Sunday, February 5, 2012

PIP bill clears first Florida Senate hurdle in 2012

Not enough for Florida PIP-reform advocates, but moving forward  that's how I would sum up the bill approved in its first Senate committee vote on Friday. The Senate bill targets fraud, eliminates reimbursement of two widely used treatments, and changes the PIP statute in several other respects highlighted below.

The Senate's fix of personal injury protection (PIP) motor vehicle insurance, contained in SB 1860, would:
  • Eliminate PIP medical benefit reimbursement for massage and acupuncture, which "are now the two most commonly billed procedures in the PIP system." Page 6 of Senate staff analysis of SB 1860 (Feb. 3, 2012).
  • Require a long-form crash reports for all crashes involving a passenger or when any party complains of pain or discomfort.
  • Require all entities providing health care services to be licensed as clinics to receive PIP reimbursement, subject to certain exemptions.
  • Increase the criminal penalties for PIP fraud.
  • Apply the offer-of-judgment law (Section 768.79, Florida Statutes) to PIP disputes.
  • Expand the fee schedule of Medicare Part B to additional services, supplies, and equipment.
Responding to criticisms from other stakeholders, the Senate bill would also:
  • Give priority to the payment of the $5,000 death benefit over other PIP benefits.
  • Expand to hospitals the requirement to reserve $5,000 of PIP benefits (currently limited to physicians or dentists providing emergency treatment).
  • Make it a requirement of law that insurers maintain a log of PIP benefits paid, and provide a copy of the payment log within 30 days of request from the insured or an assignee.
  • Require insurers to accept electronic transmission of notices, documents, and other communications.
For more detail on this week's Senate bill, see Senate staff analysis of SB 1860 (Feb. 3, 2012). For more of the story-line, see Senate stays the course and keeps its no-fault bill intact (The Current, Feb. 2, 2012).

A stronger PIP reform bill is working its way through the House. HB 119 would replace PIP with new Emergency Care Coverage (ECC), which would cover hospital emergency room treatment received within the first 72 hours following an accident. After the emergency, covered treatment would be confined to a limited group of health care providers (medical physicians, osteopathic physicians, dentists, physician assistants, and registered nurse practitioners).  Also in the House package are significant legal reforms, including caps on attorney fees.

For more information on the House version, see Week 3 insurance recap (PIP ECC).

This summary was prepared by Perry Cone and posted at

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