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Filing # 115283814 E-Filed 10/20/2020 01:47:38 PM
IN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT
IN AND FOR PALM BEACH COUNTY, FLORIDA
CASE NO.: — 50-2020-CA-007463-XXXX-MB
ROODY ST. GERMAIN,
Plaintiff,
v.
U.S AUTO SALES — FLORIDA, INC.
Defendants.
/
PLAINTIFF’S RESPONSE TO DEFENDANT’S COLLATERAL
SOURCE/MEDICARE/MEDICAID REQUEST FOR PRODUCTION
COMES NOW the Plaintiff, ROODY ST. GERMAIN, by and through the undersigned
attorneys and hereby responds to a Request for Production propounded by the Defendant, U.S AUTO
SALES — FLORIDA, INC., on August 10, 2020 and states as follows:
1. Copies of all documents, records, payment logs, claims for reimbursement or payment,
memoranda, notes and the like in plaintiffs or plaintiff's representatives’ possession and
control concerning plaintiff's receipt of Medicare benefits, including but not limited to
interim conditional payment information, and proposed Medicare set asides for future
benefits.
RESPONSE: None.
2. Copies of all documents, records, payment logs, memoranda, notes and the like in plaintiff's
or plaintiff's representatives’ possession and control concerning plaintiff's receipt of Medicaid
benefits.
RESPONSE: None.
3. A duly-executed authorization bearing plaintiffs date of birth and social security number
which permits this firm and other representatives of defendant to obtain copies of plaintiff's
Medicare records, a copy is attached for plaintiff's execution.
RESPONSE: Please see Plaintiffs response to Request for Production No. 16.
4. Copies of all reports, documents, transmittals, and writings of any kind by which plaintiff
and/or plaintiffs representatives have placed Medicare on notice of plaintiff's pending
personal injury claim and/or lawsuit and copies of any acknowledgement and/or responses
from Medicare.
RESPONSE: None.
Page 1 of 3
*** FILED: PALM BEACH COUNTY, FL SHARON R BOCK, CLERK. 10/20/2020 01:47:38 PM ***10.
ll.
12.
13.
Copies of all reports, documents, transmittals, and writings of any kind by which plaintiff
and/or plaintiff's representatives have placed Medicaid on notice of plaintiff's pending
personal injury claim and/or lawsuit and copies of any acknowledgement and/or responses
from Medicaid.
RESPONSE: None.
Copies of plaintiff's application for Social Security disability benefits and copies of any
responses thereto.
RESPONSE: None.
The identity of any attorney who assisted plaintiff in applying for Social Security benefits.
RESPONSE: None.
An authorization permitting defense counsel to obtain plaintiff's Social Security file, a copy is
attached for execution.
RESPONSE: Plaintiff is not able to provide such authorization as it was not provided
by the Defendant.
Copies of plaintiff's application for Medicaid benefits and copies of any responses thereto.
RESPONSE: None.
Please provide copies of all documents used in responding to the Collateral Source
Interrogatories to Plaintiff.
RESPONSE: None.
Please provide any insurance policies which were in effect at the time of the subject incident
against which you have or will make a claim.
RESPONSE: Please see Plaintiff’s response to Request for Production No. 15.
Please provide all documents, correspondence, records, and/or receipts sent between yourself
and any insurance company, HMO, state/federal agency, Medicaid, or Medicare relative to
the subject incident and your alleged damages.
RESPONSE: None.
Please provide any documentation whatsoever reflecting any lien or balance of any kind
which arose from the subject incident.
RESPONSE: None.
Page 2 of 314. All records relating to Medicare and whether you are a Medicare beneficiary or are Medicare
eligible as defined by the Medicare Secondary Payer Statute, as well as all CMS liens, all
Medicare liens, all Medicare Set Asides (MSA) as defined by the CMS, and all waivers from
CMS as to the need for a future set aside.
RESPONSE: None.
CERTIFICATE OF SERVICE
I HEREBY CERTIFY that a true and correct copy of the was filed electronically and was
sent by E-Mail from the Florida’s Court’s E-Filing Portal system, unless other noted below, on all
counsel or parties of record listed below, this 20" day of October, 2020. The foregoing document has
also been sent from the undersigned counsel by E-Mail to all counsel or parties of record listed
below.
David A. Herrero, Esq.
Cole Scott & Kissane, P.A.
9150 S. Dadeland Blvd., Suite 1400
Miami, FL 33256
David.herrero@csklegal.com; yahnny.vicente@csklegal.com
SCHULER, HALVORSON, WEISSER,
ZOELLER & OVERBECK, P.A.
Attorneys for Plaintiff
Barristers Building
1615 Forum Place, Suite 4D
West Palm Beach, FL 33401
(561) 689-8180
By: /s/ Gregory M. Cummings, Esq.
