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Florida Fourth DCA rules in PIP case that trial court erred by not allowing insurer to use Medicare payment methodology even though chiropractic services at issue were not reimbursable under Medicare

On October 6, 2021, in Progressive American Insurance Company v. Head to Toe Posture Rehab, LLC, No. 4D21 -647, the Florida Fourth DCA ruled in a personal injury protection (PIP) insurance case that the trial court erred by finding that that the defendant insurance company could not use Medicare’s Multiple Procedure Payment Reduction (MPPR) methodology, which was expressly allowed under the PIP policy, because Medicare does not reimburse chiropractors for the therapy services at issue. The Fourth DCA reversed the trial court because a provision within the PIP statute, Fla. Stat. § 627.736(5)(a)3 (2014), authorizes utilization of MPPR to limit PIP reimbursement for therapy services provided by a licensed chiropractor even though reimbursement to a chiropractor for those same services would not be provided under Medicare.

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