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This is the second of several articles on the road to success under Florida Tort Reform’s (FTR) Section 768.0427. That road is paved by a three-tiered response to the statute in which medical providers replace pre-FTR new-patient forms and practices, their attorneys prevail on motions for protective order (MPOs), and PI firms prevail on motions in limine (MILs). This second article will provide a deeper analysis of the statutory definition of “letter of protection^^ (LOP) and its impact on discovery and admissibility issues. Subsection (1)(d) defines LOP as “a promise of payment… from any judgment or settlement.M This definition may have substantial impact on three different areas – subsection (2)(b)(2), subsection (2)(b)(4), and Section 3. Subsection(2)(b)(2)states that if the claimant has health care coverage but obtains treatment under a letter of Protection or otherwise does not submit charges for any health care provider’s medical treatment or services to health care coverage … the defense can present evidence of the amount the insurer Would pay” had the patient used insurance. The concern, here, is that the insurance reimbursement amount is likely to have an “anchoring” effect that drags a jury award down from the charged amount. Notably, this subsection contains an “or” thal may allow the defense to present the evidence even without an LOP Subsection (2)(b)(4) states that “if the claimant obtains medical treatment or services under a letter of Protection and the health care provider subsequently transfers the right to receive payment under the letter of protection to a third party/* the defense can present the purchase price to the jury. Here, the concern is that the purchase price is likely to have an anchoring effect that drags a jury award down from the charged amount.Section 3 states that as a condition precedent to asserting any claim for medical expenses for treatment rendered under a letter of Protection. the claimant must disclose five different categories of information. One category of information, contained in subsection (3)(e), is “the financial relationship between a law firm and a medical provider, including the number of referrals, frequency, and financial benefit obtained.,, This is the Boecher impeachment information that Worley prohibited the defense from obtaining. Thus, the concern is that FTR abrogates Worley. But because the existence of an LOP is a condition precedent to the subsection(2)(b)(2)insurance reimbursement, the subsection (2)(b)(4) purchase price, and the Section 3 Boecher impeachment information, medical providers and PI firms have a strong plain language argument that the defense is not entitled to this information because there is no LOP. This argument requires medical providers to： Create new financial agreements that do not meet the statutory definition of LOP This requires much more than simply deleting any express promise to pay from litigation proceeds；   Revise new-patient, billing, and any other forms to exclude terms like  letter of protection LOP and litigation lien;” Never write notes that refer to LOPs or “LOP patients;” Never list the PI firm as a payor, insurer, or guarantor; Enforce financial agreements and maintain a record; In corporate representative and doctor depositions, be wary of the multiple and evolving tricks the defense will employ to blur the distinction between LOPs and the new financial agreement. These steps should constrain courts to apply the plain language of the statute and determine that no LOP exists. If so, medical providers and PI firms will prevail on MPOs and MILs under subsection(2)(b)(2), subsection(2)(b)(4), and Section 3. Aaron Proulx, Esq. THE DOCTOR’S LAWYER, PLLC. (813)486-7321 aaron@doclawfirm.com www.doclawfirm.com

How do I ensure my IT infrastructure is not only up to date but also future-proof? As a partner at a managed service provider, I hear this question and others like it often. It makes sense that leaders in the personal injury industry are looking for answers. So let’s steer you in the right direction when it comes to IT, AI and more. What is IT roadmapping? At its core, IT roadmapping is a strategic plan that guides you through your IT journey. It communicates your organization’s technology needs and makes sure the solutions are aligned with your business goals. Typically, IT roadmapping begins with a thorough assessment of your current IT infrastructure, identifying strengths and weaknesses. The roadmap then outlines the necessary steps and investments to achieve those objectives. Roadmapping is dynamic, not something you set and forget. It should be revisited periodically to adapt to changing needs and technologies. For example, you shouldn’t simply replace hardware for hardware when something breaks or ages out. You have to ask, Are we doing what we’ve done before? Is our infrastructure the same as it has been in the past?’ When you make an investment, you want to future-proof it if possible. That’s the IT roadmap’s role. How can technology help us to prep for and deal with unforeseen circumstances? There are two approaches to fortifying your PI practice: You can adopt the cloud as your ideal infrastructure. For instance, using Azure, allows you to upgrade servers, capacity, disk storage and replication to make backups easy. Or, if you’re not in the cloud, your organization should reinforce existing infrastructure.  