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Florida's Recent News

UNITED AUTOMOBILE INSURANCE COMPANY, Appellant, v. ELITE HEALTH & REHABILITATION CENTER, a/a/o JOHANNA MARQUEZ, Appellee.

18 Fla. L. Weekly Supp. 146a

Online Reference: FLWSUPP 1802MARQ

Insurance — Personal injury protection — Appeals — Motion to recall mandate is granted where motion was filed within same term opinion was issued — Examination under oath — Failure to attend — No error in finding that insured did not unreasonably refuse to attend EUO where, although insured was represented by counsel, insurer provided EUO notice to insured and partial EUO notice faxed to counsel was defective for failing to state consequences of nonattendance — Trial court erred in striking peer review because it was not obtained before suit was filed and was not based on independent medical examination

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AFFILIATED HEALTHCARE CENTERS, INC., a/a/o FRANCIS DONALDSON, AS GUARDIAN FOR UTIVA TURNER, Appellant, vs. UNITED AUTOMOBILE INSURANCE COMPANY, Appellee.

18 Fla. L. Weekly Supp. 758a

Online Reference: FLWSUPP 1809DONA

Insurance — Personal injury protection — Coverage — Medical expenses — Reasonable, related and necessary treatment — Directed verdict — Error to deny medical provider’s motion for directed verdict on issue of medical necessity of treatment where provider presented expert testimony that treatment was necessary, insurer did not present countervailing expert testimony, and insurer did not severely impeach provider’s expert with second medical report that differed in what expert termed “minutia” — Appellate court is unable to review trial court’s denial of directed verdict in favor of provider on issue of reasonableness of bills where pertinent portions of transcript have not been included in record — However, where jury failed to reach issue of reasonableness, case is remanded for factual determination on issue

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UNITED AUTOMOBILE INSURANCE COMPANY, Appellant, v. HALLANDALE BEACH ORTHOPEDICS, INC., a/a/o BIANCA GONZALEZ, Appellee.

18 Fla. L. Weekly Supp. 564a

Online Reference: FLWSUPP 1807HALL

Insurance — Personal injury protection — Appeals — Briefs — In appeal concerning whether medical fee schedules in PIP statute reenacted in 2008 after sunsetting of statute are permissive or mandatory, motion to strike appendix to initial brief which contains governor’s veto message explaining reasons for rejection of 2006 attempt to reenact sunsetted law that was not part of record before trial court and references to veto message in brief is denied where veto message is part of legislative history that can be reviewed de novo on appeal

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UNITED AUTOMOBILIE INSURANCE COMPANY, Appellant, v. HOLLYWOOD DIAGNOSTICS CENTER a/a/o FRANCISCA C. GONZALEZ, Appellee.

18 Fla. L. Weekly Supp. 503a

Online Reference: FLWSUPP 1806GONZ

Insurance — Personal injury protection — Appeals — Appendix — Extra-record documents — Inclusion in appendix to initial appellate brief of Governor’s veto message, in which then-Governor Bush explained his reasons for vetoing legislature’s attempt to re-enact sunsetted PIP law, and reference to this message in initial brief is not such an egregious or flagrant violation of rules of appellate procedure as to warrant striking of appendix or references thereto, especially where trial court’s ruling concerns pure question of law, an issue of statutory construction, and is subject to de novo review on appeal

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UNITED AUTOMOBILE INSURANCE COMPANY, a Florida Corporation, Appellant, v. FRIEDMAN CHIROPRACTIC CENTER, a/a/o Maritza Collado, Appellee.

18 Fla. L. Weekly Supp. 29b

Online Reference: FLWSUPP 1801COL2

Insurance — Personal injury protection — Admissions — Trial court abused its discretion in not granting insurer relief from admissions to assert that its policy did not cover injuries of passenger who is owner of vehicle with respect to which security is required under Florida No-Fault Law where motion to withdraw admissions was timely filed prior to trial court granting summary judgment, granting motion will facilitate presenting merits of case, and medical provider did not establish that it would be prejudiced in presenting its suit — Affirmative defenses — Abuse of discretion to deny motion to amend answer and affirmative defenses where amendment would not introduce new cause of action — Abuse of discretion to deny insurer’s request to amend interrogatory responses where leave of court is not required to amend interrogatory responses

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New Texting and Driving Law – In Effect July 1st, 2019

In Florida alone, there were 52,000 car crashes caused by distracted driving in 2018. With these staggering statistics, Florida lawmakers have passed a bill that will increase the penalties for texting while driving. It will be moving from a secondary offense to a primary offense. This will allow officers to pull over violators and give them citations without an initial purpose. When Gov. Ron DeSantis signed this bill on May 17th, he made Florida the 45th state to make texting

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Complaint Filed Against IME Doctor

An Administrative Complaint was filed against an IME doctor in Tampa. According to the complaint, the IME doctor received two MRI reports showing a possible labrum tear in the left shoulder and disc herniations in the cervical spine. Here are some blurbs from the Complaint you may find interesting. A pdf of the entire Complaint can be seen by clicking HERE. A reasonably prudent chiropractic physician performing an IME under similar circumstances and conditions would have: -viewed the MRIs and appreciated

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Financial Hardship Form

Please see the attached Financial Hardship Form. It is to be used when a patient is treating at your office and cannot afford to pay you the full co-pay amount due to financial hardship. Click here to see a nice PDF form that you can download for free A couple of things to remember: FINANCIAL HARDSHIP FORM ________________________ Patient Signature _________________________ Print Patient Name Is Massage Reimbursable Under The New PIP Law? Published on: Apr 17, 2018 @ 12:00 Does PIP

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Florida Registered Chiropractic Assistants

*The law that created the RCA license has been repealed effective July 1, 2020. The law that created the CCPA license is still valid.* Hi all! I’ve received a lot of questions about “registered chiropractic assistants” and what they can and cannot do. I’ve decided to research it and provide my readers with the information they need. (1) What is a Registered Chiropractic Assistant? “Registered Chiropractic Assistant” means a person who is registered by the board to perform chiropractic services

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American Speciality Health Group (ASHG) Denials

Were your health insurance bills denied or reduced by a health insurer based on a Peer Review by American Speciality Health Group (ASHG)? ASHG is a third party administrator for Cigna and several other health insurers. ASHG basically makes a recommendation to the insurer advising if the treatment was necessary or if a patient was “over treated” with too much physical therapy/chiropractic. Sometimes ASHG will determine if there is enough documentation regarding whether an MRI was necessary. ASHG cites medical

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What Docs Need to Know About Three Rivers Network

What Every Doc Needs to Know About Three Rivers Network and PIP insurance. Safeco, USAA, and some other PIP insurance companies have affiliated themselves with Three Rivers Network to further discount your medical bills! Be on the lookout for Explanation of Benefits that say “PPO reductions based on Three Rivers Network agreement”. There is a similar company called “Integrated Health Plans” that is doing the same thing – helping reduce your bills. Here is an example of what is happening:

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PIP EMC Form

I’ve received several requests for a sample version of the PIP EMC form. Keep in mind that there is no specific form that is required. This is just a basic form that medical providers can use. In fact, you don’t need to use a form. It can literally be one sentence added to your examination report: “Patient had an emergency medical condition’s For more on Emergency Medical Condition info click here. Click here to see the form. It is also

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