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8:00 – 8:30 am EDT
8:30 am – 12:00 pm EDT
12:00 – 1:00 pm EDT
1:00 – 4:40 pm EDT
Historical Overview and the Future of PIP S. Dutton
(Repeal and Mandatory Medical Payments Coverage) R. Lazega
Historical overview of FL PIP What the future of Florida PIP may look like
Fee Schedules and Medicare Coding and J.D. Underwood
Payment Methodologies: MPPR, 2% CMT Reduction, S. Dutton
ARNP/PA 15% Reduction, “Billed Amount”
Reasonable amount: Customarily charged, usual
and customary charges and amounts accepted
Florida PIP fee schedules
Other issues impacting PIP reimbursements under the fee schedule
Examinations Under Oath and Independent Medical Examinations S. Leiter
Timeliness of request, where conducted, who may attend
Status of Confession by Post Suit Payment R. Lazega
What constitutes a confession in PIP litigation
Impact of confession on entitlement to attorney’s fees and costs
Deductibles and (4)(c) Providers C. Vaccaro
PIP deductible litigation and current status of appeals
Deductible calculations $5K reserve for ER physicians under (4)(c)
Attorney’s Fees and Multipliers S. Leiter
Florida statute 627.428 and entitlement
Determining reasonable amount of attorney’s fees
Impact of a multiplier on reasonable attorney’s fees
Determining availability of a multiplier including case law
Duplicate Suits C. Vaccaro
Definition and scenarios when duplicate suit may occur
Emergency Medical Condition S. Dutton
Boxes or forms R. Lazega
CPT codes and medical records
Emergency services and care v. emergency medical condition
Exhaustion Then and Now C. Vaccaro
Past exhaustion of benefits cases that impact claims within 5 years
Current cases on exhaustion of benefits
CPT Codes and Reimbursement Issues C. Vaccaro
Limiting charge S. Dutton
Durable medical equipment
Material Misrepresentation C. Vaccaro
Policy application material misrepresentation J.D. Underwood
Material misrepresentation in the claims process
Pre-Suit Demands S. Dutton
Pre-suit demand letter requirements, specificity requirements, waiver, and
premature demand letters?
Standing Revisited C. Vaccaro
Current requirements for valid assignment of benefits J.D. Underwood
Legislative efforts to limit use of assignment of benefits in relation to insurance
Untimely Billing C. Vaccaro
35 day billing cycle, Exclusions to 35 day billing cycle J.D. Underwood
Each webinar session earns continuing education credit and can be registered for individually. All attendees must log-on through their own email – attendees may not watch together if they wish to earn continuing education credit. HalfMoon Education Inc. must be able to prove attendance if either the attendee or HalfMoon Education Inc. is audited.
Certificates of completion will be provided for each webinar attended and will be sent via email in PDF form about five business days after the conclusion of the series.
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8.0 CLER Credits (.5 Ethics)
8.0 Certification Credits:
– Business Litigation
– Civil Trial
Continuing Education Credit Information
This webinar is open to the public. The Florida Bar has approved it for 8.0 C.L.E.R credits, including .5 ethics credit. It is approved for 8.0 certification credits in Business Litigation and Civil Trial. The course approval extends to Florida registered paralegals.
HalfMoon Education has applied for adjuster continuing education course approval for Adjuster Law and Policy, which is under review and pending. Visit www.halfmoonseminars.org for approval status under this course listing.
Completion certificates will be awarded to participants who complete this event, respond to prompts, and earn a passing score (80%) on the quiz that follows the presentation (multiple attempts allowed).
Scott W. Dutton
Scott W. Dutton is a principal shareholder of Dutton Law Group, a statewide law firm with offices in Jacksonville, Orlando, Tampa, Fort Lauderdale, Miami and the Florida Keys. He and his firm have litigated literally tens of thousands of personal injury protection cases. Mr. Dutton earned his doctorate of law from Ohio Northern University, Pettit College of Law, in 1984. During his course of study at Ohio Northern University, Mr. Dutton was a member of the editorial staff of the Ohio Northern University Law Review. He was also a justice on the law school’s Moot Court Executive Board, and was the justice in charge of the First Year Appellate Advocacy Program. While in law school Mr. Dutton also participated in four national moot court competitions. Because of his moot court experience, he was selected to the Order of Barristers for having exhibited excellence and obtained high honor through the art of courtroom advocacy. For his outstanding academic achievement in law school, Mr. Dutton was selected to Who’s Who Among American Law Students. Prior to law school, Mr. Dutton worked for Miami-Dade County as a lifeguard lieutenant, and later was employed with the Miami Beach Fire Department and City of Deerfield Beach Fire Department as a firefighter paramedic. He was also on the City of Miami Beach SWAT team. For Mr. Dutton’s dedication to fighting insurance fraud he was honored by the Florida Insurance Fraud Education Committee (“FIFEC”) which awarded him the Jerry Zappalo Distinguished Service Award in 2012. FIFEC is a non-profit corporation comprised of the Department of Insurance Fraud (DIF), special investigative unit (SIU) departments and investigators, law enforcement personnel and dedicated individuals whose purpose is deterring, detecting, investigating and prosecuting insurance fraud. Mr. Dutton’s is an AV preeminent rated attorney in The Martindale-Hubbell Law Directory, the highest rating available. He is listed as one of Florida’s top lawyers in 2006, 2008 – 2009, 2014 – 2018 in Super Lawyers under Civil Litigation Defense and as one of Tampa’s, Orlando’s, Miami’s and Florida’s “Top Rated Lawyers.”
