Volume 11

11 Fla. L. Weekly Supp. 563c

Insurance — Personal injury protection — Claim for magnetic resonance imaging services by medical provider which performed technical component of MRI and paid radiologist to perform professional interpretive component of MRI — It is not unlawful for provider that owns or leases 100% of equipment to hire radiologist as independent contractor to perform professional component of MRI and globally bill for both components — Fee-splitting — Patient brokering — Relationship between plaintiff and radiologist is not unlawful brokering or fee-splitting

11 Fla. L. Weekly Supp. 344c

Insurance — Personal injury protection — Summary judgment granted as to fraud, relatedness, and necessity where peer review was performed after discovery cut-off — Deductible defense is withdrawn as bills are to be applied to deductible in order received by insurer — Sole issue for jury is reasonable amount for MRI bill — Motion to strike countersignature defense against assigned claim is granted

11 Fla. L. Weekly Supp. 863c

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, error to grant summary judgment for insurer on claim no adjustment was possible that because no statewide medical CPI existed

11 Fla. L. Weekly Supp. 242a

Insurance — Personal injury protection — Magnetic resonance imaging — Medical provider claiming entitlement to reimbursement for MRI pursuant to “limiting charge” of Medicare Part B fee schedule — Phrase “allowable amount under Medicare Part B” as used in section 627.736(5)(b)5 to cap amounts that may be charged to PIP insurers and insureds for MRIs refers only to Medicare’s “participating fee schedule,” not to “limiting charge” amount which is surcharge borne by Medicare patients who opt to use services of non-participating providers and submit claims on unassigned basis — PIP insurer properly reimbursed provider/assignee for MRI pursuant to Medicare Part B participating fee schedule — Summary judgment granted in favor of insurer — Question certified

11 Fla. L. Weekly Supp. 164b

Insurance — Personal injury protection — Magnetic resonance imaging — Effective date of section 627.736(5)(b)5, which places cap on amounts that may be charged to PIP insurers and insureds for MRI services became effective June 19, 2001 — Plaintiff’s ore tenus motion for leave to amend complaint is denied as untimely

11 Fla. L. Weekly Supp. 831a

Insurance — Personal injury protection — Coverage — Magnetic resonance imaging — Medicare Part B fee schedule–Statute defining reasonable amount MRI provider may collect does not require that claim form state Medicare fee schedule amount or provide penalty denying payment where form contains amount different from fee schedule amount

11 Fla. L. Weekly Supp. 842a Insurance — Personal injury protection — Coverage — Magnetic resonance imaging — Medicare Part B limiting charge — MRI

11 Fla. L. Weekly Supp. 840a

Insurance — Personal injury protection — Coverage — Magnetic resonance imaging — Payment of allowable amounts of Medicare Part B Fee Schedule — Statute requiring adjustment of payment for MRI to medical consumer price index for Florida placed insurer in impossible and unreasonable position of having to guess appropriate consumer price index to apply, as there is no medical consumer price index for Florida — Summary judgment granted in favor of insurer that paid 80% of 200% of Medicare Part B Fee Schedule for MRI without adjustment to any medical consumer price index

11 Fla. L. Weekly Supp. 676a

Insurance — Personal injury protection — Magnetic resonance imaging — Statute that requires adjustment of MRI charge under “medical Consumer Price Index for Florida” that did not exist at time payment was due is impossible to execute — Application of some other medical consumer price index or newly-enacted formula to calculate the medical consumer price index would violate principles of strict interpretation and constitute legislating — Summary judgment granted in favor of insurer

11 Fla. L. Weekly Supp. 647cNOT FINAL VERSION OF OPINION
Subsequent Changes at 11 Fla. L. Weekly Supp. 827a

Insurance — Personal injury protection — Magnetic resonance imaging — Medical provider claiming entitlement to reimbursement for MRI pursuant to “Limiting Charge” of Medicare Part B schedule — “Allowable amount under Medicare Part B” as used in Section 627.736(5)(b)5 refers to Medicare “Limiting Charge” amount, not Medicare’s “Participating Fee Schedule” — In enacting requirement that allowable amount for MRI be adjusted annually by amount equal to nonexistent “medical Consumer Price Index for Florida,” legislature intended that amount be adjusted annually, and insurer is required to make adjustments to allowable amount pursuant to Consumer Price Index, South Region-Urban Consumers under category of Medical Care — Question certified