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PIP Injunction Reversed Concerning Emergency Medical Condition Designations And $2,500 Benefit Availability; Reimbursement To Licensed Massage Therapists And Licensed Acupuncturists

The 1st District Court of Appeals recently issued an opinion in the matter of McCarty v. Myers (2013 WL 5744435, Fla. 1st DCA, October 23, 2013) reversing the temporary injunction which was granted in the circuit court matter (Myers v. McCarty, 2013 CA 73, Fla. 2d Cir. Ct.) on March 15, 2013 concerning application of changes to the Personal Injury Protection, or PIP, law which were to take effect on January 1, 2013. The new law provided, and the injunction halted, provisions that, regardless of Florida residents’ purchase $10,000.00 in PIP coverage through their automobile insurance carrier, this $10,000 would be available only for conditions designed as “emergency medical conditions” as diagnosed by specific providers – specifically excluding chiropractic physicians from making this determination; otherwise only $2,500 would be available for non-emergency medical conditions. The law also provided that licensed massage therapists and licensed acupuncturists were excluded from being reimbursed for services by PIP benefits.

The temporary injunction entered in March did not affect the provision of the new 2012 PIP Act which provided that in order for individuals injured in a motor vehicle accident to be entitled to PIP benefits in any amount, medical care must be sought from specific providers within fourteen days after the accident.

However, the 1st DCA decision did not address the constitutionality arguments made concerning the changes in the law and found that injunctive relief was not appropriate because the Plaintiffs – an acupuncture physician, a chiropractic physician and a licensed massage therapist, as well as a fictional “John Doe” which represented similarly situated medical and health care providers in Florida and a fictional “Jane Doe” which represented “all those citizens of Florida who are, were, or will be, injured as a result of motor vehicle accident that were also required to purchase $10,000…of PIP insurance coverage but may actually only receive no or $2,500 in benefits” – lacked standing to bring the suit under the constitutional challenge that the Act violates the right of people to have access to the courts to seek redress for their injuries. Specifically, the 1st DCA found that the proper injured parties to bring the claim were the parties represented as the fictional “Jane Doe” – the injured motorists whose ability to sue the at-fault party were limited; and that the providers “attempt to bootstrap the standing requirement by joining the fictional ‘Jane Doe’ … fail[s].”

While this is likely not the last we will see of the constitutionality arguments at the circuit or district court levels, with the injunction reversed, PIP providers are now able to enforce and limit the provisions of the 2012 PIP Act concerning designation of Emergency Medical Conditions and corresponding reduced availability in benefits where no EMC is designated, as well as to withhold reimbursement to licensed massage therapists and licensed acupuncturists.

If you have been injured in a motor vehicle accident, contact Pilka Adams & Reed, P.A. for a free consultation at (813) 653-3800 or [email protected].