Physicians' Group To Weigh In On 'PIP' Fees Case

Apr 5, 2016

The state Supreme Court on Thursday approved the Florida Medical Association's request to file a friend-of-the-court brief in a case about fees paid to medical providers who treat people injured in auto accidents.

Allstate Insurance is appealing a ruling by the 4th District Court of Appeal in 32 consolidated cases that involve the state's personal-injury protection, or PIP, auto insurance system. The Supreme Court agreed in January to take up the case.

A key issue focuses on whether policies were clear that Allstate would make payments to providers based on a Medicare fee schedule, which places limits on payment amounts.

Providers argued that the insurance policies were "ambiguous" on the issue, and a majority of a three-judge panel of the appeals court agreed.

The Florida Medical Association asked the Supreme Court this month for permission to file a friend-of-the-court brief --- drawing an objection from Allstate.

But the Supreme Court went along with the request Thursday.

"Substantively, Allstate is attempting to use a payment methodology that will dramatically limit or reduce the standard and customary rate of reimbursement for treatment and services for FMA members,'' the physicians' group said in its request to file the brief.

"In short, FMA physicians have seen or will see a dramatic reduction in reimbursement rates under the PIP law based on the ruling in this case, and they have a direct and significant interest in judicial determination as to the legality or propriety of application of the PIP laws under the Allstate policy."