Even with a robust IT roadmap, you can only project so much, and sometimes budget constraints limit projected actions. The bottom line? Cloud-based backups and disaster recovery plans can be lifesavers in case of data loss if they fit your budget. Al is a hot tech topic: Should Al write legal briefs? Should lawyers use AI? AI should be seen as a tool, not a replacement, for unique and original content. We see Al gaining traction in a lot of industries. But, if someone in the legal field leverages or uses an AI, they have to state that use. You can use ChatGPT to create content, but it may not be fresh, well-researched or factual. We suggest using AI as an assistant or a helper, but if proper vetting of information or data control is not done, you could put yourself in a precarious situation. Never assume the tool’s output is 100 percent accurate. What else should we know about IT roadmapping? For PI professionals delving into IT roadmapping, the biggest gap is often addressing the issue of people being a weak link from a cybersecurity standpoint. Cybersecurity awareness training must be part of your IT planning. Keeping your staff aware of and trained on the latest threats is critical. In fact, the most leveraged of these threats lurks in something your team members use every day: email. BEC, or business email compromise, is a constant problem and there’s only so much technology can do to prevent social engineering scams like phishing.  Roadmapping is dynamic, not something you set and forget. It should be revisited periodically to adapt to changing needs and technologies. Your IT Takeaway IT roadmapping is not just about keeping up; it’s about thriving no matter where technology is headed. At Internos, we know that with the right strategy and foresight, PI professionals can navigate an interconnected world with confidence, ensuring they are well-prepared for whatever lies ahead. Jairo Avila PARTNER AT INTERNOS 5781 B NW 151st Street, Miami Lakes, FL. 33014 (305) 590 5333 javila@gointernos.com www.gointernos.com

When navigating the many licenses that are regulated by AHCA, it can be overwhelming for a medical provider. These licenses can be confusing, cumbersome, and sometimes feel impossible to obtain. One of the most common questions from our providers is, “Which AHCA License do I need to operate my practice?” This really depends on the ownership of the practice.  AHCA Healthcare Clinic Exemption Obtaining a Healthcare Clinic Exemption is a straightforward process. It is very important to fill these applications out as accurately as possible and disclosing all procedures, services, payors, and exemption qualifications is crucial. HCC Exemptions can be obtained by licensed practitioners covered by section 627.419 (allopaths, osteopaths, chiropractors, podiatrists, optometrists, or dentists only]. Direct family members can also be part owner of a practice, but proof of being a direct family member such as a wife, sibling or child will need additional documented proof. Copy of the applicable medical license will be required as well.  AHCA Healthcare Clinic A Healthcare Clinic License requires more documentation for application approval. The significant difference between a Healthcare Clinic and the Exemption is that a Healthcare Clinic can be owned by a non-physician. These applications must disclose all services being rendered in the clinic, all professionals practicing in the clinic and ^ill stalTmembeTS. All of these employees or contracted professionals must pass a level 2 background screening in order to have any interaction with patients or patient information. Additionally, in order to have an approved Healthcare Clinic you must have a contracted Medical Director or Clinic Director. These contracts must meet certain requirements in order to be approved by AHCA. Obtaining a healthcare Clinic license with AHCA can be time consuming and requires tremendous attention to detail. We recommend hiring an experienced consultant or dedicating a trusted employee to this process. AHCA Home Medical Equipment A Home Medical Equipment license allows you to bill PIP for certain DME items. Some of these items include portable traction units. Aqua Therapy Units and many other therapy products. Billing some of these items to PIP without an HME license could be considered “unlicensed activityM by AHCA. The common items that are not included as home medical equipment are orthopedic bracing and TENS units. In 2020, the State of Florida changed the Statute requiring physicians to obtain the HME license in order to dispense TENS units to patients. Unfortunately, 3 years later, PIP carriers are still denying TENS based on the outdated Statute. JMS Med Consulting has a copy of this new Statute, if anyone would like a copy. The cost of obtaining an HME license is minima】，we recommend going through with the process to avoid any delaying of claim payments on you DME products. PIP adjusters commonly check the online database of Home Medical Equipment providers to verify valid HME licenses before claim payments. Matt Snyder PRESIDENT, JMS MED SUPPLY 13470 Wright Circle, Tampa, FL 33626 (855) 700-5960 www.jmsmedsupply.com

