14 Fla. L. Weekly Supp. 372a
Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Allowable amount — Adjustment to Consumer Price Index for All Urban Consumers in South Region — “Medical CPI for Florida” provision of 2001 version of section 627.736(5)(b)5 refers to medical care item of CPI for All Urban Consumers in South Region — MRI providers are entitled to begin receiving annual CPI adjustments as of November 1, 2001, not November 1, 2002
CLEARVIEW IMAGING, L.L.C. d/b/a CLEARVIEW OPEN MRI, as assignee of Judith A. Rivero, individually, and on behalf of all those similarly situated, Plaintiff, vs. PROGRESSIVE CONSUMERS INSURANCE COMPANY, Defendant. Circuit Court, 13th Judicial Circuit in and for Hillsborough County, Civil Division. Case No. 03-4174, Division C. February 13, 2006. James M. Barton, II, Judge. Counsel: J. Daniel Clark. David M. Caldevia. Scott Jeeves. Donald Blackwell.
ORDER ON THE PARTIES’ MOTION SFOR PARTIAL SUMMARY JUDGMENT
THIS CAUSE came before the Court on the following: (a) the Amended Motion for Partial Summary Judgment and supporting memorandum of law filed by the Plaintiff, Clearview Imaging, L.L.C., d/b/a Clearview Open MRI, as assignee, individually, and on behalf of all those similarly situated, on December 5, 2005; and (b) the Motions for Partial Summary Judgment filed by the Defendant, Progressive Consumers Insurance Company, on December 6, 2005. The Court, having reviewed the parties’ motions and memoranda of law, the pleadings, the discovery, affidavits, and other evidence of record, as well as the arguments of counsel, and being otherwise fully advised in the premises,
ORDERS AND ADJUDGES asfollows:
1. The Plaintiff’s Amended Motion for Partial Summary Judgment is hereby GRANTED, and the Defendant’s Motions for Partial Summary Judgment are hereby DENIED.
2. The well settled controlling principles of statutory construction, as well as the undisputed material facts, demonstrate as a matter of law that the “medical Consumer Price Index for Florida” provision of Section 627.736(5)(b)5, Florida Statutes (2001), refers to, and/or must be construed to mean, the Medical Care Item of the Consumer Price Index for All Urban Consumers in the South Region as determined by the U.S. Department of Labor’s Bureau of Labor Statistics because, among other things, it is the only generally accepted Consumer Price Index applicable to medical services most specific to the entire State of Florida. See, e.g., Fair v. State Farm Mut. Auto. Ins. Co., 11 Fla. L. Weekly Supp. 863c (Fla. 7th Jud. Cir. July 15, 2004) (Volusia Circuit Court sitting in appellate capacity held it “would be absurd” to say § 627.736(5)(b)5, Fla. Stat. (2001) refers to a “nonexistent standard”); Premier Open MRI, LLC v. Progressive Express Ins. Co., Case No. 04-5919 (Fla. 13th Jud. Cir. Ct. April 18, 2005) [12 Fla. L. Weekly Supp. 715b] (Slip Opinion) (Hillsborough Circuit Court sitting in appellate capacity held § 627.736(5)(b)5, Fla. Stat. (2001) refers to Medical Care item of the Consumer Price Index for South Region); Millennium Diagnostic Imaging Center, Inc. v. Security National Ins. Co., 882 So. 2d 1027 (Fla. 3d DCA 2004) (2003 legislation amending § 627.736(5)(b)5 was intended to “clarify” 2001 version of statute and not enact a substantive change to 2001 version).
3. The plain language of the statute, as well as the controlling principles of statutory construction and the undisputed material facts, demonstrate as a matter of law that the “Beginning November 1, 2001” and “adjusted annually” provisions of Section 627.736(5)(b)5, Florida Statutes (2001) must be construed to mean that magnetic resonance imaging (“MRI”) providers are entitled to begin receiving the annual Consumer Price Index adjustments asof November 1, 2001, not November 1, 2002. Among other things, the Medicare fee schedule “for year 2001” referenced in Section 627.736(5)(b)5 was actually published on November 1, 2000. See, Medicare Program, Revisions to Payment Policies Under the Physician Fee Schedule for Calendar Year 2001, Final Rules, Fed. Register, 65 FR 65376-01, 2000 WL 1624262 (Nov. 1, 2000). Congress requires that Medicare schedule to be established by “November. 1 of the preceding year, for each year beginning with 1998.” See, 42 USC § 1395w-4(b)(1) and (d)(1)(E)(i) (emph. added). Moreover, the data used in the Medicare schedule was “determined on the basis of the best data available . . . as of September 1, 2000.” See, 42 USC § 1395w-4(f)(3)(A). In other words, the baseline price numbers were established in the year 2000. One cannot presume the November 1, 2001 date in § 627.736(5)(b)5 and the November 1, 2000 publication date of the Medicare fee schedule are mere coincidences. Rather, it must be presumed the Legislature was aware of the federal laws governing the Medicare fee schedule when it identified November 1, 2001 as the key date in Section 627.736(5)(b)5. See, Woodgate Dev. Corp. v. Hamilton Inv. Trust, 351 So.2d 14 (Fla. 1977) (presumption is that laws are passed based on legislature’s knowledge of prior existing statutes). Because the Medicare fee schedule “for year 2001” was based on information collected before September 1, 2000 and was published on November 1, 2000, it would be absurd and punitive to make MRI providers wait until November 1, 2002 to begin receiving an annual price adjustment. Because the November 1, 2001 date in Section 627.736(5)(b)5 falls precisely one year after the Medicare schedule was adopted on November 1, 2000, it makes sense that the prices therein must be “adjusted annually” “[b]eginning on November 1, 2001,” not November 1, 2002. If the Insurance Company’s interpretation was intended, the Legislature could have easily stated that “[b]eginning November 1, 2001” MRI providers would receive the Medicare price, and would begin receiving an annual price adjustment “each year thereafter” as stated in other statutes of this nature. Compare, §766.105(2)(f), Fla. Stat. (“As of January 1, 1990, the minimum entry level amount shall be indexed to the medical component of the consumer price index and shall be adjusted by the fund each year thereafter accordingly.”) (emph. added).
