State Farm Mut. Auto. Ins. Co. v. B&A Diagnostic, Inc.

• Decision Date: 16 November 2015
• Docket Number: Case No. 14-cv-24387-KMM
• Citation: 145 F.Supp.3d 1154
• Court: U.S. District Court — Southern District of Florida
• Parties: State Farm Mutual Automobile Insurance Company and State Farm Fire & Casualty Company, Plaintiff, v. B&A Diagnostic, Inc. n/k/a Oasis Medical Center Corp., Esteban Genao, M.D., Alex Alonso, M.D., Ernesto Alvarez Velasco, and Jose Angel Ortiz Maza, Defendants.

145 F.Supp.3d 1154

State Farm Mutual Automobile Insurance Company and State Farm Fire & Casualty Company, Plaintiff,

v.B&A Diagnostic, Inc. n/k/a Oasis Medical Center Corp., Esteban Genao, M.D., Alex Alonso, M.D., Ernesto Alvarez Velasco, and Jose Angel Ortiz Maza, Defendants.

Case No. 14-cv-24387-KMM

United States District Court, S.D. Florida.

Signed November 16, 2015

Nicholas James Purvis, Akerman LLP, 222 Lakeview Avenue, Suite 400, West Palm Beach, FL 33401, Sandra Lynn Heller, Akerman Senterfitt, Las Olas Centre II, Suite 1600, 350 East Las Olas Boulevard, Fort Lauderdale, FL 33301, David Ira Spector, Akerman LLP, 777 South Flagler Drive, Suite 1100 West Tower, West Palm Beach, FL 33401, for Plaintiff.

Michael Joseph Napoleone, Gerald F. Richman, Richman Greer, P.A., 250 Australian Avenue, South, Suite 1504, West Palm Beach, FL 33401-5016, Munir David Barakat, Barakat Legal, P.A., 255 Alhambra Circle, Suite 900, Coral Gables, FL 33134, Georgia A. Thompson, Richman Greer P.A., 396 Alhambra Cir., North Tower 14th Floor, Miami, FL 33134, Michael Cosculluela, Cosculluela & Marzano PA, 14211 Commerce Way, Suite 300, Miami Lakes, FL 33016, for Defendant.

AMENDED ORDER GRANTING PLAINTIFF'S MOTION FOR SUMMARY JUDGMENT

K. MICHAEL MOORE

, CHIEF UNITED STATES DISTRICT JUDGE

THIS CAUSE came before the Court upon Plaintiff State Farm Mutual Automobile Insurance Co. and State Farm Fire & Casualty Co.'s (collectively, “State Farm” or “Plaintiff”) Motion for Summary Judgment (ECF No. 123) and Defendant Alex Alonso, M.D.'s Motion for Summary Judgment (ECF No. 128) and related responses and replies. The motions are now ripe for review. For the reasons that follow, State Farm's Motion for Summary Judgment is GRANTED.

This case involves unjust enrichment claims by State Farm against B & A Diagnostic, Dr. Esteban Genao, Dr. Alex Alonso, and Ernesto Alvarez Velasco (collectively, the “Defendants”), based on the submission of allegedly illegal and fraudulent claims for X-ray services provided to State Farm's insureds pursuant to the insureds' No–Fault Personal Injury Protection (“PIP”) policy coverage. State Farm also seeks declaratory relief, stating that it does not owe payment for any outstanding bills that arose from the performance of allegedly unlawful services.

I. BACKGROUND

As a threshold matter, the Court places great emphasis upon, and implores the parties to be mindful of, the fact that local rules have “the force of law.” Hollingsworth v. Perry, 558 U.S. 183, 191, 130 S.Ct. 705, 175 L.Ed.2d 657 (2010)

(quoting Weil v. Neary, 278 U.S. 160, 169, 49 S.Ct. 144, 73 L.Ed. 243 (1929) ). The Local Rules expressly caution that “[a]ll material facts set forth in the movant's statement filed and supported as required ... will be deemed admitted unless controverted by the opposing party's statement, provided that the Court finds that the movant's statement is supported by evidence in the record.” S.D. Fla. L.R. 56.1(b) (emphasis added). Local Rule 56.1(b) serves a vital purpose in “help[ing] the court identify and organize the issues in the case.” Mann v. Taser Int'l, Inc. , 588 F.3d 1291, 1303 (11th Cir.2009). It also preserves scarce judicial resources by preventing a court from “having to scour the record and perform time-intensive fact searching.” Joseph v. Napolitano, 839 F.Supp.2d 1324, 1329 (S.D.Fla.2012) ; see also

Borroto v. Geico, No. 1:14–CV–24659–KMM, 2015 WL 5786740, at *6 n. 3 (S.D.Fla. Sept. 30, 2015) (noting that posing such an exacting requirement on courts is “untenable”).

Despite Defendants' assertions, rules like Local Rule 56.1(b) serve more than a technical purpose, and are held in great esteem by courts around the country. See e.g., Reese v. Herbert, 527 F.3d 1253, 1268 (11th Cir.2008)

; Caban Hernandez v. Philip Morris USA, Inc. , 486 F.3d 1, 7 (1st Cir.2007) ( “Given the vital purpose that such rules serve, litigants ignore them at their peril.”); Waldridge v. Am. Hoechst Corp. , 24 F.3d 918, 921 (7th Cir.1994) (endorsing “the exacting obligation these rules impose on a party contesting summary judgment”). Although a failure to comply with the local rules can often result in harsh, if not fatal, outcomes for a party, such results are “not by calculated choice of t[he] Court.” Gossard v. JP Morgan Chase & Co. , 612 F.Supp.2d 1242, 1246 (S.D.Fla.2009).

