10 Fla. L. Weekly Supp. 1036c
Insurance — Personal injury protection — Coverage — Medical expenses — Amount — MRI fee schedule — Adjustments based on medical Consumer Price Index
SIEGFRIED K. HOLZ, M.D., P.A. a/a/o NADI ROSIUS, Plaintiff, vs. NEW HAMPSHIRE INDEMNITY CO., INC., a foreign corporation, Defendant. County Court, 13th Judicial Circuit in and for Hillsborough County, Civil Division. Case No. 03-8282 SC. Division L. October 13, 2003. Artemeus E. McNeil, Judge. Counsel: Jason F. Lamoureux, Holland & Lamoureux, Brandon, for Plaintiff. Cate MacGlashan, Delcamp & Siegel, St. Petersburg, for Defendant.
ORDER GRANTING DEFENDANT’S MOTION FOR FINAL SUMMARY JUDGMENT
THIS ACTION was heard on Defendant’s Motion for Final Summary Judgment. After carefully reviewing and considering the Motion, the Memorandum of Law, the Court file, and arguments of counsel, the Court makes the following findings of fact and law.
1. Plaintiff performed an MRI on Nadi Rosius on or about January 28, 2003.
2. Plaintiff billed for a cervical MRI under CPT 72141 in the amount of $1,450.00.
3. Prior to February 28, 2003, Defendant paid Plaintiff $828.10, which is 80% of the 200% of the amount allowed to participating providers under Medicare Part B for year 2001 for the CPT code billed for the area in which treatment was rendered.
4. The $828.00 amount paid by Defendant to Plaintiff was not adjusted to the Medical Consumer Index.
5. Prior to October 1, 2003, the effective date of the amendment to the PIP statute, no criteria existed to calculate the amount that the MRI fee schedule should be adjusted under §627.736(5) based upon the CPI, as no Florida CPI existed.
6. The Bureau of Labor Statistics (BLS) publishes monthly indexes for the national CPI as well as from regional indexes: north east, mid-west, south, and west. Indexes for major metropolitan areas are published monthly (3 areas): bi-monthly (11 areas), or semi-annually (12 areas).
7. §627.736(5)(b)(5), Florida Statute (2001) placed the Defendant in the impossible position of having to guess the appropriate CPI to apply.
8. The statute as enacted in 2001 was neither ambiguous or vague. The statute was simply in error.
WHEREFORE, the Defendant’s Motion for Final Summary Judgment is Granted.
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