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DOZIER v. PROFESSIONAL FOUNDATION FOR HEALTH CARE

No. 90-3328.

944 F.2d 814 (1991)

Laurie DOZIER, Jr., M.D., Plaintiff-Appellee, v. PROFESSIONAL FOUNDATION FOR HEALTH CARE, INC., Frank D. Tagliarini, M.D., Defendants-Appellants.

United States Court of Appeals, Eleventh Circuit.

October 11, 1991.

Attorney(s) appearing for the Case

Patricia Guilday, Pensacola, Fla., for defendants-appellants.

John C. Cooper, Douglass, Cooper, Coppins & Powell, Tallahassee, Fla., for plaintiff-appellee.

Before TJOFLAT, Chief Judge, DUBINA, Circuit Judge, and PECK, Senior Circuit Judge.

TJOFLAT, Chief Judge:

Pursuant to a contract with the Health Care Financing Administration (HCFA), the Professional Foundation for Health Care, Inc. (the Foundation), a Medicare peer review organization (PRO), reviews Medicare claims filed in the state of Florida.1 If the Foundation determines that the treatment given to a Medicare patient was unreasonable, not medically necessary, or did not meet professional standards of care, Medicare...

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