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UGP Acupuncture, P.C. v. GEICO Ins. Co.

Supreme Court of New York, Second Department
Jun 17, 2022
2022 N.Y. Slip Op. 50610 (N.Y. Sup. Ct. 2022)

Opinion

No. 2021-141 K C

06-17-2022

UGP Acupuncture, P.C., as Assignee of Lora-Martinez, Orangel, Appellant, v. GEICO Ins. Co., Respondent.

The Rybak Firm, PLLC (Damin J. Toell and Richard Rozhik of counsel), for appellant. Law Office of Goldstein, Flecker & Hopkins (Lawrence J. Chanice of counsel), for respondent.


Unpublished Opinion

The Rybak Firm, PLLC (Damin J. Toell and Richard Rozhik of counsel), for appellant.

Law Office of Goldstein, Flecker & Hopkins (Lawrence J. Chanice of counsel), for respondent.

PRESENT:: THOMAS P. ALIOTTA, P.J., MICHELLE WESTON, WAVNY TOUSSAINT, JJ

Appeal from an order of the Civil Court of the City of New York, Kings County (Odessa Kennedy, J.), dated March 22, 2021. The order, insofar as appealed from, granted the branches of defendant's motion seeking summary judgment dismissing so much of the complaint as sought to recover on plaintiff's claims for services billed using CPT codes 97810 and 97811, and for services performed on or after August 10, 2016, and denied the branch of plaintiff's cross motion seeking summary judgment.

ORDERED that the order, insofar as appealed from, is affirmed, with $25 costs.

In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from so much of an order of the Civil Court as granted the branches of defendant's motion seeking summary judgment dismissing so much of the complaint as sought to recover on plaintiff's claims for services billed using CPT codes 97810 and 97811 on the ground that defendant had paid these claims in accordance with the workers' compensation fee schedule for acupuncture services performed by chiropractors, and so much of the complaint as sought to recover on plaintiff's claims for services performed on or after August 10, 2016 on the ground of lack of medical necessity, and denied the branch of plaintiff's cross motion seeking summary judgment.

Contrary to plaintiff's contention, the affidavit plaintiff submitted in opposition to the branch of defendant's motion seeking summary judgment dismissing so much of the complaint as sought to recover on plaintiff's claims for services rendered on or after August 10, 2016 failed to raise a triable issue of fact as it did not meaningfully refer to, let alone rebut, defendant's prima facie showing of lack of medical necessity (see Pan Chiropractic, P.C. v Mercury Ins. Co., 24 Misc.3d 136 [A], 2009 NY Slip Op 51495[U] [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2009]).

To the extent plaintiff appeals from so much of the order as granted the branch of defendant's motion seeking summary judgment dismissing so much of the complaint as sought to recover on plaintiff's claims for acupuncture services billed using CPT codes 97810 and 97811, for the reasons stated in Mind & Body Acupuncture, P.C., as Assignee of Wilson, Bernadette v State Farm Mut. Auto. Ins. Co. (___ Misc.3d ___, 2022 NY Slip Op __ [appeal No. 2019-1418 K C], decided herewith), plaintiff's contention lacks merit.

Accordingly, the order, insofar as appealed from, is affirmed.

ALIOTTA, P.J., WESTON and TOUSSAINT, JJ., concur.


Summaries of

UGP Acupuncture, P.C. v. GEICO Ins. Co.

Supreme Court of New York, Second Department
Jun 17, 2022
2022 N.Y. Slip Op. 50610 (N.Y. Sup. Ct. 2022)
Case details for

UGP Acupuncture, P.C. v. GEICO Ins. Co.

Case Details

Full title:UGP Acupuncture, P.C., as Assignee of Lora-Martinez, Orangel, Appellant…

Court:Supreme Court of New York, Second Department

Date published: Jun 17, 2022

Citations

2022 N.Y. Slip Op. 50610 (N.Y. Sup. Ct. 2022)