It’s been busy, busy, busy in my little kitchen that could. I won the Chili Cook-Off last weekend and was up to my elbows in crème de menthe and crème de cacao, as I made a Grasshopper Cheesecake for a St. Paddy’s Day Potluck. Thankfully, a guest blogger came forward to allow me a little more time for my culinary endeavors…… thank you, Andrew Lukashunas!
I have always said the best law comes out of Motion Day and today’s post is no exception. We have Linda Pope v. State of DE, IAB# 1305408 (2/18/14)(ORDER). Allow me to let Andrew tell it, lest I steal his wonderful defense-oriented thunder:
“I’m attaching a Board Order from a recent motion day legal hearing. The issue was discussed at the January seminar so I thought that it may be blog-worthy.
Does the Wyatt decision preclude compensability of non-emergency care that is not pre-authorized when it is provided by an out-of-state doctor? According to Linda Pope v. State of Delaware, the answer is yes.
The Order (authored by Chief Hearing Officer Baum) concludes that the neither the statute (regarding provider certification) nor the Supreme Court in Wyatt provided an exception for out-of-state medical providers. The Board concluded that the statute was unambiguous, per the Wyatt decision, and therefore not subject to statutory interpretation; thus, the Board was not empowered to read in an out-of-state provider exception. Ultimately, the Board recognized that although the application may seem “harsh”, avoiding such an application would require legislative action.”
It remains to be seen where this will go. I have to think we haven’t heard the end of it, lest we end up with West Coast, Rocky Mountain or even Deep South claimants ultimately denied the right to medical care, which seems to thwart the intent of Section 2322, provider certification requirements notwithstanding. Talk about being all bandaged up and nowhere to treat…………:>)
Irreverently yours,Cassandra Roberts
Visit Delaware Detour & Frolic, a law blog by Cassandra Roberts
For more information about LexisNexis products and solutions connect with us through our corporate site