KITTY COOK, APPELLANT,
v.
PALM BEACH COUNTY SCHOOL BOARD AND F.A. RICHARD & ASSOCIATES, APPELLEES
AI-generated. These summaries, headnotes, and key points are machine-generated and may contain errors or omissions. Always verify against the full opinion text below. Not legal advice.
Kitty Cook sought worker's compensation benefits for unpaid medical bills from treatment received in 1994. The trial judge ruled it lacked jurisdiction because the dispute was a reimbursement disagreement between the healthcare provider and carrier under Florida law, which falls under the Department of Financial Services' exclusive jurisdiction. The appellate court affirmed, holding the judge properly dismissed the petition.
The court held that the Judge of Compensation Claims lacked jurisdiction over the dispute because disagreements between healthcare providers and carriers concerning payment for medical treatment constitute reimbursement disputes, which fall under the exclusive jurisdiction of the Department of Financial Services.
[1] A disagreement between a healthcare provider or facility and a carrier concerning payment for medical treatment constitutes a reimbursement dispute.
[2] The Department of Financial Services has exclusive jurisdiction over reimbursement disputes in workers' compensation cases.
Previewing 2 of 5 headnotes on this case. FLexlaw’s editorially structured points of law — every proposition, pinpointed — are reserved for members.
Join FLexlaw to unlock all legal intelligence“any disagreement between a health care provider or health care facility and carrier concerning payment for medical treatment”
Establishes the statutory definition of a reimbursement dispute under Florida Statute section 440.13(1)(r)
Previewing 1 of 3 key quotes on this case — the court’s exact language, pinpointed for members.
Join FLexlaw to unlock all legal intelligenceKitty Cook sustained work-related injuries on August 23, 1994. In February 2010, over 15 years later, she filed a petition for worker's compensation b…
The full statement of facts, procedural history, and disposition for this case are member content.
Join FLexlaw to unlock all legal intelligence© FLexlaw, Inc. — AI-generated enrichments are proprietary. All rights reserved.
Explore caselaw by topic → Browse Summary Final Order cases and more on FLexlaw
On February 10, 2010, Kitty Cook (“Claimant”) filed a petition for worker’s compensation benefits seeking medical benefits for work-related injuries she sustained on August 23, 1994. Specifically, she sought from the Employer/Carrier (“E/C”) payment of five medical bills for treatment she received from Dr. Alex Igle-sias. The E/C responded to the petition stating they had not denied treatment, but Dr. Iglesias had never submitted medical bills for payment. Having finally received the bills via Claimant’s petition, the E/C sent them on for processing and payment. The E/C moved for a summary final order arguing that Claimant’s request for payment of Dr. Iglesias’ bills is a reimbursement dispute over which the Judge of Compensation Claims (“JCC”) lacks jurisdiction. The JCC agreed, and entered an Amended Order Granting Employer/Carrier’s Motion for Summary Final Order, which Claimant now appeals. We affirm the JCC’s order.
Claimant asserts on appeal, as she did below, that there is a genuine dispute of material fact as to whether Dr. Iglesias was and continues to be authorized. See Fla. Admin. Code R. 60Q-6.120. She has presented no evidence, however, to contravene the E/C’s position that Dr. Iglesias was and remains authorized. The fact of nonpayment suggests nothing about the doctor’s authorization status because, as the E/C’s response to the petition indicates, the E/C had not declined to pay but merely was not in receipt of the bills. Elsewhere in the record is evidence that the bills were paid shortly thereafter. Because there is no evidence that Dr. Iglesias was not or is not authorized, and viewing the evidence in a light most favorable to the nonmoving party, it appears Dr. Iglesi-as was and remains authorized. See Thomas v. Eckerd Drugs, 987 So.2d 1262 (Fla. 1st DCA 2008) (viewing evidence in light most favorable to nonmoving party, on review of summary final order). Hence, there is no genuine question of *620material fact — only a disputed question of law as to whether this is a reimbursement.
The JCC correctly resolved the legal dispute. Under section 440.13(1)(r), Florida Statutes (2009), “any disagreement between a health care provider or health care facility and carrier concerning payment for medical treatment” is a reimbursement dispute. The Department of Financial Services has exclusive jurisdiction over such disputes. See § 440.13(11)(c), Fla. Stat. (2009); Bryan LGH Med. Ctr. v. Fla. Beauty Flora, Inc., 36 So.3d 795, 796 (Fla. 1st DCA 2010). Accordingly, the JCC lacked jurisdiction over Claimant’s petition and correctly granted the E/C’s motion for summary final order. See Avalon Ctr. v. Hardaway, 967 So.2d 268, 273 (Fla. 1st DCA 2007) (holding JCC does not have jurisdiction over reimbursement dispute because jurisdiction is vested in another agency).
AFFIRMED.
WEBSTER and ROWE, JJ., concur.
Cases With Similar Vibessemantic neighbors from the corpus
Citator
Cited By
-
Marine Max, Inc. v. Blair, 268 So. 3d 839 (Fla. 1st DCA 2019)…d all reimbursement disputes fall under the exclusive jurisdiction of DFS. See § 440.13(11)(c), Fla. Stat. (stating that DFS “has exclusive jurisdiction to decide any matters concerning reimbursement”); see also Cook v. Palm Beach Cty. Sch. Bd., 51 So. 3d 619, 620 (Fla. 1st DCA 2011) (holding JCCs lack jurisdiction over payment disputes); Orange County v. Willis, 996 So. 2d 870, 871 (Fla. 1st DCA 2008) (holding claimant “did not have standing to enforce payment of the doctor’s bill”). Moreover, even…
-
Palm Beach Cnty. Sch. Dist. v. Smith (Fla. 1st DCA 2022)…parameters and protocols established in accordance with this chapter.”); § 440.13(11)(c), Fla. Stat. (setting forth the Department’s “exclusive jurisdiction to decide any matters concerning reimbursement”); see also Cook v. Palm Beach Cty. Sch. Bd., 51 So. 3d 619, 620 (Fla. 1st DCA 2011) (recognizing that JCCs lack jurisdiction over payment disputes); Orange County v. Willis, 996 So. 2d 870, 871 (Fla. 1st DCA 2008) (holding claimant “did not have standing to enforce payment of the doctor’s bill”); Wolk v. Ja…
Authorities Cited
- The Avalon Ctr. & Unisource Administrators v. Hardaway, 967 So. 2d 268 (Fla. 1st DCA 2007)
- Thomas v. Eckerd Drugs and AIG, 987 So. 2d 1262 (Fla. 1st DCA 2008)
- Bryan LGH Med. Ctr. v. Fla. Beauty Flora, Inc., 36 So. 3d 795 (Fla. 1st DCA 2010)