Michigan Court of Appeals; Docket #355249; Unpublished
Judges Kelly, Stephens, and Redford; Per Curiam
Official Michigan Reporter Citation: Not Applicable; Link to Opinion
STATUTORY INDEXING:
Not Applicable
TOPICAL INDEXING:
Evidentiary Issues
Intervention by Service Providers and Third Party Payors in PIP Claims
SUMMARY:
In this unanimous unpublished per curiam decision, the Court of Appeals affirmed the trial court’s summary disposition order denying EQMD, Inc.’s (“EQMD”) motion to intervene in Plaintiff Rafael Sabbar’s first-party action against Defendant State Farm Mutual Automobile Insurance Company (“State Farm”). The Court of Appeals held that EQMD, a “nationwide provider of pharmaceutical dispensing solutions for physicians,” did not have an interest in Sabbar’s claim for unpaid no-fault PIP benefits and was therefore not entitled to intervene in his suit against State Farm.
After Sabbar was injured in a car crash, he filed a complaint against State Farm for unpaid no-fault PIP benefits. State Farm moved for summary disposition with regard to certain bills Sabbar incurred from EQMD, arguing that EQMD was an unlicensed pharmaceutical manufacturer and wholesale distributor which was not “lawfully rendering services” for purposes of the no-fault act. The trial court granted State Farm’s motion, after which EQMD filed a motion to intervene, arguing that it had an interest in Sabbar’s claim for PIP benefits because, “a licensed physician prescribed and dispensed [Sabbar’s] prescriptions for medications that were reasonable and necessary for treatment of injuries [Sabbar] sustained in an auto crash,” and because, “EQMD [had] been charged by that physician with billing for and collecting the costs of Plaintiff’s prescriptions.” EQMD attached a bill to its motion, which identified Sabbar as a patient of Star Management & Rehab (“Star”). EQMD did not submit any documentation to support its allegation that EQMD had been retained by Star to recover payment of the bill, nor did the bill, itself, specify that the charges were for treatment or prescriptions related to the motor-vehicle crash. Ultimately, the trial court denied EQMD’s motion to intervene.
The Court of Appeals affirmed the trial court’s denial of EQMD’s motion to intervene, holding that EQMD was not a healthcare provider nor in possession of an assignment from Sabbar, and thus that EQMD had no direct cause of action against State Farm. Furthermore, EQMD failed to establish that it was retained for purposes of collecting unpaid monies on behalf of any healthcare provider that rendered treatment to Sabbar. In sum, the Court of Appeals held that EQMD simply failed to establish that it had an interest in Sabbar’s claim for PIP benefits, such that it should have been permitted to intervene.
“To support its allegation, [EQMD] attached a bill for $2,293.64. The bill, which is dated January 30, 2020, indicates that it was for patient ‘Rafal Sabbar,’ that the date of service was December 12, 2017, and that the facility was ‘Star Management & Rehab.’ No documentation was submitted to support the allegation that EQMD had been charged by a licensed physician to recover those costs. Nor is there any indication that the prescriptions were dispensed to Sabbar as a result of a motor-vehicle crash.4 Finally, EQMD acknowledged that it had not received an assignment from Sabbar that would entitle it to seek recovery of PIP benefits owed to Sabbar. See Covenant Med Ctr, Inc v State Farm Mut Auto Ins Co, 500 Mich 191, 217 n 40; 895 NW2d 490 (2017) (noting that an insured who is entitled to PIP benefits under the no-fault act may assign his or her right to past or presently due benefits to a healthcare provider); see also MCL 500.3112 as amended by 2019 PA 21 (stating that a healthcare provider listed in MCL 500.3157 ‘may make a claim and assert a direct cause of action against an insurer . . . .’).
Thus, based on EQMD’s motion to intervene, it is clear that EQMD is not a healthcare provider, nor does it have an assignment from Sabbar entitling it to pursue a direct cause of action against State Farm to recover PIP-benefits owed to Sabbar. As a result, it is not entitled to pursue a direct cause of action against State Farm to recover PIP benefits allegedly owed to Sabbar. Moreover, there is no documentation supporting EQMD’s claim that it was charged with collecting the $2,293.64 on behalf of a healthcare provider. In sum, we conclude that, in this case, EQMD has not established an interest in the PIP benefits at issue, so it was not entitled to intervene under MCR 2.209(A)(3). The trial court, therefore, did not abuse its discretion by denying the motion to intervene.”