Lab. Corp. of Am. v. Davis

• Decision Date: 26 May 2022
• Docket Number: SC19-1923, No. SC19-1936
• Citation: 339 So.3d 318
• Parties: LABORATORY CORPORATION OF AMERICA, et al., Petitioners, v. Patty DAVIS, etc., et al., Respondents. Sheridan Radiology Services of Pinellas, Inc., et al., Petitioners, v. Patty Davis, etc., et al., Respondents.
• Court: Florida Supreme Court

339 So.3d 318

LABORATORY CORPORATION OF AMERICA, et al., Petitioners,

v.Patty DAVIS, etc., et al., Respondents.

Sheridan Radiology Services of Pinellas, Inc., et al., Petitioners,

v.Patty Davis, etc., et al., Respondents.

No. SC19-1923

No. SC19-1936

Supreme Court of Florida.

May 26, 2022

James L. VanLandingham of Hogan Lovells US LLP, Miami, Florida, Catherine E. Stetson of Hogan Lovells US LLP, Washington, District of Columbia, and Steven F. Barley of Hogan Lovells US LLP, Baltimore, Maryland, for Petitioners Laboratory Corporation of America and Laboratory Corporation of America Holdings

Jane Kreusler-Walsh, Rebecca Mercier Vargas, and Stephanie L. Serafin of Kreusler-Walsh, Vargas & Serafin, P.A., West Palm Beach, Florida, on behalf of Sheridan Radiology Services of Pinellas, Inc. and Sheridan Healthcare, Inc; David S. Johnson and Scott W. Anderson of Johnson Daboll Anderson, PLLC, Tampa, Florida, on behalf of Sheridan Radiology Services of Pinellas, Inc; and Susan N. Eisenberg and Jennifer T. Williams of Cozen O'Connor, Miami, Florida, on behalf of Sheridan Healthcare, Inc, for Petitioners Sheridan Radiology Services of Pinellas, Inc. and Sheridan Healthcare, Inc.

Kristin A. Norse and Stuart C. Markman of Kynes, Markman & Felman, P.A., Tampa, Florida; Bryan S. Gowdy of Creed & Gowdy, P.A., Jacksonville, Florida; and Christa L. Collins of Collins Law PL, Saint Petersburg, Florida, for Respondents

Paul Michael Anderson of Anderson & Hart, P.A., Tallahassee, Florida, for Amici Curiae Workers’ Compensation Section of The Florida Bar and Florida Workers’ Advocates

PER CURIAM.

In this case we consider the interaction between the statutory remedy for prohibited consumer debt collection practices provided by the Florida Consumer Collection Practices Act (FCCPA)¹ and the provision of the Workers’ Compensation Law (WCL)² vesting the Department of Financial Services (DFS) with exclusive jurisdiction to decide matters concerning workers’ compensation reimbursement. Before the Court for review is the decision of the Second District Court of Appeal in Davis v. Sheridan Healthcare, Inc. , 281 So. 3d 1259 (Fla. 2d DCA 2019), in which the court held the WCL exclusive jurisdiction provision to be inapplicable as a bar to suit by an injured worker against a health care provider for prohibited debt collection practices. Id. at 1261. The Second District certified the following question to be of great public importance:

DOES SECTION 440.13(11)(c) OF THE WORKERS’ COMPENSATION LAW PRECLUDE CIRCUIT COURT JURISDICTION OVER CLAIMS UNDER SECTION 559.77(1) OF THE FLORIDA CONSUMER COLLECTION PRACTICES ACT?

Id. at 1267. We have jurisdiction. See art. V, § 3(b)(4), Fla. Const. We answer the certified question in the negative and approve the result reached by the Second District.

I

Patty Davis was injured during the course of her employment. Subsequently, Davis utilized workers’ compensation benefits to receive medical care for her work-related injuries. Davis received medical care from two providers: Sheridan Radiology Services of Pinellas, Inc., a subsidiary of Sheridan Healthcare, Inc. (Sheridan); and Laboratory Corporation of America and Laboratory Corporation of America Holdings (Labcorp). Thereafter, Sheridan and Labcorp repeatedly billed Davis directly for the medical care that she received.

Davis then filed two separate actions against Sheridan and Labcorp under section 559.77(1), Florida Statutes (2014), of the FCCPA. Davis argued that as an injured employee under the WCL—chapter 440, Florida Statutes (2014)—she was not to be billed for seeking medical care for her work-related injuries. Instead, according to Davis's claim, her employer's workers’ compensation carrier, Commercial Risk Management, Inc. (CRM), was responsible for reimbursing Sheridan and Labcorp. In turn, Davis maintained that Sheridan and Labcorp's attempts to collect the debt from her constituted an attempt to collect an illegitimate debt, violating section 559.72, Florida Statutes (2014), of the FCCPA.

