Providers Represented

2012 /2013 PIP LAW

  1. Initial Services and Care

In order to receive Personal Injury Protection (PIP) benefits, an injured person MUST seek initial services and care within 14 days of the motor vehicle accident. Initial services and care may be provided by, supervised, ordered OR prescribed by: MD, DO, Dentist, Chiropractor, or provided in a hospital, provided by a facility that owns/is owned by a hospital, Ambulance/EMTs

Failing to seek treatment within 14 days will result in a complete forfeiture of a patient's PIP benefits.

  1. Follow Up Services and Care

May be obtained upon a referral from any of the 7 providers (listed above) of initial services and care

Treatment MUST be "consistent with the underlying medical diagnosis rendered."

It is anticipated that there will be a lot of litigation regarding "underlying medical diagnosis" and "care consistent with" this diagnosis.

May be provided by, supervised, ordered OR prescribed ONLY by: MD/DO/Dentist/Chiropractor, A Physician's Assistant (PA) or an Advanced Registered Nurse Practitioner (ARNP) working under MD/DO/Dentist/Chiropractor , a hospital/ambulatory surgical center, an entity wholly owned by MD/DO/Dentist/Chiropractor and their spouse/parent/child/sibling, an entity that owns/ is owned by a hospital, a Physical Therapist (PT) IF the referral is made to the PT by MD/DO/Dentist/Chiropractor, or a Certified Health Care Clinic

  1. Reimbursement

The patient will be eligible for $10,000.00 if an MD/DO/PA/ARNP has determined that the injured person had an Emergency Medical Condition (EMC).

The patient will be eligible for a maximum of $2500.00 if any of the providers who rendered initial care or follow up care determines that the injured person did not have an Emergency Medical Condition.

Emergency Medical Condition Defined (Fla. Stat. 627.732(16)

"Emergency medical condition" means a medical condition manifesting itself by acute symptoms of sufficient severity, which may include severe pain, such that the absence of immediate medical attention could reasonably be expected to result in any of the following:

(a) Serious jeopardy to patient health.

(b) Serious impairment to bodily functions.

(c) Serious dysfunction of any bodily organ or part.

According to the Statute, a Chiropractor cannot determine if an Emergency Medical Condition exists, but can determine that an Emergency Medical Condition does not exist.

The Statute does not say where in the course of treatment the EMC must be determined. It does not reference whether EMC is established in either the initial care or follow up care, nor does it say that an initial treating provider or follow up provider must be the one to determine that an EMC existed.