Kleinberg v. Southeastern Pennsylvania Transportation Authority

765 A.2d 405, 2000 Pa. Commw. LEXIS 627
CourtCommonwealth Court of Pennsylvania
DecidedNovember 29, 2000
StatusPublished
Cited by3 cases

This text of 765 A.2d 405 (Kleinberg v. Southeastern Pennsylvania Transportation Authority) is published on Counsel Stack Legal Research, covering Commonwealth Court of Pennsylvania primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Kleinberg v. Southeastern Pennsylvania Transportation Authority, 765 A.2d 405, 2000 Pa. Commw. LEXIS 627 (Pa. Ct. App. 2000).

Opinion

COLINS, Judge.

Southeastern Pennsylvania Transportation Authority (SEPTA) appeals from the January 19, 2000 order entered by the Court of Common Pleas of Philadelphia County (Trial Court) which order granted, in favor of Plaintiff Dr. Harvey S. Klein-berg, et al., individually, and on behalf of all others similarly situated, and against Defendant SEPTA: (1) a motion for summary judgment as to liability and as to SEPTA’s counterclaim; (2) partial summary judgment as to damages; and, (3) injunctive and declaratory relief. Said or[406]*406der further denied SEPTA’s motion for partial summary judgment as to liability on its counterclaim. We reverse and remand.

The following facts gave rise to the present appeal. Dr. Harvey S. Kleinberg, a licensed osteopathic physician, is representative of a designated class of medical and osteopathic physicians (hereinafter Physician Class) who personally diagnosed and evaluated their patients’ injuries, after which they prescribed specific, individualized physical therapy programs. The record indicates that the Physician Class delegated the tasks of implementing the foregoing physical therapy programs to trained, supervised technicians.

SEPTA, a self-insurer pursuant to the Pennsylvania Motor Vehicle Financial Responsibility Law (MVFRL),1 is responsible for providing first-party medical benefits to individuals injured in a motor vehicle accident involving a SEPTA vehicle, pursuant to § 1712(1) of the MVFRL.2 In approximately August 1997, SEPTA adopted a policy of refusing to pay first-party medical benefits for physical therapy procedures for its insureds, unless the person providing the physical therapy was licensed pursuant to the Pennsylvania Physical Therapy Practice Act (PTPA).3

By order dated January 15, 1999, the Trial Court certified a mandatory class of all Pennsylvania physicians who had billed SEPTA for physical therapy/physieal medicine services rendered to its insureds as part of treatment for injuries sustained in motor vehicle accidents involving SEPTA vehicles, and whose claims for reimbursement were denied by SEPTA because the physical therapy/physical medicine services were not performed personally by physicians or by other individuals licensed pursuant to the PTPA.

As a result of SEPTA’s refusal to provide coverage as indicated, the Physician Class commenced an action against SEPTA in the Philadelphia County Court of Common Pleas. The litigants, however, agreed to a temporary stay of their case pending appellate resolution of Nelson v. Nationwide Mutual Insurance Co., 36 Pa.D. & C. 4th 1 (1998), aff'd, No. 1998-924, 736 A.2d 22 (Pa.Super.Ct., filed Dec. 2, 1998), because of the similarity of legal issues between the present matter and Nelson. On December 2,1998, the Superi- or Court of Pennsylvania affirmed the Trial Court’s decision in Nelson. The defendant Nationwide Insurance then filed a petition for allowance of appeal to the Supreme Court, which petition was granted. However, prior to the Supreme Court’s decision, the parties reached a settlement.

At this juncture, SEPTA filed a petition with the Supreme Court asking either to be substituted as a party in Nelson v. Nationwide for the purpose of prosecuting [407]*407Nationwide’s appeal or, alternatively, that the Supreme Court exercise its King’s Bench power and assume full jurisdiction over the present case, based upon SEPTA’s argument that the salient legal issue in the present matter was “identical” to that in Nelson. On November 19, 1999, the Supreme Court denied SEPTA’s petition. Thereafter, SEPTA filed with this Court an appeal from the Trial Court’s January 19, 2000 order.4

On appeal, SEPTA argues that the Trial Court erred in granting the . summary judgment motion filed by the Physician Class and contends that under the MVFRL, motor vehicle insurers and self-insurers are required to provide coverage for “licensed physical therapy.” Interpreting this “plain and ordinary” statutory language, SEPTA avers that the word “licensed” cannot be ignored, that the individual rendering physical therapy must be licensed and certified, and that a physician cannot delegate physical therapy to an unlicensed, uncertified individual and still expect an insurer to provide coverage. It is SEPTA’s position that the MVFRL, the PTPA, the Medical Practice Act of 1985(MPA),5 and the Osteopathic Medical Practice Act (OMPA),6 when properly construed, all prohibit unlicensed individuals from performing physical therapy services. Accordingly, SEPTA avers that both the Superior Court’s decision in Nelson and the Trial Court’s decision in the instant matter have misconstrued the foregoing statutes by relying upon case law holding that the MVFRL is to be “construed broadly to provide the greatest possible coverage to injured claimants.” Danko v. Erie Insurance Exchange, 428 Pa.Super. 223, 630 A.2d 1219, 1222 (1993), aff'd per curiam, 538 Pa. 572, 649 A.2d 935 (1994).

SEPTA further maintains that requiring an insurer to pay for physical therapy at the statutory rate, where such services are performed by unlicensed, uncertified individuals who may or may not be under a physician’s supervision, is inequitable. In support of its position, SEPTA emphasizes public policy considerations, specifically the deleterious impact upon patients receiving physical therapy from unqualified personnel, as being critical to concluding that the Trial Court erred in accepting the Physician Class’s argument that “custom and practice” authorized a physician to delegate physical therapy/physical medicine services even to unqualified individuals. SEPTA also argues that the record is devoid of any evidence proffered by the Physician Class, other than uncorroborated allegations, to establish that the technicians performing the physical therapy services at issue were competent and under close supervision of the physicians, so as to entitle the latter to be reimbursed for such services.

Before this Court for determination is whether the Trial Court erred in granting the motion for summary judgment filed by the Physician Class against SEPTA. In Marks v. Tasman, 527 Pa. 132, 135, 589 A.2d 205, 206 (1991) (citations omitted), our Supreme Court reaffirmed the principles governing the grant or denial of a summary judgment motion as follows:

Summary judgment is properly granted where “the pleadings, depositions, answers to interrogatories, and admissions on file, together with the affidavits if any, show that there is no genuine issue as to any material fact and that the moving party is entitled to a judgment as a matter of law.” Pa.R.C.P. 1035(b). An entry of summary judgment may be granted only in cases where the right is clear and free from doubt. The moving party has the burden of proving the [408]*408nonexistence of any genuine issue of material fact. The record must be viewed in the light most favorable to the non-moving party, and all doubts as to the existence of a genuine issue of material fact must be resolved against the moving party.

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Related

State Farm Mutual Automobile Insurance v. Cavoto
34 A.3d 123 (Superior Court of Pennsylvania, 2011)
Board v. SEPTA
14 Pa. D. & C.5th 301 (Philadelphia County Court of Common Pleas, 2010)
Mora v. Nationwide Mutual Fire Insurance
65 Pa. D. & C.4th 59 (Lawrence County Court of Common Pleas, 2003)

Cite This Page — Counsel Stack

Bluebook (online)
765 A.2d 405, 2000 Pa. Commw. LEXIS 627, Counsel Stack Legal Research, https://law.counselstack.com/opinion/kleinberg-v-southeastern-pennsylvania-transportation-authority-pacommwct-2000.