11 Fla. L. Weekly Supp. 306b
Insurance — Personal injury protection — Medical bills — Reduction — Preferred provider organization rates — No-fault law does not prohibit insurer from making payment for healthcare services covered by PIP benefits at reduced PPO rates — Remand to address issues regarding scope and validity of PPO agreements
NATIONWIDE PROPERTY & CASUALTY INSURANCE COMPANY, Appellant, vs. DRS. SHEER, AHEARN & ASSOCIATES, P.A. (as assignee of SHERRY HOLDAWAY), Appellee. Circuit Court, 13th Judicial Circuit (Appellate) in and for Hillsborough County. Case No. 03-4596. Division X. L.C. Case No. 02-7329-SC. January 20, 2004. Gregory P. Holder, Judge. Review of a final order of the County Ct., Hillsborough County. Counsel: Charles Tyler Cone, Fowler White Boggs Banker, P.A., Tampa, for Appellant. Bradley Souders, Tampa, for Appellee.
Appellant, an insurer under the no-fault statute, seeks review of a trial court determination that section 627.736(10), Florida Statutes (hereinafter “subsection 10”), prohibits it from making payment for healthcare services covered by personal injury protection (PIP) at reduced preferred provider organization (PPO) rates to the appellee healthcare provider. The facts of this case are substantially similar to the recently decided Nationwide Property & Casualty Company v. Lasswell (a/a/o Laurence Brindley) 03-3092 (Fla. 13th Jud. Cir. Dec. 9, 2003) [11 Fla. L. Weekly Supp. 203a], citing Nationwide Mutual Insurance Company v. Jewell & Hudson/Nationwide Mutual Fire Insurance Co. v. Davis, 2D01-5714 (Fla. 2d DCA Nov. 14, 2003). Based on the foregoing authority, we reverse the decision of the trial court with respect to its interpretation of subsection (10). However, because the trial court did not address issues relating to the scope and validity of the provider agreements and the payor contracts which are the subject of this dispute, we remand this cause to the trial court for the purpose of addressing those issues.
It is therefore ORDERED that this cause is REVERSED and REMANDED for further proceedings. (ARNOLD and BARTON, JJ., concur.)
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