NOT FOR PUBLICATION WITHOUT THE APPROVAL OF THE APPELLATE DIVISION This opinion shall not "constitute precedent or be binding upon any court." Although it is posted on the internet, this opinion is binding only on the parties in the case and its use in other cases is limited. R. 1:36-3.
SUPERIOR COURT OF NEW JERSEY APPELLATE DIVISION DOCKET NO. A-3972-23
CITIZENS UNITED RECIPROCAL EXCHANGE,
Plaintiff-Appellant,
v.
NEUROLOGICAL SURGERY SPINE SPECIALISTS a/s/o RASHEEDA ROBINSON,
Defendant-Respondent. ______________________________
Submitted November 20, 2025 – Decided December 22, 2025
Before Judges Mawla and Marczyk.
On appeal from the Superior Court of New Jersey, Law Division, Mercer County, Docket No. L-1008-22.
Brennan & Sponder, attorneys for appellant (Stewart M. Martinez, of counsel and on the briefs).
Law Offices of Lora B. Glick, LLC, attorney for respondent (Lora B. Glick, of counsel and on the brief).
PER CURIAM Plaintiff Citizens United Reciprocal Exchange (CURE) appeals from the
July 2, 2024 trial court order denying its application to vacate the arbitration
award entered in favor of defendant Neurological Surgery Spine Specialists a/s/o
Rasheeda Robinson (NSSS) under the Alternative Procedure for Dispute
Resolution Act (APDRA), N.J.S.A. 2A:23A-1 to -30. Based on our review of
the record and applicable legal principles, we dismiss for lack of jurisdiction.
I.
On August 11, 2016, Robinson was injured in an automobile accident
when another vehicle rear-ended the car she was driving, which was owned by
a CURE-insured individual, while she was stopped at a red light. Later that day,
Robinson sought medical treatment at Jersey City Medical Center, reporting
severe neck pain radiating up the left side of her face and lower back pai n. She
was given medication for her pain and discharged that same day.
In the months that followed, Robinson underwent various diagnostic
procedures and medical treatments for her ongoing neck and back pain. An MRI
of her cervical spine from January 2017 showed disc herniations at the C3-C4
and C4-C5 levels, and disc bulges at the C5-C6 and C6-C7 levels. Thereafter,
Robinson attended physical therapy for cervical and lumbar myelopathy and
radiculopathy between January and February 2017, then again from November
A-3972-23 2 2017 to April 2018, during which time she "complain[ed] of constant cervical
spine pain and stiffness . . . radiating down to [her] left hand." In June 2018, a
second MRI of Robinson's cervical spine again showed disc herniations at the
C3-C4 and C4-C5 levels, as well as the C5-C6 and C6-C7 levels, with a "small
to moderate-sized paracentral disc extrusion" at C4-C5 that "contact[ed] the
right ventral aspect of the spinal cord." An electromyography from July 2018
"revealed evidence of chronic ongoing right C5 radiculopathy."
In November 2019, Robinson presented to an urgent care facility with
complaints of "neck pain and vomiting," for which she was prescribed a steroid
and pain medication. Later that month, she was treated at Newark Beth Israel
Hospital for "neck pain radiating to [her] head" and underwent a third MRI of
her cervical spine, which an interpreting radiologist found showed disc
herniations at the C3-C4, C4-C5, and C6-C7 levels, as well as disc bulges at the
C5-C6 and C7-T1 levels.
Notably, on November 26, 2019, Robinson consulted Dr. John R. Cifelli
of NSSS for a neurological assessment, who, after examining her and reviewing
her medical history, referred her to Dr. Jose Colon at the Newark Rehabilitation
Center for a cervical epidural steroid injection. That December, Dr. Colon
conducted a physical examination of Robinson and determined "her symptoms
A-3972-23 3 [we]re consistent with C3-4 and C4-5 [level] disc derangement and
radiculopathy." He noted Robinson complained of "neck pain radiating to both
upper extremities," rating the pain a "9/10 [o]n a scale of 0-10." On Dr. Colon's
advice, Robinson received a cervical epidural steroid injection in January 2020,
but she reported no improvement at a follow-up visit in February and, thus, was
referred to an orthopedic spine surgeon for an evaluation.
