Volume 18

18 Fla. L. Weekly Supp. 1203b

Online Reference: FLWSUPP 1811BARI

Insurance — Personal injury protection — Coverage — MRI — 2008 PIP statute which limits amount insurers reimburse medical providers for MRI services does not apply retroactively to policy in effect before effective date of statute — PIP statute does not authorize insurer to cap reimbursement pursuant to Outpatient Prospective Payment System

18 Fla. L. Weekly Supp. 490a

Online Reference: FLWSUPP 1805MEDI

Insurance — Personal injury protection — Coverage — Policy that provides that insurer will pay reasonable reimbursement amount in accordance with No-Fault Act and specifies that insurer will not pay any charge No-Fault Act does not require it to pay or any charge that exceeds amount No-Fault Act allows to be charged authorizes insurer to use fee schedule limits in PIP statute — Outpatient Prospective Payment System cap is applicable to reimbursement under PIP statute

18 Fla. L. Weekly Supp. 406b

Online Reference: FLWSUPP 1804ALEX

Insurance — Personal injury protection — Coverage — Despite fact that PIP policy issued in 2008 does not specifically reference fee schedule in 2008 PIP statute or incorporate specific fee schedule, statutory fee schedule is made applicable by section 627.7407(2) — Question of whether insurer was authorized by PIP statute to cap amount of PIP benefits paid for MRI services by applying Medicare outpatient prospective payment system is stayed pending disposition of issue in class action to which medical provider is party

18 Fla. L. Weekly Supp. 80b

Online Reference: FLWSUPP 1801PULL

Insurance — Personal injury protection — Coverage — Medical expenses — MRI — PIP statute does not authorize insurer to utilize Medicare’s Hospital Outpatient Prospective Payment System limitations or any other limitations not expressly described in PIP statute when determining amounts due for MRI services provided to PIP insured in non-emergency, non-hospital setting

18 Fla. L. Weekly Supp. 211a

Online Reference: FLWSUPP 1802MORE

Insurance — Personal injury protection — Coverage — Medical expenses — Mobile x-ray — Alleged failure to prove that it was impractical to transfer insured to stationary x-ray facility may constitute evidence that mobile x-ray was not medically necessary but did not render x-ray unlawful — Insurer is entitled to jury trial on issue of whether mobile x-ray was medically necessary if x-ray was performed in violation of administrative rule providing that mobile x-ray shall only be used where it is impractical to transport patient

18 Fla. L. Weekly Supp. 552a

.Online Reference: FLWSUPP 1806ADVA

Insurance — Personal injury protection — Coverage — Provision of 2008 PIP statute allowing insurer to limit reimbursement to 200% of Medicare fee schedule is permissive — Policy language providing that insured will pay 80% of reasonable expenses controls reimbursement

18 Fla. L. Weekly Supp. 551a

Online Reference: FLWSUPP 1806TRAP

Insurance — Personal injury protection — Coverage — Provision of 2008 PIP statute allowing insurer to limit reimbursement to 200% of Medicare fee schedule is permissive — Policy language providing that insured will pay 80% of reasonable expenses controls reimbursement

18 Fla. L. Weekly Supp. 393a

Online Reference: FLWSUPP 1804PROC

Insurance — Personal injury protection — Coverage — Provision of 2008 PIP statute allowing insurer to limit reimbursement to 200% of Medicare fee schedule is permissive — Where policy is insufficient to place insured on notice that insurer will calculate payments based on Medicare fee schedule or apply OPPS reductions, policy language providing that insurer will pay 80% of reasonable charges controls reimbursement

18 Fla. L. Weekly Supp. 403a

Online Reference: FLWSUPP 1804LOPE

Insurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered services — 2008 statute that prohibits employment of chiropractic physician as independent contractor by any person that is not entity wholly owned by chiropractic physicians or who is not chiropractic physician and provides that any contract entered into or renewed on or after July 1, 2008, in violation of statute will be void does not bar reimbursement for service rendered by chiropractic physician in clinic owned by chiropractic assistant where assistant has certificate of exemption to own and operate clinic and has not entered into or renewed any contracts on or after July 1, 2008

18 Fla. L. Weekly Supp. 604a

Online Reference: FLWSUPP 1807BEHR

Insurance — Personal injury protection — Coverage — Medical expenses — Lawfully rendered treatment — Where medical provider failed to comply with applicable Minimal Recordkeeping Standards, treatment was not lawfully rendered, and insurer is not obligated to pay for treatment