United States District Court, S.D. Florida, Miami Division
UR HEALTH CHIROPRACTIC CORP., a/a/o Oxana Kouzmenko, on behalf of itself and all others similarly situated, Plaintiff,
PROGRESSIVE SELECT INSURANCE COMPANY, Defendant.
ORDER GRANTING DEFENDANT'S MOTION TO
FEDERICO A. MORENO UNITED STATES DISTRICT JUDGE
UR Health Chiropractic Corporation brought this action
against Defendant Progressive Select Insurance Company to
challenge its reimbursement practices related to personal
injury protection benefits. Progressive subsequently moved to
dismiss the complaint for failure to state a claim upon which
relief can be granted. For the reasons discussed below, it is
ADJUDGED that Progressive's motion to dismiss is GRANTED.
Kouzmenko is a Florida resident who sustained injuries during
an automobile accident that occurred on August 6, 2016. At
that time, Kouzemenko was covered under an insurance policy
issued by Defendant Progressive Select Insurance Company. The
Policy provided Kouzmenko with personal injury protection
benefits in accordance with Florida's Motor Vehicle
No-Fault Law. Kouzmenko assigned the benefits
under this Policy to UR Health and, in exchange, UR Health
provided medical services to help treat Kouzmenko's
Plaintiff- UR Health Chiropractic Corporation
Health is a Florida corporation with its principal place of
business in Broward County, Florida. It provides chiropractic
services to help patients with a variety of injuries.
Defendant - Progressive Select Insurance
Select Insurance Company is a foreign corporation that
provides, among other things, automobile insurance in
Florida. Progressive sold an automobile insurance policy to
Kouzmenko. This Policy was in effect at the time of
Kouzmenko's automobile accident, which triggered
Progessive's obligation to provide Kouzmenko with the
personal injury protection benefits included in the policy.
the 2016 automobile accident, Kouzmenko assigned the personal
injury protection benefits from her Progressive automobile
insurance policy to UR Health. In turn, UR Health provided
chiropractic services to help Kouzmenko recover from the
personal injuries she sustained during the accident.
Progressive subsequently reimbursed UR Health for certain
medical services covered by the policy.
calculate the reimbursement owed to UR Health under
Kouzmenko's insurance policy, Progressive applied
Medicare's Multiple Procedure Payment Reduction Rule to
UR Health's bills for chiropractic services. The Multiple
Procedure Payment Reduction Rule- which accounts for the
savings and efficiencies achieved when a provider performs
multiple medical procedures in a single day-reduces payment
to a healthcare provider by a set percentage for second and
subsequent procedures provided to the same patient on the
same day. See 7 ...