In February 2020, NSSS submitted a precertification request to CURE for
Robinson to have an office visit with Dr. Cifelli, to which CURE responded its
"[p]recertification decision [wa]s pending the result of an Independent Medical
Exam" (IME) evaluating whether Robinson's treatment was a medical necessity.
Dr. Michael J. Giordano subsequently conducted the IME; he reviewed, among
other records, the three MRI reports of Robinson's cervical spine and performed
a physical examination. He diagnosed Robinson with "[a]ctive cervical
strain/sprain," "[r]esolved disc herniation," "[a]ctive cervical radiculopathy,"
and "[c]ervical spine pain secondary to radiculopathy." Dr. Giordano noted
there was "no nerve root compression by any cervical disc" and attributed
Robinson's radiculopathy symptoms to "a traction injury." He further found a
"causal relationship between [Robinson's] injuries and the motor vehicle
accident" from August 2016 but opined she had reached "maximum medical
A-3972-23 4 improvement" (MMI) and asserted no pre-existing medical conditions affected
her recovery.
Based on Dr. Giordano's IME, CURE denied NSSS's precertification
request for Robinson's appointment with Dr. Cifelli. NSSS appealed the denial
through CURE's internal appeals process to no avail. CURE also denied NSSS's
precertification request for Dr. Cifelli to perform cervical surgery on Robinson
based on the IME findings.
Despite CURE's denials, Dr. Cifelli performed cervical spine surgery on
Robinson in June 2020. Postoperatively, Robinson reported her symptoms had
either improved or resolved. NSSS billed CURE approximately $296,258.50
for the surgery, but CURE denied payment based on the IME report's
determination surgery was not a medical necessity; NSSS appealed. CURE also
denied NSSS's precertification request for a second follow-up examination of
Robinson in November 2020.
Having exhausted CURE's internal appeals process, NSSS filed a demand
for personal injury protection (PIP) arbitration pursuant to N.J.S.A. 39:6A-5.1,
seeking reimbursement of $297,928.30 for Robinson's surgery and follow-up
appointments. In January 2021, CURE requested a medical review organization
(MRO) perform an independent review of Robinson's medical records to assess
A-3972-23 5 the issues of medical necessity and causation. In March 2021, the MRO issued
a report by Dr. Abbott J. Krieger, who, after reviewing Robinson's records,
MRIs, and the IME, concluded "the procedure performed by Dr. Cifelli was not
medical[ly] necessary or causally related to" the 2016 motor vehicle accident,
noting there had been "multiple gaps in treatment" between the accident and
when Dr. Cifelli recommended surgery nearly four years later. Dr. Krieger
agreed with the IME's conclusion there were multiple disc bulges "but no
appreciable neural element compromise," and that Robinson had reached
neurosurgical MMI, which he wrote was supported by her 2019 MRI.
In September 2021, the parties appeared before a dispute resolution
professional (DRP) for a Forthright 1 arbitration hearing. The DRP heard
testimony from Dr. Cifelli, and reviewed Robinson's prior MRI reports, Dr.
Krieger's MRO report, Dr. Giordano's IME, and a rebuttal report by Dr. Cifelli
dated May 30, 2021. In November 2021, the DRP provided his findings of facts
and conclusions of law in a comprehensive, thirteen-page arbitration award,
1 The Commissioner of Banking and Insurance has been authorized by the Legislature to designate an organization to serve as an arbitration forum for PIP disputes. N.J.S.A. 39:6A-5.1(b). Forthright currently serves in that capacity. Allstate N.J. Ins. Co. v. Carteret Comprehensive Med. Care, P.C., 480 N.J. Super. 566, 580 (App. Div. 2025); Kimba Med. Supply v. Allstate Ins. Co. of N.J., 431 N.J. Super. 463, 468 (2013).