A recent decision by Florida’s Fourth District Court of Appeal (4th DCA) is a winner for medical providers who have had services denied by a Personal Injury Protection (PIP) insurer because the code billed does not have an established reimbursement amount under Medicare or Florida Workers’ Compensation. The case was a consolidated appeal requesting reversal of the trial court’s order in favor of MD Now Medical Centers, Inc. which required insurers to reimburse MD Now for billed urgent care center facility fees under Code S9088. (See Safeco Ins. Co. v. MD Now Med. Ctrs., Inc., Nos. 4D22-846, 4D22-847, 4D22-1486, 2023 Fla. App. LEXIS 5401, at *1 (4th DCA Aug. 2, 2023) ) In each of three cases, the insureds were injured in automobile accidents and received treatment at one of MD Now’s urgent care centers. Each of the insureds assigned their PIP benefits to MD Now. MD Now submitted medical bills to the insurers, who paid all charges except for the urgent care facility fee under Code S9088. MD Now uses this code to bill for services provided in an urgent care center. The insurers denied payment of Code S9088, claiming it wasn’t a covered expense pursuant to Section 627.736(5)(a)(1)(f), Florida Statutes because it is not reimbursable under either the Medicare or Florida’s Workers’ Compensation Fee Schedules. The insurers asserted that (i) neither Medicare nor Workers’ Compensation have a set fee for Code S9088, and (2) Workers’ Compensation reimburses urgent care centers using the non-facility Maximum Reimbursable Amount (“MRA’). MD Now argued that Code S9088 was reimbursable under Workers’ Compensation and the Florida Workers’ Compensation Health Care Provider Reimbursement Manual. MD Now contended that codes that do not have a set MRA require insurers to have an established methodology for determining the reimbursement amount. MD Now submitted evidence that Workers’ Compensation insurers consistently reimbursed for Code Sgo88 in the three years prior to the filing of this lawsuit and that Workers’ Compensation insurers have repeatedly used Code S9088 since 2002 when the code first went into effect. The 4th DCA looked to the language of the PIP statute, specifically Section 627.736(5)(a)(1)(f), Florida Statutes, which states in pertinent part: “…if such services, supplies, or care is not reimbursable under Medicare Part B, as provided in this subparagraph, the insurer may limit reimbursement to 80 percent of the maximum reimbursable allowance under workers’ compensation, as determined under s. 440./3 and rules adopted thereunder which are in effect at the time such services, supplies or care is provided. Services, supplies or care that is not reimbursable under Medicare or workers’ compensation is not required to be reimbursed by the insurer.” The question presented to the 4th DCA was whether, under Section 627.736(5)(a)(1)(f), Florida Statutes, Code S9088 is a type of service which is reimbursable under Workers’ Compensation such that a PIP insurer is required to pay those charges. The 4th DCA affirmed the lower courts’ decisions, holding that reimbursement of Code S9088 is permitted “under a plain reading of the statutes, regulations and applicable reference guide provision.” In their decision, the Court explained that, in conjunction with Section 440.13, Florida Statutes, the Florida Administrative Code Rule 69L-7.020 adopts the Florida Workers’ Compensation Health Care Provider Reimbursement Manual. The Manual stipulates that if a code does not have an established Maximum Reimbursable Amount (“MRA’), the insurer must have a methodology for determining reimbursement for that code that is done by comparing the billed code(s) with clinically similar codes found in the Current Procedural Terminology (CPT) Manual or the Healthcare Common Procedure Coding System (HCPCS) Manual. This means that codes like Code S9088, which do not have established MRA’s, still must be reimbursed by Florida PIP insurers. The 4th DCA’s decision will allow medical providers to be compensated if they were previously denied reimbursement for Code S9088 and for other codes that were denied for the same reason. Currently, the 4th DCA is the only Florida DCA to have ruled on this issue, which means that it applies to the entire State of Florida, unless and until another DCA issues a conflicting opinion.  Christopher M. Tuccitto,Esq. FLORIDA ADVOCATES PA. Florida Advocates 45 East Sheridan Street Dania Beach, FL 33004 (754) 263-4252 chris@fladvocates.com www.fladvocates.com

To be able to represent your client properly and aggressively to the fullest, the importance of prompt and comprehensive documentation cannot be overstated. This article gives a few key pointers on the type of documentation that is required to have a robust personal injury case. For the Plaintiff, seeking immediate medical attention is paramount after a motor vehicle accident. However, timely medical care is no use if it is not properly documented. The documentation not only ensures coverage and the well-being of the individuals involved but also establishes a crucial foundation for document-ing injuries, that can then be used to build the value of the plaintiff’s case. Early intervention allows for accurate diagnosis and treatment, setting the stage for the points you will want to harp on when either negotiating the case with the adjuster or things that you will want to draw the jury*s attention to in trial. Accurate documentation of injuries creates a clear link we need between the accident and the resulting physical harm. These records become instrumental in establishing the extent of injuries, their connection to the incident, and the necessary course of medical treatment. Additionally, these records serve as the ammunition your attorneys use when doing battle with the insurance company to obtain just compensation for the injuries incurred as a result of the subject accident. As you