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Appeals court reverses ruling striking limits on PIP payments to chiropractors

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A state appeals court has upheld a law limiting payments to chiropractors under reforms to Florida’s personal-injury protection insurance system the Legislature approved in 2012.

The 3rd District Court of Appeal on Wednesday reversed a ruling by Miami-Dade County Circuit Judge Michaelle Gonzalez-Paulson holding that the limits were unconstitutional.

“We must presume that the Legislature conducted its own evaluation of the respective professionals’ qualifications,” the appeals court wrote.

“When no suspect class or fundamental right is implicated, our inquiry is limited to whether the law bears a reasonable relationship to a legitimate governmental objective. Plainly, the reduction of fraud in order to lower the cost of insurance premiums is a valid governmental objective.”

The case is Garrido v. Progressive American Insurance Co.

Chiropractor Eduardo Garrido, armed with an assignment of benefits agreement signed by patient injured in an accident, challenged the law’s exclusion of chiropractors from the list of medical professionals qualified to diagnose an emergency medical condition.

The law allows only a licensed doctor, osteopath, dentist, or physician’s assistant to render that diagnosis, which would have qualified Garrido to bill for up to $10,000 under his patient’s PIP coverage.

Since Garrido was not authorized to make the diagnosis, the company paid him only $2,500 against his $6,075 bill.

Gonzalez-Paulson concluded the limit was unconstitutional on equal-protection and due-process grounds.

The appeal court, in a unanimous ruling by Chief Judge Richard Suarez, cited “a strong presumption of validity if there is a rational relationship between the disparity of treatment of those persons or groups and a legitimate governmental objective.”

In this case, the court said, that was “to reduce fraud in order to lower the cost of insurance premiums.”

The separation-of-powers doctrine obliges courts to defer to reasonable legislative decisions, the court continued.

“Courts are required to give great deference to legislative policy choices, and it constitutes reversible error for a trial court to subject legislative fact-finding to courtroom fact-finding standards,” the court said.

“In this vein, and recognizing the hallmark constitutional principle of separation of powers, even laws that a judge perceives ‘as unwise or unfair’ pass constitutional muster under the rational-basis test.”

Michael Moline is a former assistant managing editor of The National Law Journal and managing editor of the San Francisco Daily Journal. Previously, he reported on politics and the courts in Tallahassee for United Press International. He is a graduate of Florida State University, where he served as editor of the Florida Flambeau. His family’s roots in Jackson County date back many generations.

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