so much of the complaint as sought to recover for those claims. The appeal is deemed to be from so much of a judgment of the same court entered September 21, 2010 as dismissed so much of the complaint as sought to recover for those claims (see CPLR 5501 [c]).
ORDERED that the judgment, insofar as appealed from, is affirmed, without 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. Plaintiff appeals, as limited by its brief, from so much of an order of the Civil Court as denied the branches of plaintiff’s motion seeking summary judgment as to its claims for services rendered from June 28, 2006 to September 26, 2006 and billed under procedure code 97810, and granted the branches of defendant’s cross motion seeking summary judgment dismissing so much of the complaint as sought to recover for those claims. The appeal is deemed to be from so much of a judgment of the same court entered September 21, 2010 as dismissed the [*2]complaint insofar as it sought to recover for those claims (see CPLR 5501 [c]).
Contrary to plaintiff’s arguments on appeal, defendant demonstrated that it had fully paid plaintiff for the acupuncture services at issue in accordance with the workers’ compensation fee schedule (see Great Wall Acupuncture, P.C. v Geico Ins. Co., 26 Misc 3d 23 [App Term, 2d, 11th & 13th Jud Dists 2009]). Accordingly, the judgment, insofar as appealed from, is affirmed.
Pesce, P.J., Rios and Aliotta, JJ., concur.
Decision Date: September 13, 2012
Legal questions
A question of no-fault law this decision rules on, from our Legal Questions pages. Bars count the decisions on the question by year and court, coloured by category; circles are this decision and the decisions on the question it cites or that cite it. Point at a bar or circle for details. The categories and summaries are Beynenson Law’s classification, made by a language model and checked by a second reading.
Did the insurer prove that the amount billed exceeded the applicable workers’ compensation fee schedule?
This decision: Insurer proved the billed amount exceeded the applicable fee schedule
Held the insurer demonstrated it had fully paid the acupuncture services billed under code 97810 in accordance with the workers' compensation fee schedule, so dismissal of those claims was affirmed.
Of the 284 decisions on this question in the Second Department courts and the Court of Appeals, 146 (this one included) are in the same category.
Cited in this decision
A label shows how this decision treated the case it cites.
- Great Wall Acupuncture, P.C. v Geico Ins. Co. (2009 NY Slip Op 29467) FollowedAn insurer may use the chiropractic acupuncture fee schedule to reimburse acupuncture services performed by a licensed acupuncturist.
Similar decisions
- Health Needles Acupuncture, P.C. v GEICO Ins. Co. (2014 NY Slip Op 51864(U))The insurer established full payment for the disputed acupuncture services under the workers' compensation fee schedule for chiropractors.
- Raz Acupuncture, P.C. v New S. Ins. Co. (2012 NY Slip Op 50865(U))The insurer established full payment under the workers' compensation fee schedule for the four challenged causes of action.
- BQE Acupuncture, P.C. v GEICO Ins. Co. (2019 NY Slip Op 50743(U))The insurer established full payment for acupuncture services under the workers' compensation fee schedule applicable to chiropractors.
- Acupuncture Now, P.C. v GEICO Ins. Co. (2017 NY Slip Op 51809(U))The insurer's summary judgment cross motion on fee schedule claims was granted after its mailing and fee schedule proof were upheld.
- Gentle Care Acupuncture, P.C. v GEICO (2011 NY Slip Op 51121(U))An insurer may use the workers' compensation fee schedule for chiropractors' acupuncture services to reimburse a licensed acupuncturist.