17 Fla. L. Weekly Supp. 1039a
Online Reference: FLWSUPP 1710AQU2
Insurance — Personal injury protection — Coverage — Medical expenses — MRI — PIP insurer cannot pay benefits in accordance with permissive fee limitations of 2008 version of PIP statute where policy language requires payment of 80% of reasonable charges — PIP statute does not authorize insurer to utilize Medicare’s Outpatient Prospective Payment System to calculate permissive limitations
MR SERVICES I, LLC D/B/A C & R IMAGING OF HOLLYWOOD, a Florida Corporation (assignee of Aquino, Juan), Plaintiff, v. STATE FARM FIRE AND CASUALTY COMPANY, Defendant. County Court, 17th Judicial Circuit in and for Broward County. Case No. 08-016858 COCE 53. July 19, 2010. Robert W. Lee, Judge. Counsel: Russel Lazega, Law Office of Russel Lazega, North Miami. Mark J. Rose, Roig, Tutan, Rosenberg & Zlotnick, P.A., Deerfield Beach.
ORDER GRANTING PLAINTIFF’S MOTION FOR FINAL SUMMARY JUDGMENT AND DENYING DEFENDANT’S MOTION FOR FINAL SUMMARY JUDGMENT AND FINAL JUDGMENT IN FAVOR OF THE PLAINTIFF
THIS CAUSE came before the Court for hearing on July 12, 2010 on Plaintiff’s Motion for Summary Judgment and Defendant’s Motion for Summary Judgment and, having reviewed the motions and entire Court file; heard argument; reviewed the relevant legal authorities; and been sufficiently advised in the premises, the Court finds as follows:
Background:This is a P.I.P. case brought by an MRI Service provider seeking payment in the amount of $200.28 for OPPS reductions taken by Defendant pursuant to F.S.s. 627.736(5)(a)(2) (2008). Additionally, Plaintiff seeks interest and attorney’s fees and costs. The policy in question was issued March 20, 2008 for a 6 month term. The accident in question was dated April 14, 2008. The MRI service in question was done June 23, 2008. The parties have stipulated that the sole remaining issues are questions of law, namely:
1.) Whether the Defendant could avail itself of the permissive fee limitation contained in 627.736(5)(a)(2) (2008) in light of its policy language calling for payment of 80% of reasonable charges incurred for necessary medical services and
2.) Whether F.S.s 627.736(5)(a)(2) (2008) allows for the use of the OPPS Fee Schedule in calculating the permissive limitations under F.S.s. 627.736(5)(a)(2)(2008).
CONCLUSION OF LAW
The Court continues to follow its prior ruling in Hollywood Diagnostic Center v. Mercury Insurance Company, Case No.: 09-844 COCE 53 (Broward Cty. Ct.).
Accordingly, Plaintiff’s Motion for Final Summary Judgment is Granted and Defendant’s Motion for Final Summary Judgment is Denied.
The Plaintiff, MR Services I, LLC d/b/a C & R Imaging of Hollywood, whose address is 4310 Sheridan Street, Hollywood, FL 33021, shall recover from the Defendant, State Farm Fire & Casualty Company, whose address is 7401 Cypress Gardens Blvd., Winter Haven, FL 33888, the principal sum of $200.28 together with interest at the rate of 11% pursuant to F.S.s. 627.736(4) from July 7, 2008 to July 12, 2010 in the amount of $44.36.
This judgment shall bear post-judgment interest at the rate of 6% per year from date of entry until satisfied.
The draft shall be payable to MR Services I, LLC and delivered to Russel Lazega, Esq. at The Law Office of Russel Lazega, P.A., whose address is 13499 Biscayne Blvd, Suite 107, North Miami, FL 33181. Plaintiff is the prevailing party and is entitled to recover attorney’s fees and costs pursuant to F.S.s. 627.428.
The Court reserves jurisdiction to determine the reasonable amount of attorney’s fees and costs and enter judgment accordingly.
Let execution issue for the above sums.