Here, neither set of defendants¹ filed an opposition to Plaintiff's Statement of Undisputed Material Facts in compliance with Local Rule 56.1(b). Nor did the Defendants controvert Plaintiff's statement of facts through factual assertions or citations within their respective Responses to Plaintiff's Motion for Summary Judgment. See (ECF Nos. 134, 135). Instead, Defendants offered only conclusory and self-serving declarations in an attempt to create a genuine issue of material fact. Defendants' efforts are unsuccessful. Conclusory declarations lack any probative value and are insufficient as a matter of law. Gordon v. Terry, 684 F.2d 736, 744 (11th Cir.1982)

; see also

Hilburn v. Murata Elects.

N. Am., Inc. , 181 F.3d 1220, 1227–28 (11th Cir.1999) (noting that a “conclusory statement is insufficient to create a genuine issue of a material fact”).

In essence, the non-moving parties' failure to comply with Local Rule 56.1(b) presents the Court with “the functional analog of an unopposed motion for summary judgment.” Reese, 527 F.3d at 1268

. Although Plaintiff's submitted facts are deemed admitted, this “[C]ourt must still review the movant's citations to the record to determine if there is, indeed, no genuine issue of material fact.” Mann v. Taser Int'l, Inc. , 588 F.3d 1291, 1303 (11th Cir.2009) ; see also

United States v. One Piece of Real Prop. Located at 5800 SW 74th Ave., Miami, Fla., 363 F.3d 1099, 1101–02 (11th Cir.2004) (“At the least, the district court must review all of the evidentiary materials submitted in support of the motion for summary judgment.”). This requirement provides the Court an opportunity to address the merits of the motion. See

Dunlap v. Transamerica Occidental Life Ins. Co., 858 F.2d 629, 632 (11th Cir.1988).

With this framework in mind, the following facts are undisputed and supported by the record before this Court.²

Defendant B & A Diagnostic, Inc. (“B & A”), is a Florida corporation licensed by Florida's Agency for Health Care Administration (“AHCA”), which operates as a health care clinic and provides X-ray and other diagnostic services to patients in Miami, Florida. Pl.'s Statement of Undisputed Material Facts ¶ 1 (ECF No. 122). B & A submits medical bills to State Farm for X-ray services rendered to State Farm's insureds. Id. ¶ 2. Felipe Aguilar, a layperson, is the sole owner of B & A, and is responsible for interviewing and hiring the medical directors for the clinic. Id. ¶¶ 8–9.

Defendant Esteban Genao, M.D. served as the statutorily designated Medical Director for B & A from March 21, 2008 through March 31, 2010. Id. ¶ 5. Defendant Alex Alonso, M.D. subsequently served as the statutorily designated Medical Director of B & A from April 1, 2010 through the present.³ Id. ¶ 6. From June 2009 through November 30, 2010, Defendant Ernesto Alvarez Velasco was employed by B & A to perform X-ray scans on B & A patients. Id. ¶ 4. Likewise, former Defendant Jose Angel Ortiz Maza performed X-ray services for B & A from approximately July 2009 through November 2011. Id. ¶ 7.

In approximately June 2009, Alvarez applied for employment with B & A and was interviewed only by Aguilar. Id. ¶ 19. No one at B & A instructed Alvarez that he needed a certification from the Florida Department of Health (“DOH”) to conduct X-rays lawfully. Id. As a result, Alvarez believed that a certification from the American Registry of Radiologic Technicians (“ARRT”) was all that was required to conduct X-rays lawfully in Florida. Id. ¶ 21. However, Alvarez admitted that the ARRT website expressly indicates that the State is the appropriate licensing authority and ARRT certification is separate from the radiological technician licensing process. Id. Alvarez thus acknowledged that he needed to provide more than his ARRT certification to the Florida DOH in order to obtain his license from the State. Id. Included among the additional required items Alvarez needed to submit for certification were proof of educational qualifications, proof of completion of an HIV course, and proof that Alvarez passed a knowledge-based exam. Id. According to Alvarez's application to the Florida DOH, Alvarez did not complete the required HIV course until October 6, 2010. Id. ¶ 28.

Dr. Alonso never verified whether Alvarez was properly certified by the Florida DOH. Id. at ¶ 26. Once it was discovered that Alvarez lacked certification in October 2010, no one at B & A instructed Alvarez to discontinue performing X-rays. Id. ¶¶ 27, 29. State Farm became generally aware of the issue of Alvarez's lack of certification in December 2010. Id. ¶ 30. Alvarez signed a “Disclosure and Acknowledgement Form” for each X-ray he performed upon a State Farm insured prior to November 30, 2010 indicating that he was the one who performed the technical component of the X-ray. Id. ¶ 25.

On April 22, 2005, Ortiz received his certification from the State of Florida as a Basic Machine Operator (“BMO”). Id. ¶ 32. At some point in 2007, Ortiz became an employee of B & A after an interview with Aguilar. Id. ¶ 33. Ortiz was employed full-time and continuously at B & A from 2007 through September or October 2013. Id. Ortiz's primary duty was to perform X-ray scans, and he would typically perform between two and six X-rays daily. Id. ¶ 40.

During Ortiz's employment, B & A had no rules or policies requiring a medical doctor to be present at the clinic when Ortiz was conducting X-ray scans. Id. ¶ 41. Ortiz routinely conducted X-rays at B & A while there was no licensed medical doctor present. Id. For each X-ray scan that Ortiz performed at B & A, Ortiz signed the appropriate disclosure form indicating that he was the individual...