A-3972-23 6 concluding NSSS had established the medical necessity of Robinson's exams
and spinal surgery and ordering CURE to pay NSSS $158,388.35 in medical
expense benefits. He found Dr. Cifelli's rebuttal report and testimony to be
credible and detailed, noting the presumption of correctness afforded to Dr.
Krieger's MRO report had been rebutted by a preponderance of the evidence.
The DRP stated Dr. Krieger failed to examine Robinson, despite being
permitted to do so, "crucially hobbling his determinations." He concluded Dr.
Krieger "erroneously and unfoundedly denied causation and necessity due to
treatment gaps/delays, where there is no such medical standard or support, and
which contradicts the Care Paths" and "also incorrectly found MMI as of
[November] 2019." The DRP highlighted Dr. Cifelli's point that Robinson did
not seek treatment immediately after the accident because she "did not
understand PIP benefits access."
The DRP further noted Dr. Cifelli had observed Robinson's "disc
herniations at C4-C5, C5-C6 and C6-C7, which were clinically and operatively
confirmed, and with spinal cord contact, . . . which was consistent with the
reading radiologist." He indicated the three cervical MRIs confirmed the
presence of "spinal cord contacts, protrusions, and herniations." The DRP found
Robinson's "surgery was appropriate, contrary to (and in rebuttal of) the MRO
A-3972-23 7 physician," as Dr. Colon's pain management report showed "ongoing upper -
extremities radiating pain," and the presurgical options only "worsened"
Robinson's "chronic pain."
Weighing the parties' proofs, the DRP found the medical necessity of Dr.
Cifelli's spinal surgery and exams had been established by a preponderance of
the evidence and determined NSSS had effectively rebutted the presumption of
correctness afforded to Dr. Krieger's MRO report. He did not find Dr. Krieger's
report persuasive because both NSSS's and CURE's medical experts found the
2016 car accident caused Robinson's injuries, but "to the detriment of his
credibility," Dr. Krieger "deemed otherwise." In contrast, the DRP found Dr.
Cifelli's rebuttal report "thoroughly and credibly" detailed the deficiencies of
Dr. Krieger's explanations, noting it "persuasive[ly]" "point[ed] out the flaws
. . . in Dr. Krieger's [MRO] report," and concluded Dr. Cifelli's testimony was
credible. Specifically, he explained:
[Dr. Cifelli's] analysis relays the progressing, rather than, as suggested in oblique fashion by Dr. Krieger, abating, presence of disc abnormalities and cord impingement, and [Robinson's] re-presentation to the [emergency room] well after the [motor vehicle accident] with severe radiating pain symptoms, underscores that. How the multiple disc herniations resolved without surgery, given the absence of pre- existing conditions, is unindicated. Dr. C[i]felli's exams, in which persisting severe and intractable
A-3972-23 8 radiating neck pain, with numbness and tingling, and objective neurological clinical findings, along with his MRI analysis that dispels that of Dr. Krieger's brief comments in detail and breadth, serve to further counter his opinion by a preponderance . . . . The lack of a shown medical standard denigrating the necessity of neurosurgery based on gaps in care is also compelling.
In March 2022, CURE appealed from the PIP arbitration award to an
internal Forthright panel pursuant to N.J.S.A. 2A:23A-13, arguing the DRP
erred in determining medical necessity and finding NSSS overcame the
presumption of correctness afforded to the MRO report. It contended "the DRP,
in making the award, exceeded his power or so imperfectly executed that power
that a final and definite award was not made," N.J.S.A. 2A:23A-13(c)(3), and
"committed prejudicial error by erroneously applying law to the issues and facts
presented for alternative resolution," N.J.S.A. 2A:23A-13(c)(5).
