Volume 11

11 Fla. L. Weekly Supp. 136b

Insurance — Personal injury protection — Action against insurer which paid 80% of amount allowed to participating providers under Medicare Part B for cervical MRI but failed to adjust amount to Medical Consumer Price Index for Florida — Because at time insurer paid for MRI, prior to amendment to PIP statute, no criteria existed to calculate amount that MRI fee schedule should be adjusted under statute based on CPI for Florida, as no CPI existed for Florida, statute placed insurer in impossible position of having to guess appropriate CPI to apply — Summary judgment granted in favor of insurer

11 Fla. L. Weekly Supp. 1024a

Insurance — Personal injury protection — Coverage — Medical benefits — MRI — Fact that amount billed on provider’s HCFA claim form exceeds fee schedule amount set forth in statute does not relieve insurer of liability for payment on ground that bill does not constitute proper notice of a claim — MRI bill, if otherwise payable, is payable at the fee schedule amount as defined in section 627.736(5)(b)(5) — Unrefuted testimony by treating chiropractor that MRI was necessary to determine nature and extent of injuries, if any, insured sustained in automobile accident was sufficient to establish that bill was reasonable, related and medically necessary, and report provided by defendant in which radiologist opined that film identified no evidence of acute trauma from accident at issue did not address issue of whether MRI was reasonable, related, or medically necessary — Provider entitled to recover medical expenses and prejudgment interest on overdue benefits

11 Fla. L. Weekly Supp. 748a

Insurance — Personal injury protection — Magnetic Resonance Imaging — Phrase “allowable amount under Medicare Part B” in section 627.736(5)(b)(5) refers to participating fee schedule

11 Fla. L. Weekly Supp. 917a

Insurance — Personal injury protection — Coverage — Magnetic resonance imaging

11 Fla. L. Weekly Supp. 727a

Insurance — Personal injury protection — Coverage — Magnetic resonance imaging — Medical provider which performed technical component of MRI on machine it owns or leases, contracted with independent radiologist on non-contingent basis to perform professional component, transmitted MRI films to radiologist, received and transmitted interpretation to ordering physician and insurer, and billed insurer globally for both technical and professional component, rendered MRI within meaning of section 627.736(5) — Summary judgment for insurer is denied

11 Fla. L. Weekly Supp. 1097a

Insurance — Personal injury protection — Coverage — Magnetic resonance imaging — Summary judgment granted in favor of medical provider on issues of reasonableness, necessity, and relatedness of MRI; whether amount of PIP benefits for MRI are payable according to preset fee schedule, and whether provider was properly licensed to perform MRI

11 Fla. L. Weekly Supp. 796b

Insurance — Personal injury protection — Coverage — Medical provider — Entity not performing necessary medical services — No error in concluding that entity which picked up CT scan and x-ray studies from medical provider that conducted tests and gave studies to doctors contracted to interpret studies did not provide necessary medical services under PIP statute — Summary judgment for insurer affirmed

11 Fla. L. Weekly Supp. 1112a

Insurance — Personal injury protection — Any PIP provider seeking to obtain PIP benefits from an insurer must have requisite medical licenses pertaining to particular provider’s qualifications and competency to perform the provider’s particular speciality under the applicable medical chapter of Florida statutes — Requirement for having county occupational license has nothing to do with having requisite qualifications to perform particular medical profession and specialty — Insurer’s amended motion for summary judgment denied

11 Fla. L. Weekly Supp. 966b

Insurance — Personal injury protection — PIP claimant is not required to prove that medical providers are licensed

11 Fla. L. Weekly Supp. 818b

Insurance — Personal injury protection — Coverage — Lawfully rendered services — Massage therapy services were lawfully rendered despite fact that provider/assignee did not have establishment license at time services were rendered — Provider which provided massage by licensed therapist only to patients of chiropractor employed by provider is not “establishment” required by administrative rule to have establishment license — Partial summary judgment granted in favor of provider