In response, Sheridan and Labcorp asserted that the trial courts lacked subject matter jurisdiction for the alleged FCCPA violations. Under Sheridan and Labcorp's reasoning, section 440.13(11)(c) of the WCL unequivocally states that DFS "has exclusive jurisdiction to decide any matters concerning reimbursement." Consequently, Sheridan and Labcorp claimed, because their billing Davis was merely a "matter[ ] concerning reimbursement," exclusive jurisdiction over the matter was vested in DFS.

The trial courts agreed with Sheridan and Labcorp and dismissed Davis's FCCPA claims. Davis appealed. In its consolidated opinion, the Second District held that "the WCL does not preclude Davis's claims filed against her workers’ compensation medical providers under section 559.77(1) of the FCCPA," reversed both trial court dismissals, and certified to this Court the question of great public importance set forth above. Davis , 281 So. 3d at 1261, 1267.

II

Section 559.72 of the FCCPA prohibits various debt collection practices. Subsection (9) provides that "no person shall ... [c]laim, attempt, or threaten to enforce a debt when such person knows that the debt is not legitimate, or assert the existence of some other legal right when such person knows that the right does not exist." Section 559.77 contains provisions authorizing and governing civil remedies for violations of the FCCPA. Subsection (1) provides that "[a] debtor may bring a civil action against a person violating the provisions of s. 559.72." Subsection (2) provides for the award of "actual damages and for additional statutory damages ... not exceeding $1,000." Punitive damages and other equitable relief are also authorized.

Section 440.13 of the WCL establishes the framework for the provision of medical services to injured workers and for the reimbursement of medical providers by carriers and employers for those services. Subsection (3)(g) provides that "[t]he employee is not liable for payment for medical treatment or services provided pursuant to this section except as otherwise provided in this section." In addition, subsection (13)(a) provides that "provider[s] may not collect or receive a fee from an injured employee within this state" unless otherwise provided and that "providers have recourse against the employer or carrier for payment for services rendered in accordance with [the WCL]."³

Subsection (11)(a) of section 440.13 grants DFS the power to "investigate health care providers to determine whether providers are complying with [the WCL] and with rules adopted by [DFS]," including "whether the providers are engaging in overutilization, [and] whether providers are engaging in improper billing practices."⁴ "If [DFS] finds that a health care provider has improperly billed, overutilized, or failed to comply with [DFS] rules or the requirements of [the WCL]" DFS "may determine that the health care provider may not receive payment from the carrier or may impose penalties as set forth [elsewhere in the WCL]." If a provider has received improper payments "from a carrier," the provider "must return those payments to the carrier." DFS is authorized to impose "a penalty not to exceed $500" for overpayments that are not timely refunded.

Subsection (11)(c)—which is the focus of the issue presented by this case—provides that DFS "has exclusive jurisdiction to decide any matters concerning reimbursement , to resolve any overutilization dispute under subsection (7), and to decide any question concerning overutilization under subsection (8)." (Emphasis added.) The first mentioned subsection provides for remedies against carriers that improperly deny reimbursement, and the second subsection provides penalties against providers that engage in overutilization.

Subsection (7) establishes the administrative process for resolving "utilization and reimbursement disputes" between carriers and providers. Subsection (1)(q) defines "[r]eimbursement dispute" as "any disagreement between a health care provider or health care facility and carrier concerning payment for medical treatment." Subsection (7)(d) provides that when DFS "finds an improper disallowance or improper adjustment of payment by an insurer, the insurer shall reimburse the health care provider, facility, insurer, or employer." Provision is made in subsection (7)(f) for the imposition of various penalties on "[a]ny carrier that engages in a pattern or practice of arbitrarily or unreasonably disallowing or reducing payments to health care providers." The authorized penalties are "[r]epayment of the appropriate amount to the ... provider," administrative fines by DFS of up to $5,000 for each improper disallowance or reduction of payments, and the award of the provider's costs, including a reasonable attorney's fee.

Subsection (8) establishes the process for the determination by DFS that a provider has engaged in a pattern or practice of overutilization. Subsection (8)(b) enumerates penalties that may be imposed on a provider that "has engaged in a pattern or practice of overutilization or a violation of [the WCL] or rules adopted by [DFS]": "[a]n order barring the provider from payment;" "[d]eauthorization of care under review;" "[d]enial of payment for care rendered in the future;" "[a]n administrative fine of $5,000;" and "[n]otification of and review by the appropriate licensing authority" of licensed practitioners as provided by the WCL.

III

According to the petitioner healthcare providers, the claim made by Davis under the FCCPA that the providers had improperly billed her—rather than the workers’ compensation carrier—in violation of the WCL fell within the scope of section 440.13(11)(c)’s provision vesting "exclusive jurisdiction" in DFS "to decide any matters concerning reimbursement." The petitioners contend that the only basis for Davis's claim under the FCCPA was the WCL's "particularized reimbursement requirements," i.e., the general prohibition on charging injured workers.

The...