On May 9, 2022, the Forthright panel unanimously affirmed the DRP's
arbitration award, finding the DRP had properly considered all evidence,
including Dr. Cifelli's rebuttal report, and thoroughly explained why the
presumption in favor of the MRO report had been overcome. It rejected CURE's
argument the DRP improperly accepted and considered the rebuttal report in
violation of Forthright Rule 15, which, according to CURE, required NSSS to
submit the report at the time CURE requested the MRO. The panel rejected this
A-3972-23 9 argument because "[l]ogically, one cannot rebut something until such time as
there is something to rebut."
The panel further determined the record supported the DRP's opinion and
reasons for finding the MRO had been successfully rebutted. It indicated the
DRP "specifically and thoroughly" addressed whether NSSS rebutted the
presumption of correctness afforded to the MRO, and noted there was "no
evidence" the DRP failed to afford that presumption to the MRO's conclusions.
The panel rejected CURE's attempt to demonstrate Dr. Cifelli's report failed to
rebut the MRO report because CURE only "reference[d] a difference in
interpretation of a cervical MRI" by noting Dr. Krieger, unlike Dr. Cifelli, found
the MRIs did not indicate nerve compression. It reasoned the DRP made a
"factual determination as to which opinion [wa]s more credible or persuasive"
and emphasized accepting, considering, and weighing evidence "is wholly
within the purview of the DRP."
In June 2022, CURE filed a verified complaint and order to show cause
seeking to vacate the DRP award and the Forthright panel award affirming the
DRP. CURE alleged the DRP and panel failed to presume the correctness of the
MRO report, the DRP erroneously applied the law to the issues and facts
presented, and the DRP exceeded or imperfectly executed his powers in making
A-3972-23 10 the award. At oral argument, CURE principally contended the presumption of
correctness afforded to an MRO physician's conclusions can only be rebutted by
evidence provided to the MRO, not new evidence or "extraneous or conditional
information," such as Dr. Cifelli's rebuttal report, which Dr. Krieger did not
review.
On July 2, 2024, the court entered an order, accompanied by a written
opinion, denying CURE's application to vacate the arbitration award because
CURE could not "show th[e] DRP . . . erroneously applied [the] law to the issues
and facts presented." The court found CURE failed to cite any authority to
support its argument NSSS "was barred from submitting its own report to rebut
[the] MRO report." As such, CURE did not establish the DRP erroneously
applied the law by considering and relying upon Dr. Cifelli's rebuttal report.
The court further determined "when granting the arbitration award, [the] DRP
. . . cited [NSSS]'s report and also made detailed findings regarding the deficits
of [CURE]'s MRO report." Therefore, it "decline[d] to vacate the arbitration
award."
II.
CURE contends we have jurisdiction to review this appeal because it
invokes our supervisory function and raises important public policy concerns.
A-3972-23 11 It reprises its argument the trial court should have limited the DRP's use of Dr.
Cifelli's rebuttal report, avers the court failed to give proper deference to the
MRO report, and asserts the court failed to conduct a de novo review. CURE
also argues this court should reverse the DRP's finding of medical necessity
because the MRO report was supported by the record, and the rebuttal report
does not undermine the MRO's finding the surgery was not medically necessary.
CURE, as a New Jersey-based auto insurer, is required to provide PIP
benefits under its policies. The New Jersey Automobile Reparation Reform Act,
N.J.S.A. 39:6A-1 to -35, "mandates that automobile liability insurance policies
provide PIP coverage, including payment of 'reasonable medical expenses,'
N.J.S.A. 39:6A-4(a)." Cobo v. Mkt. Transition Facility, 293 N.J. Super. 374,
384 (App. Div. 1996). Disputes regarding the appropriateness and amount of
PIP coverage are determined in "dispute resolution." N.J.S.A. 39:6A-5.1(a); see
also Citizens United Reciprocal Exch. v. N. N.J. Orthopedic Specialists, 445
N.J. Super. 371, 376-77 (App. Div. 2016) (stating disputes between health care
providers and insurers over billing covered by PIP insurance provisions are
typically settled through arbitration).
