Healthmakers Med. Group, P.C. v Travelers Indem. Co. (2006 NY Slip Op 52118(U))

Healthmakers Med. Group, P.C. v Travelers Indem. Co.

2006 NY Slip Op 52118(U) [13 Misc 3d 136(A)]

Decided on November 9, 2006

Appellate Term, First Department

Published by New York State Law Reporting Bureau pursuant to Judiciary Law § 431.

This opinion is uncorrected and will not be published in the printed Official Reports.

Healthmakers Medical Group, P.C. a/a/o Maria Martinez, Plaintiff-Respondent, - -

against

Travelers Indemnity Company, Defendant-Appellant.

Defendant appeals from that portion of an order of the Civil Court, Bronx County (Julia I. Rodriguez, J.), entered October 31, 2005, which denied its motion for summary judgment.

Order (Julia I. Rodriguez, J.) entered October 31, 2005, affirmed, with $10 costs.

Summary judgment dismissal was properly denied. It is uncontroverted that plaintiff was duly formed as a professional medical corporation, and that Dr. Harold James, the sole shareholder of plaintiff corporation, is licensed to practice medicine in accordance with Business Corporation Law § 1503(b). Defendant has not offered any proof to demonstrate that the plaintiff provider is fraudulently licensed in violation of Business Law § 1507, so as to fall within the ambit of 11 NYCRR 65-3.16 (a)(12), proscribing the reimbursement of health care providers who fail to comply with applicable New York State or local licensing requirements. The chiropractic and acupuncture services in question were rendered by duly licensed practitioners employed by plaintiff. Consistent with the position of the New York State Insurance Department, which is accorded great deference (see Matter of Medical Malpractice Ins. Assn. v Superintendent of Ins. of State of N.Y., 72 NY2d 753, 761-62 [1988], cert denied 490 US 1080 [1989]), a medical professional corporation is entitled to payment of assigned no-fault benefits for services performed by properly licensed nonphysician employees, such as chiropractors or acupuncturists, provided that the services are billed in accordance with the applicable fee schedules for the employees rendering the services (see Ops Gen Counsel NY Ins Dept 4-26-02 [No. 02-04-26]). Defendant cites no persuasive authority to support its contention that plaintiff's employment of licensed nonphysicians constitutes an unauthorized "engage[ment] in any business other than the rendering of the professional services for which it was incorporated" (Business Corporation Law § 1506).

This constitutes the decision and order of the court. [*2]
I concurI concurI concur
Decision Date: November 9, 2006