Gov’t Employees Ins. Co. v. Avanguard Med. Group, PLLC

Defendant, Avanguard Medical Group, PLLC was accredited by the State of New York as a facility for the provision of office-based surgery (OBS). Plaintiffs (collectively, GEICO) commenced this action for a declaratory judgment that GEICO was not legally obligated under N.Y. Ins. Law 5102 to reimburse Avanguard for facility fees related to the use of its physical location and related support services. Supreme Court denied GEICO’s motion for summary judgment. The Appellate Division reversed and granted the motion, declaring that GEICO was not required to reimburse Avanguard for OBS facility fees. The Court of Appeals affirmed, holding that neither the applicable statutory nor regulatory framework mandate that a no-fault insurance carrier pay a facility fee to an accredited OBS center. View "Gov’t Employees Ins. Co. v. Avanguard Med. Group, PLLC" on Justia Law