The forum for PIP arbitration is the APDRA. N.J.S.A. 2A:23-13.
Although proceedings under the APDRA are frequently referred to as
A-3972-23 12 "arbitrations," and are indeed similar in style and substance to arbitrations, the
APDRA is distinct from the Arbitration Act, N.J.S.A. 2A:23B-1 to -36. An
APDRA decision is binding, subject to "vacation, modification[,] or correction"
by the Superior Court in limited instances. N.J.S.A. 2A:23A-13(a). In matters
where jurisdiction exists, an award may only be vacated if the rights of a party
were prejudiced by:
(1) Corruption, fraud[,] or misconduct in procuring the award;
(2) Partiality of an umpire appointed as a neutral;
(3) In making the award, the umpire's exceeding their power or so imperfectly executing that power that a final and definite award was not made;
(4) Failure to follow the procedures set forth in [the APDRA], unless the party applying to vacate the award continued with the proceeding with notice of the defect and without objection; or
(5) The umpire's committing prejudicial error by erroneously applying law to the issues and facts presented for alternative resolution.
[Selective Ins. Co. of Am. v. Rothman, 414 N.J. Super. 331, 341 (App. Div. 2010) (quoting N.J.S.A. 2A:23A- 13).]
N.J.S.A. 2A:23A-18(b) makes clear once the trial court, sitting as an
appellate court, has issued an order "confirming, modifying[,] or correcting" a
A-3972-23 13 decision, "[t]here shall be no further appeal or review of the judgment or
decree." Our Supreme Court upheld the constitutionality of N.J.S.A. 2A:23A-
18(b) in Mt. Hope Development Associates v. Mt. Hope Waterpower Project,
L.P., 154 N.J. 141, 148-52 (1998). The Court ruled "the language of [the]
APDRA unmistakably informs parties that by utilizing its procedures they are
waiving th[eir] right" to appeal beyond the trial court, and that such a waiver
generally must be enforced. Id. at 148.
While there are exceptions to the appellate bar set by N.J.S.A. 2A:23A-
18(b), they are limited. There are exceptions when it is "necessary for [the
Court] to carry out its 'supervisory function over the [trial] courts.'" Morel v.
State Farm Ins. Co., 396 N.J. Super. 472, 475-76 (App. Div. 2007) (quoting Mt.
Hope, 154 N.J. at 152). This "supervisory function" permits us to exercise
appellate jurisdiction when a trial court has exceeded its jurisdiction under the
APDRA. See id. at 476. As our Supreme Court instructed in Mt. Hope, although
arbitration can be a favored procedure, there may be "'rare circumstances'
grounded in public policy" that may warrant "limited appellate review" over trial
court decisions in APDRA matters. 154 N.J. at 152 (quoting Tretina Printing,
Inc. v. Fitzpatrick & Assocs., Inc., 135 N.J. 349, 364-65 (1994)). Appellate
review is thus allowed "where public policy would require" it. Ibid. One
A-3972-23 14 example identified by the Court is a child support order, ibid.; another example
is an award of attorney's fees. Allstate Ins. Co. v. Sabato, 380 N.J. Super. 463,
472-76 (App. Div. 2005).
However, "when the trial judge adheres to the statutory grounds in
reversing, modifying[,] or correcting an arbitration award, we have no
jurisdiction to tamper with the judge's decision or do anything other than
recognize that the judge has acted within [their] jurisdiction." N.J. Citizens
Underwriting Reciprocal Exch. v. Kieran Collins, D.C., LLC, 399 N.J. Super.
40, 48 (App. Div. 2008). Thus, "we review the decision of the trial judge . . .
for the limited purpose of determining whether [they] exceeded the authority
granted to [them] by [the] APDRA." Ibid.
A.
CURE contends this matter invokes our supervisory function because the
trial judge failed to conduct a de novo review of the DRP's finding of medical
necessity. The parties do not dispute CURE's application to vacate the
arbitration award was premised upon allegations the DRP exceeded his powers
such that a final and definite award was not made, N.J.S.A. 2A:23A-13(c)(3),
and that the DRP misapplied the law and fact, N.J.S.A. 2A:23A-13(c)(5).