Russel Lazega is an honor’s graduate of both the University of Florida (B.A. `93) and The Florida State University College of Law (J.D. `96, Law Review, Environmental Law Journal Editorial Board, International Law Journal Editorial Board). He was a judicial intern to Supreme Court Justice Harry Lee Anstead, and later was the assistant to the head of company regulation for the Florida Department of Insurance Legal Services Section. Currently, Mr. Lazega is an AV- rated insurance litigation attorney who heads a 14-attorney practice with offices in Miami, Winter Park, Dania Beach, and Tampa, representing insurance consumers and medical service providers in pursuit of payment of reduced or unpaid insurance claims. Additionally, he is general counsel to a leading auto insurer, The Responsive Auto Insurance Company. Mr. Lazega has written and co-authored several of Thomson Reuters’ (formerly West Publishing) leading treatises on Florida insurance law including Florida Motor Vehicle No-Fault Law & Practices and Florida Insurance Law & Practice. He is the president of the South Broward Bar Association, previously served as president of the North Dade Bar Association, and has presented proposals for insurance reform to the Florida House and Senate. Mr. Lazega has been listed on Florida Trend Magazine’s list of legal elite insurance attorneys, and helped establish a medical provider’s right to sue insurers before the Florida Supreme Court.
Steven Leiter is a partner and co-founder of Leiter, Belsky & Tharp. He has handled claims, litigated and tried cases throughout the state of Florida involving Personal Injury Protection, first party insurance coverage disputes, third party auto negligence, and various premises liability and products liability cases. He previously served as an arbitrator in PIP insurance claims and is a qualified expert to testify at attorney fee hearings. Mr. Leiter was a faculty member and presenter on “Emerging Issues in PIP” at the 2015 Annual Education Program of the Conference of County Court Judges of Florida (July 2015) and was selected to serve as a faculty member for PIP at the Annual Business Meeting of the Conference of County Court Judges (July 1996). In addition to being a frequent lecturer for insurance companies on PIP issues and proper claims handling procedures, he has also served as a faculty member at seminars sponsored by Foxmoor Continuing Education f/k/a Professional Education Systems Institute, LLC. (PESI) since 2004 and for the Broward County Bar Association (January 2013). Mr. Leiter is a Miami native who earned his Bachelor of Arts degree from the University of Georgia (1989), and his juris doctor degree, cum laude, from the University of Miami School of Law (1992) (Articles and Comments Editor, The Inter-American Law Review.
J.D. Underwood has been with The Law Office of Russel Lazega, P.A. since April of 2000. He started as a law clerk and has worked as an associate attorney with the firm since September of 2000, focusing cases throughout Florida. Mr. Underwood recently worked closely in an advisory capacity with The Responsive Automobile Insurance Company, a new auto insurance carrier located in South Florida. He graduated from Emory and Henry College and St. Thomas University School of Law, Miami (J.D. degree, 2000). Mr. Underwood participated in Moot Court during law school and has been a contributing author to Thomsen Reuters’ (formerly West Publishing) Florida Motor Vehicle No-Fault Law (2002-2008). He has served on the Executive Board and as president of the North Dade Bar Association. Mr. Underwood has participated in lectures to the Florida Chiropractic Practitioner’s Assoc, for PESI Seminars (now HalfMoon Education), and for the 2003 PIP Law Update for physicians, billers, and attorneys.
Charles Leonard Vaccaro
Charles Leonard Vaccaro is a Florida board certified specialist in civil trial law who has been licensed to practice in the State of Florida since 1986. Mr. Vaccaro has also been licensed to practice in the State of Texas since 2001, handling a substantial amount of cases involving automobile accidents and insurance in Texas. He is a member of the U.S. Court of Appeals for the 11th Circuit, the U.S.D.C. for the Middle District of Florida and the general and trial bars for the U.S.D.C. for the Southern District of Florida. Mr. Vaccaro has been involved with PIP litigation since 1988. Over the years he has defended thousands of automobile accident cases involving PIP, bodily injury and bad faith claims for numerous insurance companies. During the same time period he maintained a prolific plaintiff practice, handling an even greater number of plaintiff PIP claims at both the trial and appellate level. These include the noteworthy PIP cases of Amador v. United Automobile Insurance Company, 748 So.2d 307 (Fla. 3d DCA 1999) and State Farm Mutual Automobile Insurance Company v. Universal Medical Center as assignee of Blanco Franco, 881 So.2d 5557 (Fla. 3d DCA 2004). In 2017 and 2018, Mr. Vaccaro was the featured speaker on the Florida Bar Award of Excellence Recipient Radio Program “Legal News and Review”, which was broadcast worldwide on iHeart Radio on the topics of “Insurance Bad Faith” and “Florida PIP Insurance.”