UGP Acupuncture, P.C. v. 21st Century Ins. Co.

UGP Acupuncture, P.C., as Assignee of Santana, Nicole, Appellant, against 21st Century Insurance Company, Respondent. The Rybak Firm, PLLC (Damin J. Toell of counsel ), for appellant. Law Offices of Bryan M. Rothenberg (Deepak D. Sohi of counsel), for respondent. Appeal from an order of the Civil Court of the City of New York, Kings County (Richard J. Montelione, J.), entered May 23, 2016. The order granted defendant's motion for summary judgment dismissing the complaint. ORDERED that the order is affirmed, with $25 costs. In this action by a provider to recover assigned first-party no-fault benefits, plaintiff appeals from an order of the Civil Court which granted defendant's motion for summary judgment dismissing the complaint on the ground that the amounts plaintiff sought to recover, for services rendered after April 1, 2013, were in excess of the workers' compensation fee schedule. Plaintiff argues that defendant failed to establish that defendant's fee reductions, which had been done in accordance with the workers' compensation fee schedule for acupuncture services performed by chiropractors, were proper. However, this court has held, "as a matter of law, that an insurer may use the workers' compensation fee schedule for acupuncture services performed by chiropractors to determine the amount which a licensed acupuncturist is entitled to receive for such acupuncture services" (Great Wall Acupuncture, P.C. v Geico Ins. Co., 26 Misc 3d 23, 24 [App Term, 2d Dept, 2d, 11th & 13th Jud Dists 2009]). Accordingly, the order is affirmed. PESCE, P.J., ALIOTTA and ELLIOT, JJ., concur. ENTER: Paul Kenny Chief Clerk Decision Date: November 16, 2018