Accordingly, pursuant to N.J.S.A. 2A:23A-13(b), the Law Division needed only
A-3972-23 15 to make an independent determination of "any facts relevant" to CURE's
application pertaining to subsection (c)(3) de novo.
CURE insists had "the judge . . . engaged in a de novo determination, the
judge would have realized that some of the material facts upon which the DRP
cited from the rebuttal report were inaccurate." However, its application to
vacate the award did not necessitate a review of the DRP's factual findings and
conclusion of medical necessity. Specifically, before the Law Division, CURE
alleged the DRP "exceeded his power by erroneously applying the appropriate
law, regulations, and facts to the case" because he "did not give the MRO report
the presumption of correctness afforded . . . under the law" but rather weighed
the credibility of Dr. Cifelli's rebuttal report and Dr. Krieger's MRO report "as
if they were both expert reports." Hence, CURE's application to vacate was
limited to determining whether the DRP properly considered the rebuttal report
and applied the correct standard in concluding the MRO report had been
rebutted. This determination did not require the Law Division to revisit the issue
of medical necessity, as CURE's argument focused on a legal, rather than
factual, issue.
The Law Division properly determined CURE failed to show the DRP
exceeded his powers such that a final and definite award was not made, N.J.S.A.
A-3972-23 16 2A:23A-13(c)(3), because CURE did not provide any authority to support its
argument the DRP's reliance on NSSS's rebuttal report was an error.
Additionally, the Law Division further found the DRP cited NSSS's report and
made detailed findings as to the deficits of the MRO report. Indeed, CURE's
challenge ignores the DRP's comprehensive factual findings and legal
conclusions explaining the deficits of the MRO report and why the evidence
rebutted the presumption of correctness to prove the medical necessity of
Robinson's surgery. Again, these "detailed findings" were ultimately relied
upon by the court in declining to vacate the arbitration award.
Moreover, CURE failed to cite any authority supporting its assertion the
rebuttal report "should be considered . . . for the limited purpose of legal
argument," rather than "as factual evidence," because it "was not submitted as
evidence to the MRO." Pursuant to N.J.S.A. 39:6A-5.1(d), upon the request of
a party to a PIP arbitration, the DRP must "refer the matter to a[n] [MRO] for a
determination" with respect to a dispute regarding "the medical necessity of the
treatment or diagnostic test administered to the injured person." "The
determination of the [MRO report] on the dispute referred shall be presumed to
be correct by the [DRP], which presumption may be rebutted by a preponderance
of the evidence." Ibid. (emphasis added).
A-3972-23 17 In effect, CURE asserts NSSS should have submitted Dr. Cifelli's rebuttal
report to Dr. Krieger for him to consider in authoring the MRO report. CURE's
reading of the statute, if adopted, would vitiate the DRP's ability to consider a
contrary opinion that rebuts an MRO's determination. Instead, the rebuttal
report fulfilled the statute's intended purpose by serving as evidence to rebut the
presumption of correctness afforded to the MRO's determination. Furthermore,
it is unclear how Dr. Cifelli's rebuttal report could have been provided to Dr.
Krieger prior to the issuance of his MRO report. As the DRP panel aptly stated,
"[l]ogically, one cannot rebut something until such time as there is something to
rebut."
B.
CURE next asserts we should exercise our supervisory function because
the DRP erred in considering the MRO's credibility and opining the MRO report
was less reliable than Dr. Cifelli's rebuttal report because Dr. Cifelli physically
examined Robinson. This argument is unpersuasive, as CURE fails to cite any
authority precluding the DRP from weighing the persuasiveness of the
respective reports. Notably, there is no suggestion Dr. Cifelli had access to
different documents or information than Dr. Krieger had when authoring his
MRO report. Rather, the DRP simply found Dr. Cifelli's rebuttal report
A-3972-23 18 "point[ed] out the flaws he perceived present in Dr. Krieger's report based on
records previously presented," and "accomplished this in [a] persuasive
manner." While CURE disagrees with the DRP's decision to reject Dr. Krieger's
opinion regarding medical necessity and causation between the accident and
injury, that alone does not suggest the DRP exceeded his powers or erroneously
applied the law to the facts in reaching those conclusions.
