Volume 13

13 Fla. L. Weekly Supp. 1088a

Insurance — Personal injury protection — Coverage — Medical expenses — Withdrawal of benefits — Peer review report — Where insurer denied payment for nerve conduction velocity test based on peer review report that was based solely on conclusions drawn from examination of records, insurer failed to obtain valid report allowing withdrawal of payment — Medical provider’s motion for summary judgment granted 

13 Fla. L. Weekly Supp. 1160a

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Despite opposing affidavit and independent medical report, there was sufficient evidence that MRI was reasonable, related and necessary to support entry of summary judgment in favor of medical provider

13 Fla. L. Weekly Supp. 378a

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Patient brokering — Fee splitting — Where undisputed facts demonstrate that medical provider rendered no professional or technical services pertaining to MRI bill, lease agreement between provider and scan center and employment agreement between provider and physician that interpreted MRI constitute illegal patient brokering and/or fee splitting

13 Fla. L. Weekly Supp. 494b

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Summary judgment is entered in favor of medical provider where affidavit of physician establishes that MRI was reasonable, related and necessary as result of accident, and medical provider has not filed anything in opposition to motion for summary judgment — Where provider is not accredited MRI facility, charges are payable at 175% of Medicare Part B fee schedule

13 Fla. L. Weekly Supp. 416a

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Medicare Part B fee schedule — Consumer Price Index adjustment — Trial court erred in retroactively applying 2003 amendment to section 627.736(5)(b)5, which changed the timing of CPI adjustments to Medicare Part B fee schedule for MRI services to August 1 to reflect entire calendar year’s CPI changes, where inclusion of effective date in statute rebuts any argument that statute is retroactive — Where applicable 2001 version of statute provides that first annual CPI adjustment was to occur on November 1, 2002, insurer was not required to make CPI adjustment to fee schedule before paying bills for MRI service provided prior to November 1, 2002

13 Fla. L. Weekly Supp. 901a

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Allowable amount — Adjustment to Florida Medical Consumer Price Index — Court may refer to 2003 amendment to section 627.736(5)(b)(5), clarifying that term “Florida Medical Consumer Price Index” in 2001 statute refers to annual medical care item of Consumer Price Index for All Urban Consumers in South Region, to interpret meaning of CPI language in 2001 statute — No merit to argument that reliance on 2003 amendment to interpret CPI language in 2001 statute would result in unconstitutional retroactive application of 2003 amendment — Correct amount of CPI adjustment calculated — Question certified

13 Fla. L. Weekly Supp. 912b

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Allowable amount — Adjustment to Consumer Price Index for All Urban Consumers in South Region — Calculation — CPI calculation must be made annually and cumulatively, reflecting combined prior years’ increases from 2001 through August 1 of year MRI was performed — Correct CPI adjustment calculation reveals insurer paid medical provider less than allowable amount for MRI

13 Fla. L. Weekly Supp. 785a

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Allowable amount — Adjustment to Florida Medical Consumer Price Index — Error to grant summary judgment in favor of insurer that failed to apply CPI adjustment to MRI payment on grounds that Florida CPI named in 2001 version of statute did not exist at time of payment where construction of statute to find legislature intended payments be adjusted by nonexistent standard would be absurd and render statute meaningless — Based on rules of statutory construction and consideration of 2003 amendment specifying that CPI for southern region of country be applied, insurer was required to adjust payment pursuant to CPI for southern region

13 Fla. L. Weekly Supp. 1099a

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Allowable amount — Adjustment to Consumer Price Index for All Urban Consumers in South Region — Calculation — CPI calculation must be made annually and cumulatively, reflecting combined prior years’ increases from 2001 through August 1 of year MRI was performed and percentage in change of prices for 12-month period ending June 30 of that year — Correct CPI adjustment calculation reveals insurer paid medical provider less than allowable amount for MRI

13 Fla. L. Weekly Supp. 1097a

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — Allowable amount — Adjustment to Consumer Price Index for All Urban Consumers in South Region — Calculation — CPI calculation must be made annually and cumulatively, reflecting combined prior years’ increases from 2001 through August 1 of year MRI was performed and percentage in change of prices for 12-month period ending June 30 of that year — Correct CPI adjustment calculation reveals insurer paid medical provider less than allowable amount for MRI