Selective Ins. Co. v. Rothman

998 A.2d 523, 414 N.J. Super. 331
CourtNew Jersey Superior Court Appellate Division
DecidedJuly 13, 2010
DocketDOCKET NOS. A-5288-08T3, A-5289-08T3, A-5290-08T3
StatusPublished
Cited by9 cases

This text of 998 A.2d 523 (Selective Ins. Co. v. Rothman) is published on Counsel Stack Legal Research, covering New Jersey Superior Court Appellate Division primary law. Counsel Stack provides free access to over 12 million legal documents including statutes, case law, regulations, and constitutions.

Bluebook
Selective Ins. Co. v. Rothman, 998 A.2d 523, 414 N.J. Super. 331 (N.J. Ct. App. 2010).

Opinion

998 A.2d 523 (2010)
414 N.J. Super. 331

SELECTIVE INSURANCE COMPANY OF AMERICA, Plaintiff-Appellant,
v.
Arthur C. ROTHMAN, M.D., Ph.D., P.A., a/s/o D.R., Defendant-Respondent.
Dr. Arthur C. Rothman, a/s/o D.R., Plaintiff-Respondent,
v.
Selective Insurance Company, Defendant-Appellant.
Arthur C. Rothman, M.D., Ph.D., P.A., Plaintiff-Respondent,
v.
Selective Insurance Company of America, Defendant-Appellant.

DOCKET NOS. A-5288-08T3, A-5289-08T3, A-5290-08T3.

Superior Court of New Jersey, Appellate Division.

Argued May 17, 2010.
Decided July 13, 2010.

*524 Gordon S. Graber argued the cause for appellant Selective Insurance Company of America (Sullivan and Graber, attorneys; Mr. Graber, of counsel; Chryzanta K. Hentisz, Morristown, on the brief).

Robert B. Hille argued the cause for respondent Arthur C. Rothman, M.D., Ph. D., P.A. (Kalison, McBride, Jackson & Hetzel, P.C., attorneys; Mr. Hille, of counsel and on the brief; James A. Robertson, Warren, and John W. Kaveney, on the brief).

Joseph M. Ariyan, Fairview, argued the cause for respondent Arthur C. Rothman, M.D., Ph.D., P.A., a/s/o D.R. (Ariyan, Khoury & Schildiner, L.L.P., attorneys; Mr. Ariyan, on the brief).

Harwood Lloyd, L.L.C., attorneys for amicus curiae American Academy of Physician Assistants and The New Jersey State Society of Physician Assistants (Evelyn R. Storch, Newark, on the brief).

Mandelbaum, Salsburg, Gold, Lazris & Discenza, P.C., attorneys for amicus curiae American Medical Association and Medical Society of New Jersey (Dennis J. Alessi, West Orange, and Casey L. Carhart, of counsel and on the brief).

Before Judges RODRÍGUEZ, REISNER and YANNOTTI.

The opinion of the court was delivered by YANNOTTI, J.A.D.

In A-5288-08, Selective Insurance Company of America (Selective) appeals from an order entered by the trial court on June 9, 2009, denying Selective's motion to vacate and modify the arbitration award entered in favor of Dr. Arthur C. Rothman (Rothman). In A-5289-08, Selective appeals from an order entered by the trial court on June 9, 2009, which confirmed the aforementioned arbitration award. In A-5290-08, Selective appeals from a judgment entered by the trial court on June 9, 2009, which declared that physician assistants are permitted to perform needle electromyography (EMG) studies. For the reasons that follow, we reverse.

I.

These appeals arise from the following facts. Rothman is a physician licensed to practice medicine and surgery in New Jersey. Through his professional corporation, Rothman performs electrodiagnostic studies, including EMGs and nerve conduction velocity (NCV) tests. EMG studies involve the study of spontaneous and voluntary chemical activity of muscle, which is performed by the insertion of a needle electrode into the muscle and recording the electrical activity at rest and during voluntary muscle contraction. NCV tests involve the application of electrical stimulation at various points along or near a nerve using surface electrodes for stimulation and recording of data.