Furthermore, CURE asserts the judge failed to address Orthopaedic
Associates v. Department of Banking & Insurance, 405 N.J. Super. 54 (App.
Div. 2009), and New Jersey Coalition of Health Care Professionals, Inc. v. New
Jersey Department of Banking & Insurance, Division of Insurance, 323 N.J.
Super. 207 (App. Div. 1999). It claims these cases stand for the proposition
"that an MRO opinion is not just another expert witness but rather a decision by
a trier of fact to be accepted if supported by the record and not weigh[]ed against
other evidence."
We did not address the current issue before us in those cases, which were
decided in the context of challenges to the validity of the PIP dispute resolution
procedures utilized by the Department of Banking and Insurance. See
Orthopaedic Assocs., 405 N.J. Super. at 56, 65-66; N.J. Coal., 323 N.J. Super.
at 264-69. Neither case suggests a DRP must accept the MRO's determination,
A-3972-23 19 which, as a practical matter, would largely nullify the DRP's role in arbitration
proceedings. CURE's reliance on those cases for its assertion the MRO's
decision must be accepted if supported by the record is belied by N.J.S.A.
39:6A-5.1(d), which clearly permits a party to offer evidence to rebut the
presumption of correctness afforded to an MRO's determination.
C.
CURE further contends this matter raises important public policy
concerns because it provides us with the opportunity to resolve a "split in the
treatment of MRO reports." It asserts DRPs will sometimes defer to an MRO's
decision unless it is unsupported by the record, but, on other occasions, use
MRO reports as expert witness reports, weighing the evidence and argument
before reaching a conclusion. CURE perceives "several problems" with the
latter approach, taken by the DRP here, and urges us to adopt the former.
CURE's argument is unavailing. It finds a "split" in authority where none
exists, as N.J.S.A. 39:6A-5.1(d) provides the relevant standard for addressing
MRO reports in PIP arbitrations. As previously stated, upon request by a party,
the DRP will "refer the matter to a[n MRO] for a determination" regarding,
among other things, the medical necessity of the treatment or causation between
the injury and event. N.J.S.A. 39:6A-5.1(d). Importantly, "[t]he determination
A-3972-23 20 of the [MRO] on the dispute referred shall be presumed to be correct by the
[DRP], which presumption may be rebutted by a preponderance of the
evidence." Ibid. That is the standard the DRP applied in this matter, which the
trial court affirmed. Meaning, under the statute, an MRO report is presumed
correct unless rebutted by a preponderance of the evidence, and in such
instances, a DRP is statutorily authorized to find the presumption of correctness
has been rebutted. Consequently, CURE's assertion—"[u]nless the MRO
physician has made a glaring mistake, his unbiased determination must stand"—
conflicts with the plain language of N.J.S.A. 39:6A-5.1(d). If the Legislature
desired to afford MRO reports almost complete deference and limit a DRP's
discretion to reject an MRO's opinion, as CURE advocates, it could have done
so.
We conclude the trial judge properly exercised the authority granted under
the APDRA and adhered to the statutory grounds in confirming the DRP award.
Moreover, CURE failed to present an issue raising a significant public policy
concern warranting our review. Accordingly, the appeal is dismissed for lack
of jurisdiction pursuant to N.J.S.A. 2A:23A-18(b).
A-3972-23 21 To the extent we have not specifically addressed any of CURE's remaining
arguments, we conclude they lack sufficient merit to warrant discussion in a
written opinion. R. 2:11-3(e)(1)(E).
Dismissed.
A-3972-23 22