Opinion
Case No. 3D02-2483.
Opinion filed November 19, 2003.
An Appeal from the Circuit Court for Miami-Dade County, Ellen Sue Venzer, Judge. Lower Tribunal No. 00-8381.
Green, Murphy, Wilke, Murphy Spellacy, and Jonathan S. Brooks; Bunnell, Woulfe, Kirschbaum, Keller, McIntyre Gregoire, and Nancy Gregoire, for appellant.
Lidsky, Vaccaro Montes, and Charles L. Vaccaro, for appellee.
Before LEVY, GERSTEN, and RAMIREZ, JJ.
State Farm Mutual Automobile, Ins. Co. appeals the entry of final judgment in favor of appellee Universal Medical Center of South Florida, Inc. underlying which is Universal's suit against State Farm for services it rendered to a State Farm insured. We reverse because the medical assistants in this case were unauthorized under Florida law to perform physical therapy.
On August 28, 2000, Blanca Franco was injured in an automobile accident. State Farm was Franco's automobile insurance carrier at the time of the accident and Universal is the health care provider that treated Franco for the injuries she sustained in the auto accident.
State Farm declined to pay for a number of services that Universal rendered to Franco from August 2000 to December 2000. Universal, as Franco's assignee, subsequently sued State Farm seeking damages for State Farm's failure to pay the entire claim and subsequent breach of Franco's policy. State Farm answered and raised various affirmative defenses, including that the bills which were sued upon were unreasonable, unnecessary or unrelated to the accident, represented treatment that was unlawfully rendered and not ordered, and that Universal did not provide any treatment, service or accommodation to Franco.
At trial, Dr. Carlos D. Carranza, Universal's office manager and a licensed medical doctor, testified that he recommended that Franco receive a course of physical therapy. A number of medical assistants, all of whom were unlicensed medical assistants, administered the physical therapy which included: the application of hot packs, electrical muscle stimulations, ultrasound therapy treatments, and mechanical massages.
State Farm moved for directed verdict arguing that the services rendered were illegal because the medical assistants were unauthorized under Florida law to perform physical therapy. The trial court denied the motion. The jury subsequently returned a verdict in Universal's favor finding that State Farm breached its insurance contract by failing to pay Universal for the medical services Universal rendered to Franco that were reasonable, necessary, and causally related to the auto accident. The jury awarded Universal $1,584.00. State Farm moved for rehearing or for certification of question of great public importance. The trial court denied the motion for rehearing, entered its final judgment in Universal's favor, and certified the following question to this Court:
Whether a person defined as a medical assistant under section 458.3485, Florida Statutes (2001), but not licensed as a physical therapist under chapter 486, Florida Statutes (2001), may `lawfully render' any of the physical therapy modalities enumerated in section 486.021(11), Florida Statutes (2001) for purposes of qualifying for payment of assigned personal injury protection benefits under section 627.736(5)(a), Florida Statutes (2001).
State Farm argues that the physical therapy performed on Franco was illegal because chapter 486 specifically requires that type of therapy to be performed by licensed physical therapists and the therapists who performed the therapy were unlicensed. We find that State Farm's position finds support in the specific language of chapter 486, the legislative intent underlying that statute, the rules of statutory interpretation, decisions from this district and other jurisdictions, as well as public policy.
Chapter 486, Florida Statutes (2001), governs the practice of physical therapy. Section 486.021(5) defines a physical therapist as one "who is licensed and who practices physical therapy in accordance with the provisions of the chapter." Section 486.021(11) describes the practice of physical therapy as follows:
[T]he performance of physical therapy assessments and the treatment of any disability, injury, disease, or other health condition of human beings . . . as related thereto by the use of the physical, chemical, and other properties of air; electricity; exercise; massage [and] the use of radiant energy, including ultraviolet, visible, and infrared rays; ultrasound [and] [t]he use of apparatus and equipment in the application of the foregoing or related thereto.
On the other hand, chapter 458, Florida Statutes (2001), governs "Medical Practice" and the medical assistant profession. Under section 458.3485(1), Florida Statutes (2001), a medical assistant is permitted to assist "in all aspects of medical practice under the direct supervision and responsibility of a physician." Section 458.3485(2)(c) specifically authorizes a medical assistant to assist "with patient examinations or treatments," and section (d) authorizes the medical assistant to operate "office medical equipment." The medical assistant is also authorized under the statute to perform a number of other medically related procedures not necessarily relevant here.
We begin our discussion with a basic principle of statutory construction, that a specific statute covering a particular subject area controls over a statute that covers the same and other subjects in more general terms. See McKendry v. State, 641 So.2d 45, 46 (Fla. 1994). See also De Armas v. Ross, 680 So.2d 1130 (Fla. 3d DCA 1996); Fleischman v. Department of Prof. Reg., 441 So.2d 1121 (Fla. 3d DCA 1983). Specific statutes are to be considered exceptions to the general terms contained in more general statutes. McKendry, 641 So.2d at 46. Courts must further construe statutes so as not to effect an absurd result that would defeat the intent of the legislature. See Aetna Cas. Sur. Co. v. Huntington Nat'l Bank, 609 So.2d 1315, 1317 (Fla. 1992); Indian Harbour Beach v. Melbourne, 265 So.2d 422, 424 (Fla. 4th DCA 1972).
In this case, chapter 486 specifically controls the practice of physical therapy. Chapter 458, on the other hand, controls the medical practice and the medical assistant profession. We must thus conclude that chapter 486 supersedes the general provisions of chapter 458, more so in light of the closely related subject matter of both chapter 458 and chapter 486. See State v. Fuchs, 769 So.2d 1006, 1009 (Fla. 2000) (holding that statutes that "relate to the same or closely related subjects should be read in pari materia"). See also De Armas, 680 So.2d at 1131 ("From a view of the whole law in pari materia, the court will determine legislative intent"); Fleischman, 441 So.2d at 1123. To accept Universal's argument calls for the construction of chapter 458, the statute that contains general provisions, in isolation when that chapter should be read in context with chapter 486, the statute that contains more specific provisions. This would not only be contrary to the long recognized principles of statutory construction, but would undermine the legislative intent underlying the statutory scheme whose aim is to "ensure that every physical therapy practitioner practicing in this state meets minimum requirements for safe practice," and to prohibit physical practice therapy to those "practitioners who fall below minimum competency or who otherwise present a danger to the public." See § 486.015, Fla. Stat. (2001).
Universal argues that section 458.3485 allowed the medical assistants to assist the doctor in this case while the doctor was present at the facility and while under that doctor's supervision. However, whether or not the actual physical therapy modalities performed by the medical assistants were performed under the supervision of a licensed physician is irrelevant and inconsequential. Chapter 486 required these medical assistants who performed the physical therapy modalities outlined in section 486.021(11), including ultrasound therapy treatments and the mechanical massages, to be licensed. The medical assistants in this case were unlicensed and thus their services were unlawfully rendered for which State Farm is not obligated to pay under section 627.736, Florida Statutes (2001).
We therefore reverse the final judgment, answer the certified question in the negative, and remand the case with directions to enter judgment in State Farm's favor consistent with this opinion.
Reversed and remanded.
NOT FINAL UNTIL TIME EXPIRES TO FILE REHEARING MOTION AND, IF FILED, DISPOSED OF.