know, motor vehicle accidents can result in a wide range of injuries, from visible bruises and cuts to less apparent internal trauma. Ifs imperative that the medical provider fully evaluate your client and properly document all injuries to ensure that nothing is overlooked. Photographs provide a visual record of the immediate aftermath and can then be used either as part of the demand package or blown up to be used as exhibits in trial to show the jury the extent of the damage that the accident caused. Make sure to ask your clients to take pictures of visible injuries, bruises, cuts, and any physical damage sustained during the accident. Finding medical providers that understand the importance of obtaining clear and concise information from your client regarding their injury and being able information accurately in medical documents is a game changer and goes a long way to strengthening the overall documentation of the case. The progress reports created during appointments provide a timeline of healing and contribute to the overall strength of the injury claim. If the provider fails to sufficiently document injuries and progress, or lack thereof, it can have severe legal consequences. Incomplete or inaccurate records may compromise the credibility of the injury claim, potentially impacting the outcome of legal proceedings. Don’t be afraid to contact your client and have a direct and open conversation with them regarding how they are feeling and any progress that has been made with their injuries. Often, they may overlook things that they may not realize is a result of the accident and can be beneficial to their claim. Aside from medical records, sending a preservation letter (Spoliation Letter) to the insurance company or the at fault party is a must! This ensures that any information they may have that could benefit your case is preserved, if and when litigation ensues. In conclusion, in the aftermath of a motor vehicle accident, obtaining detailed documentation of injuries is not just recommended, it’s required. From immediate medical care to future legal proceedings, proper documentation forms the bedrock of a successful personal injury case. All parties involved should prioritize this process, understanding that it is the best way to secure the intended outcome. Michael Mills, Esq. I.A.N.INJURY ASSISTANCE NETWORK 823 N. Thornton Ave Orlando, FL 32803 (800) 988-2341 mmills@injuryassistancenetwork.com www.injuryassistancenetwork.com

Attorney fee deferral strategies involve delaying the receipt of fees to a future date, often for tax planning reasons. There are several reasons a law firm, or solo practitioner may want to take advantage of these strategies. Here are a few common strategies：  Structured Attorney fees： Attorneys can structure their fees using period payments, like structured settlement annuities, using a structured settlement advisor.  Qualified Settlement Funds (QSFs)： Attorneys can use QSFs to defer the recognition of income. Instead of receiving the settlement directly from a defendant, the funds are placed in a QSF, and the attorney only recognizes income when funds are distributed. Non-Qualified Assignment： Attorneys may use non-qualified assignments, such as a non-fixed annuity, to transfer their fee to a third party in exchange for periodic payments. Tax Guidance for Structured Attorney Fees Much like a structured settlement for injured plaintiffs, tax treatment hinges on avoiding constructive receipt. In Childs v. Commissioner, 103 T.C. 634 (1994), aff’d, 89 F. 3d 856 (Table)(11th Cir. 1996), the Tax Court ruled that because the attorney’s fees were transferred from the defendant directly to the assignment company, the attorney did not have constructive receipt of the fees； therefore, the fees did not yet count as taxable income.  The use of these deferral strategies is not for everyone. A firm or attorney that’s in growth mode may need their fees right away to support expansion costs. While in growth mode, a firm is always looking for needed capital to continue its marketing costs, on top of funding existing cases. If this is your hrm, then perhaps these strategies might not be the best right now, unless of course you have a huge settlement come in that you know you can allow to cash flow over time. A mature firm or attorney closer to retirement may be interested in creating a long-term revenue stream to support them in their future years. In myopinion, aside from large settlements that allow for cash flow over time, this is where these deferral strategies make the most sense. A mature firm (or solo practitioner) may not need as much in cash flow today to run their firm and if retirement savings wasn’t always on the agenda, deferring your current wins to long term annuities could help retirement be achievable at an earlier age It should be noted that the ability to defer fees must be included in the settlement agreement, and the above noted deferral strategies should be discussed with your tax advisor and a reputable structured settlement agent. The information provided here is for general informational purposes only and should not be construed as tax advice. It is not intended to be a substitute for professional tax advice. Tax laws are always subject to change and individual circumstances may vary. Consult with a licensed tax professional for advice tailored to your specific situation. Matthew Shiebler, CPA INTERACTIVE ACCOUNTANTS (305) 517-3977 ext. 104 (914)263-9806 Matt@ia.tax interactiveaccountants.com