Lamounette v. Akins, 89-1339

Decision Date10 August 1989
Docket NumberNo. 89-1339,89-1339
Citation14 Fla. L. Weekly 1903,547 So.2d 1001
CourtFlorida District Court of Appeals
Parties14 Fla. L. Weekly 1903 Robert G. LAMOUNETTE, D.C., James M. Barrass, D.C., and Gainesville Chiropractic Clinic, P.A., Petitioners, v. Honorable Elwyn M. AKINS, Deputy Commissioner, and Wal-Mart Stores and Corporate Service, Inc., Respondents.

Douglas W. Abruzzo of Barton, Davis & Fernandes, Gainesville, for petitioners.

Richard S. Thompson of Zimmerman, Shuffield, Kiser & Sutcliffe, Orlando, for respondents Wal-Mart Stores and Corporate Service, Inc.

No appearance for respondent Akins.

PER CURIAM.

Robert G. Lamounette, D.C., James M. Barrass, D.C., and Gainesville Chiropractic Clinic, P.A., petition this court for a writ of prohibition, contending that Deputy Commissioner Akins lacks subject matter jurisdiction of their dispute with a workers' compensation employer/carrier over payment of a bill for services. We agree and grant relief.

In 1986, Barbara Knowles was an employee of Wal-Mart Stores when she suffered a compensable back injury. She was treated by Dr. Lamounette, an employee of Dr. Barrass and his clinic, for a period of nine or ten months and he rendered a statement in the amount of $11,057.25. The employer/carrier paid the bill but subsequently concluded there may have been overutilization of services and sought to recover the funds. Records were submitted to the Utilization Review Committee which referred the case to the Chiropractic Peer Review Committee (CPRC). After a hearing the CPRC determined that Dr. Lamounette had overutilized his services in the treatment of Ms. Knowles. The employer/carrier then filed a motion for order to show cause with the Division of Workers' Compensation. The file was forwarded by the division to Deputy Commissioner Akins for further action. Dr. Lamounette moved to strike contending, inter alia, that the deputy lacked jurisdiction to resolve this dispute. The motion to strike was denied and the physician was ordered to show cause why he should not be required to repay the amount in issue. This petition then followed and we issued an order to show cause, directing the employer/carrier to respond and giving Deputy Commissioner Akins the option to also respond, in his discretion. The employer/carrier timely filed their response and no response was received from the deputy.

Petitioners first argue that the employer/carrier and the division did not follow the statutorily-mandated procedures in making an initial determination that there was overutilization of services. They also contend that the CPRC review was premature and that the hearing violated due process guarantees. We expressly decline to address these arguments, finding that they can be adequately addressed on appeal from a final order.

We must concur, however, with the petitioners' suggestion that the deputy commissioner lacks jurisdiction to issue an order to show cause and to hold a hearing on the alleged overutilization of services. Section 440.13(4)(d)4 (Supp.1988) provides:

If it is determined that a physician improperly overutilized, or otherwise rendered or ordered, inappropriate medical treatment or services, or that the reimbursement for such treatment or services was inappropriate, the division may order the physician to show cause why he should not be required to repay the amount which was paid for the rendering or ordering of such treatment or services and shall inform him of his right to a hearing under the provisions of s. 120.57. If a hearing is not requested within 30 days of receipt of the order and the division director decides to proceed with the matter, a hearing shall be conducted, a prima facie case established, and a final order issued. If the final order, including judicial review if the order is appealed, is adverse to the physician, the division shall provide the licensing board of the physician with full...

To continue reading

Request your trial
11 cases
  • Alford v. G. Pierce Woods Memorial Hosp., 91-3297
    • United States
    • Florida District Court of Appeals
    • July 7, 1993
    ...of the same community as the physician whose services are reviewed serve on review committees. See, e.g., Lamounette v. Akins, 547 So.2d 1001, 1002 (Fla. 1st DCA 1989) (to determine whether chiropractic physician over utilized services he rendered to the injured employee, the physician's re......
  • Westinghouse Elec. v. Widlan
    • United States
    • Florida District Court of Appeals
    • April 16, 1993
    ...for chiropractic services found to have been necessary after carrier's notice of deauthorization). Our decisions in Lamounette v. Akins, 547 So.2d 1001 (Fla. 1st DCA 1989) (issue of overutilization of services) and Atlantic Foundation v. Gurlacz, 582 So.2d 10 (Fla. 1st DCA 1991) (reimbursem......
  • Miccosukee Tribe of Indians v. Napoleoni, 1D04-1774.
    • United States
    • Florida District Court of Appeals
    • December 15, 2004
    ...that the JCC has no jurisdiction, we grant the writ of prohibition, barring further proceedings in this matter. See Lamounette v. Akins, 547 So.2d 1001 (Fla. 1st DCA 1989) (granting writ of prohibition to prohibit JCC from determining dispute between chiropractors and E/C over payment becau......
  • Furtick v. William Shults Contractor, 94-51
    • United States
    • Florida District Court of Appeals
    • November 16, 1995
    ...pursued before the judge of compensation claims. Terners of Miami v. Freshwater, 599 So.2d 674 (Fla. 1st DCA 1992); Lamounette v. Akins, 547 So.2d 1001 (Fla. 1st DCA 1989); Long Grove. An employer/carrier may deauthorize a provider's care 2 upon a determination of overutilization after in-h......
  • Request a trial to view additional results

VLEX uses login cookies to provide you with a better browsing experience. If you click on 'Accept' or continue browsing this site we consider that you accept our cookie policy. ACCEPT