WILLIAM D. ZOELLER
Fla. Bar No.: 155233
wzoeller@shw-law.com
tcoffey@shw-law.com
GREGORY M. CUMMINGS
Fla. Bar No.: 126074
gcummings@shw-law.com
jdaza@shw-law.com
Page 3 of 3
Preview
Filing # 115283814 E-Filed 10/20/2020 01:47:38 PM IN THE CIRCUIT COURT OF THE FIFTEENTH JUDICIAL CIRCUIT IN AND FOR PALM BEACH COUNTY, FLORIDA CASE NO.: — 50-2020-CA-007463-XXXX-MB ROODY ST. GERMAIN, Plaintiff, v. U.S AUTO SALES — FLORIDA, INC. Defendants. / PLAINTIFF’S RESPONSE TO DEFENDANT’S COLLATERAL SOURCE/MEDICARE/MEDICAID REQUEST FOR PRODUCTION COMES NOW the Plaintiff, ROODY ST. GERMAIN, by and through the undersigned attorneys and hereby responds to a Request for Production propounded by the Defendant, U.S AUTO SALES — FLORIDA, INC., on August 10, 2020 and states as follows: 1. Copies of all documents, records, payment logs, claims for reimbursement or payment, memoranda, notes and the like in plaintiffs or plaintiff's representatives’ possession and control concerning plaintiff's receipt of Medicare benefits, including but not limited to interim conditional payment information, and proposed Medicare set asides for future benefits. RESPONSE: None. 2. Copies of all documents, records, payment logs, memoranda, notes and the like in plaintiff's or plaintiff's representatives’ possession and control concerning plaintiff's receipt of Medicaid benefits. RESPONSE: None. 3. A duly-executed authorization bearing plaintiffs date of birth and social security number which permits this firm and other representatives of defendant to obtain copies of plaintiff's Medicare records, a copy is attached for plaintiff's execution. RESPONSE: Please see Plaintiffs response to Request for Production No. 16. 4. Copies of all reports, documents, transmittals, and writings of any kind by which plaintiff and/or plaintiffs representatives have placed Medicare on notice of plaintiff's pending personal injury claim and/or lawsuit and copies of any acknowledgement and/or responses from Medicare. RESPONSE: None. Page 1 of 3 *** FILED: PALM BEACH COUNTY, FL SHARON R BOCK, CLERK. 10/20/2020 01:47:38 PM ***10. ll. 12. 13. Copies of all reports, documents, transmittals, and writings of any kind by which plaintiff and/or plaintiff's representatives have placed Medicaid on notice of plaintiff's pending personal injury claim and/or lawsuit and copies of any acknowledgement and/or responses from Medicaid. RESPONSE: None. Copies of plaintiff's application for Social Security disability benefits and copies of any responses thereto. RESPONSE: None. The identity of any attorney who assisted plaintiff in applying for Social Security benefits. RESPONSE: None. An authorization permitting defense counsel to obtain plaintiff's Social Security file, a copy is attached for execution. RESPONSE: Plaintiff is not able to provide such authorization as it was not provided by the Defendant. Copies of plaintiff's application for Medicaid benefits and copies of any responses thereto. RESPONSE: None. Please provide copies of all documents used in responding to the Collateral Source Interrogatories to Plaintiff. RESPONSE: None. Please provide any insurance policies which were in effect at the time of the subject incident against which you have or will make a claim. RESPONSE: Please see Plaintiff’s response to Request for Production No. 15. Please provide all documents, correspondence, records, and/or receipts sent between yourself and any insurance company, HMO, state/federal agency, Medicaid, or Medicare relative to the subject incident and your alleged damages. RESPONSE: None. Please provide any documentation whatsoever reflecting any lien or balance of any kind which arose from the subject incident. RESPONSE: None. Page 2 of 314. All records relating to Medicare and whether you are a Medicare beneficiary or are Medicare eligible as defined by the Medicare Secondary Payer Statute, as well as all CMS liens, all Medicare liens, all Medicare Set Asides (MSA) as defined by the CMS, and all waivers from CMS as to the need for a future set aside. RESPONSE: None. CERTIFICATE OF SERVICE I HEREBY CERTIFY that a true and correct copy of the was filed electronically and was sent by E-Mail from the Florida’s Court’s E-Filing Portal system, unless other noted below, on all counsel or parties of record listed below, this 20" day of October, 2020. The foregoing document has also been sent from the undersigned counsel by E-Mail to all counsel or parties of record listed below. David A. Herrero, Esq. Cole Scott & Kissane, P.A. 9150 S. Dadeland Blvd., Suite 1400 Miami, FL 33256 David.herrero@csklegal.com; yahnny.vicente@csklegal.com SCHULER, HALVORSON, WEISSER, ZOELLER & OVERBECK, P.A. Attorneys for Plaintiff Barristers Building 1615 Forum Place, Suite 4D West Palm Beach, FL 33401 (561) 689-8180 By: /s/ Gregory M. Cummings, Esq. WILLIAM D. ZOELLER Fla. Bar No.: 155233 wzoeller@shw-law.com tcoffey@shw-law.com GREGORY M. CUMMINGS Fla. Bar No.: 126074 gcummings@shw-law.com jdaza@shw-law.com Page 3 of 3