*525 D.R. was injured in an auto accident and, on August 27, 2007, electrodiagnostic tests were performed on D.R.'s right upper extremity in Rothman's office. As D.R.'s subrogee, Rothman submitted a claim to Selective for the cost of the tests. The claims were made pursuant to the provisions of the Selective policy and the statute governing payment of personal injury protection (PIP) benefits, specifically N.J.S.A. 39:6A-4(a).

Selective refused to pay the claim. Selective asserted, among other things, that Rothman did not personally perform the needle EMG test. Selective claimed that the test had been performed by Bracha "Beth" Mazin (Mazin), a physician assistant in Rothman's office, and she was not legally authorized to perform the test. The matter was submitted to dispute resolution pursuant to N.J.S.A. 39:6A-5.1.

The Dispute Resolution Professional (DRP) issued a report dated November 28, 2008. He stated that there are two elements of electrodiagnostic testing: "the compilation of data during the test and the interpretation of [that] data with due regard to the clinical presentation and examination of the patient." The DRP found that Mazin had retrieved the data, while Rothman had interpreted the data compiled. The DRP noted that both Rothman and Mazin had signed the test report, thereby acknowledging that they were both involved in the testing process. The DRP found that N.J.S.A. 45:9-5.2(a) did not preclude Mazin from performing the EMG testing "for the compilation of data" that the supervising physician may interpret.

The DRP ordered Selective to pay Rothman's claim, and awarded him attorney's fees and costs. Thereafter, Selective filed a motion with the DRP for modification or clarification of the award. The DRP entered an order dated February 23, 2009, denying the motion. On March 13, 2009, Rothman filed a verified complaint and order to show cause in the Law Division, seeking an order confirming the arbitration award.

On March 13, 2009, Rothman also filed a complaint in the Chancery Division seeking a judgment declaring that physician assistants are legally authorized to perform EMG studies. Among other things, Rothman alleged that Selective had refused to pay about twenty-five to thirty claims for EMG testing on the ground that the tests had been performed by a physician assistant. Rothman sought an order compelling Selective to pay the disputed claims.

On April 15, 2009, the Chancery Division entered an order transferring the declaratory judgment action to the Law Division, where it was considered along with Rothman's application to confirm the arbitration award. On June 8, 2009, the trial court filed a written opinion in which it concluded that physician assistants were legally authorized to perform EMG studies under the supervision of a licensed physician. The court entered orders dated June 9, 2009, confirming the arbitration award in the D.R. matter and granting Rothman the declaratory relief he sought. Selective filed separate appeals from the trial court's orders. We entered an order dated August 31, 2009, granting Selective's motion to consolidate the appeals.

II.

We turn first to Selective's appeal from the judgment entered in the declaratory judgment action. Selective argues that the trial court erred by finding that N.J.S.A. 45:9-5.2(a) does not preclude physician assistants from performing EMG testing.

*526 The statute at issue is N.J.S.A. 45:9-5.2. It provides as follows:

a. A person shall not perform needle electromyography unless that person is licensed to practice medicine and surgery in this State pursuant to chapter 9 of Title 45 of the Revised Statutes.
A person shall not interpret evoked potentials or nerve conduction studies unless that person is licensed to practice: medicine and surgery in this State pursuant to chapter 9 of Title 45 of the Revised Statutes; audiology in this State pursuant to chapter 3B of Title 45 of the Revised Statutes; or chiropractic in this State pursuant to chapter 9 of Title 45 of the Revised Statutes.
b. As used in this act:

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998 A.2d 523, 414 N.J. Super. 331, Counsel Stack Legal Research, https://law.counselstack.com/opinion/selective-ins-co-v-rothman-njsuperctappdiv-2010.