Volume 26

26 Fla. L. Weekly Supp. 704a

Online Reference: FLWSUPP 2609SAMBInsurance — Personal injury protection — Coverage — Medical expenses — Relatedness and necessity of services — Trial court erred in entering summary judgment in favor of medical provider on issues of relatedness and necessity of reading and interpreting x-rays of insured where opposing affidavit and deposition filed by insurer raised genuine issue of fact regarding relatedness and necessity of reading x-rays over one month after they were prescribed — Reasonableness of charges — Trial court erred in entering summary judgment in favor of provider on issue of reasonableness of charges where opposing affidavit filed by insurer raised issues of material fact

26 Fla. L. Weekly Supp. 255b

Online Reference: FLWSUPP 2604CADAInsurance — Personal injury protection — Coverage — Medical expenses — Reasonable and related treatment — Affidavit in opposition to provider’s motion for summary judgment was sufficient to create genuine issues of fact regarding reasonableness and necessity of x-ray review and interpretation — Trial court erred in entering summary judgment in favor of provider

26 Fla. L. Weekly Supp. 51a

Online Reference: FLWSUPP 2601SILVInsurance — Personal injury protection — Coverage — Medical expenses — Reasonable, related, and necessary treatment — Provider entitled to summary judgment on issue of relatedness of treatment to accident at issue and on medical necessity and reasonableness of MRIs of left elbow and lumbar spine

26 Fla. L. Weekly Supp. 618b

Online Reference: FLWSUPP 2608SABAInsurance — Coverage — Medical expenses — Reasonable, related and necessary treatment — Summary judgment reversed where provider did not present timely, competent evidence of assignment of benefits and genuine issues of fact remain regarding whether the person mentioned in accident report is same person provider treated, whether treatments were medically necessary and related to accident, and whether the charges for such treatments was reasonable

26 Fla. L. Weekly Supp. 936a

Online Reference: FLWSUPP 2612PHILInsurance — Personal injury protection — Coverage — Medical expenses — Reasonable, related, and necessary treatment — MRI and reading and interpretation of MRI — Civil procedure — Summary judgment — Trial court did not abuse its discretion by refusing to accept insurer’s late-filed affidavit in opposition to motion for summary judgment on issue of reasonableness where insurer was not attempting to correct technical defect in a prior, timely-submitted, affidavit, but was instead attempting to submit entirely new affidavit after deciding not to rely on the earlier affidavit — Relatedness and necessity — Opposing affidavit was legally sufficient and created genuine issue of material fact as to relatedness and necessity of MRI, and the reading of it

26 Fla. L. Weekly Supp. 597a

Online Reference: FLWSUPP 2607BEECInsurance — Personal injury protection — Voluntary dismissal — Striking — Under rule 1.540(b), trial court has jurisdiction to consider and rule on insurer’s motion to strike medical provider’s notice of voluntary dismissal without prejudice — Notice of voluntary dismissal filed after court granted provider’s motion for summary judgment is void — Because motion to strike attacks void dismissal, fact that motion was filed more than one year after filing of notice of voluntary dismissal is of no consequence — Statutory fee schedules — Clear and unambiguous election by insurer — Insurer’s motion for rehearing is granted based on Florida Supreme Court decision in Orthopedic Specialists — Where provider previously represented to court that case involved pure issue of law regarding whether policy provided sufficient notice of intent to limit reimbursement to statutory fee schedules, provider is estopped from now raising other issues to avoid entry of final judgment in favor of insurer

26 Fla. L. Weekly Supp. 48b

Online Reference: FLWSUPP 2601INJUInsurance — Personal injury protection — Coverage — Medical expenses — Statutory fee schedules — Policy properly incorporated ability to limit payment pursuant to section 627.736(5)(a)(1) — Statute allows insurers to use Medicare coding policies and payment methodologies of federal Centers for Medicare and Medicaid Services, including applicable modifiers, to determine appropriate reimbursement if coding policy or payment methodology does not constitute utilization limit — Policy provided adequate notice that defendant would be using same — Limits for physician assistant services constitute a Medicare coding policy or payment methodology of federal Centers for Medicare and Medicaid Services

26 Fla. L. Weekly Supp. 913a

Online Reference: FLWSUPP 2611SZABInsurance — Personal injury protection — Coverage — Medical expenses — Insurer properly based its payment for CPT 98940 on participating physician fee schedule of Medicare Part B, as mandated by policy and controlling statute

26 Fla. L. Weekly Supp. 307a

Online Reference: FLWSUPP 2604RALVInsurance — Personal injury protection — Coverage — Medical benefits — Licensed massage therapist — Pursuant to section 627.736(1)(a)5, licensed massage therapists are precluded from recovery of PIP benefits for all services that they perform, not just for massage therapy — No merit to argument that section 627.736(1)(a)5 does not preclude reimbursement for services provided by licensed massage therapist where clinic that employs therapist, not therapist, is entity seeking compensation

26 Fla. L. Weekly Supp. 238b

Online Reference: FLWSUPP 2603JLUMInsurance — Personal injury protection — Coverage — Medical expenses — Licensed massage therapist services provided on behalf of a non-LMT owned and duly licensed healthcare clinic are compensable and reimbursable as PIP benefits under section 627.736(1)(a)(5)