12 Fla. L. Weekly Supp. 681a
Insurance — Personal injury protection — Coverage — MRI — Payment of allowable amount of Medicare Part B — Medical consumer price index adjustment — Where legislature intended that amount of payment authorized for MRI was to be adjusted annually, and legislature’s subsequent amendment of statute to set standard for adjustment as CPI for all urban consumers for the south reveals what intent of legislature was, insurer was obligated to adjust amount it pays to MRI providers annually in accord with south regional CPI — Summary judgment granted in favor of medical provider as to liability
FLORIDA MRI, INC., (Nabila Raza), Plaintiff, vs. PROGRESSIVE EXPRESS INSURANCE COMPANY, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 02-023526 COCE (55). May 2, 2005. Eric M. Beller, Judge. Counsel: Steven Lander, Steven Lander, P.A., Fort Lauderdale. Matt Hellman.
ORDER
THIS CAUSE having come on before this Court on: PLAINTIFF’S MOTION FOR SUMMARY JUDGMENT AND DEFENDANT’S CROSS MOTION FOR SUMMARY JUDGMENT, and the Court having heard argument of counsel, and being otherwise advised in the Premises, and the same is hereby ordered and adjudged:
On October 24, 2002 the Plaintiff, Florida MRI, performed an MRI on the Defendant’s insured, Nabila Raza. Florida MRI billed the Defendant, Progressive, directly for the technical portion of that MRI. Thereafter, Progressive issued a payment of $663.86 to the Plaintiff for the MRI services. That amount was paid pursuant to the participating fee schedule under Medicare Part B (2001). No consumer price index increase was made relative to that payment.
The Court reviewed the cases provided by counsel, most notably the appellate case of Betty Fair vs. State Farm Mutual Automobile Insurance Company, 11 Fla. L. Weekly Supp. 863c. In that case the Circuit Court of the Seventh Judicial Circuit in and for Volusia County, Case Number: 04-00004-CAAC, in its appellate capacity, ruled that “The legislature intended that the amount of authorized payments was to be adjusted annually. To accept the appellee’s position, one would have to accept that the legislature unwittingly enacted the section because under the interpretation of the appellee, the subsection is meaningless. For the legislature to intend that payments be adjusted by a nonexistent standard would be absurd. The appellant points out accurately that the only CPI to completely subsume the state of Florida is the south regional CPI. The legislature lateramended Statute 627.736(5)(b)5, to set the standard by which the authorized payments were to be adjusted.”
In light of this appellate decision and argument of counsel this Court finds that the Defendant/Insurer, beginning August 1, 2002, was obligated to increase the amount it pays to MRI providers, adjusting annually on August 1 to reflect the prior calendar year’s changes in the annual in accord with the Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the Bureau of Labor Statistics of the United States Department of Labor for the 12-month period ending June 30 of that year. Fla. Stat. 627.736(5)(b)5 (2003). As the Defendant failed to pay pursuant to the statutorily mandated schedule it is liable to the Plaintiff for damages.
Accordingly, Summary Judgment is hereby entered in favor of the Plaintiff as to liability. Defendant’s Cross Motion for Summary Judgment is hereby denied.
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