Two months to go: Florida PIP law 10 key changes for 2013 impact health care providers and insurers alike

Consider the 2012 PIP law changes from the perspective of health care providers treating auto injury patients in 2013. Some providers may see reduced payments. Massage therapists and acupuncturists are frozen out. Hospitals and most physician practice groups could actually benefit from limitations on other providers.

For insurers and health care providers alike, procedures will need to be modified. The effective date for most changes is January 1, 2013 - barely two months away. A summary of 10 key PIP law changes is presented below.

Insurance resources posted for September & August

Just in case you haven’t kept up ... new reports and presentations for September and August are posted on the "2012 Resource Library" tab of TallyInsLaw.com, including:

Property & casualty:

• "Impact Analysis of HB119," the independent actuarial study of savings expected from the 2012 PIP (no-fault auto insurance) reform law (Aug. 20, 2012).

• Office of Insurance Regulation's caveats on the "Impact Analysis of HB119" (Aug. 21, 2012).

• "Historical U.S. Hurricanes That Would Cause $10 Billion or More in Insured Losses Today," a report by Karen Clark & Company (Aug. 21, 2012).

• "Twenty Years of Progress: Advances in the Property Insurance Industry Since Hurricane Andrew," a special report from Property Casualty Insurers Association of America (Aug. 22, 2012).

• Citizens' Rate Hearing Press Kit - a summary of Citizens' proposed rate increase proposal for 2013 (Sept. 20, 2012).

• OIR announces Citizens take-out approvals - nearly 300,000 policies have been approved for removal from Citizens in non-bonus and non-loan takeout plans (Sept. 24, 2012)

Life & health:

• Long-term Care Managed Care Technical Advisory Workgroup Final Report (Aug. 21, 2012).

• Allianz Life Insurance Co. multi-state settlement agreement and OIR press release (Sept. 4, 2012) regarding sale of fixed annuity products.

This summary was prepared by Perry Cone and posted at TallyInsLaw.com.
Legal Notice and Disclaimer

PIP reform analysis 2012: Only 2 changes likely to lower costs

Just two! That's the number of provisions of 2012 PIP law HB 119 that are predicted to have a material impact on reducing PIP loss costs and premiums. The key changes are the $2,500 cap on non-emergency treatment and the exclusion of massage therapy. Their combination is estimated to be as much as 96% of the new law's impact on cost savings.

These are some of the conclusions of Pinnacle Actuarial Resources, Inc. (Pinnacle), in its actuarial analysis of HB 119. Enacted in the 2012 Florida legislative session, HB 119 directed the Office of Insurance Regulation (OIR) to engage an independent actuary to calculate the savings expected from HB 119. OIR selected Pinnacle, which released its final report on August 20, 2012.

Resource library updated - P&C and Health Insurance

If you haven't visited it recently, the 2012 Resource Library has been updated. June-July additions marked with an * include the following resources:

• Citizens SB408 sinkhole savings actuarial analysis, depopulation committee exhibits, and 2013 rate filings exhibits (bottom of heading no. 2. Citizens).

• OIR's Order suspending prior-approval requirement for P&C form filings (bottom of heading no. 4. Property Insurance).

• State of the Florida Homeowners’ Insurance Market presentation by OIR Commissioner Kevin McCarty (bottom of heading no. 5. General Insurance).

• Health insurance presentations by OIR to the Florida Health Insurance Advisory Board (bottom of heading no. 9 Health Care).

This summary was prepared by Perry Cone and posted at TallyInsLaw.com.

Legal Notice and Disclaimer

PIP reform passes in last hours of 2012 Florida session

Finally. . . at 9:20 pm this evening, PIP passed. The Florida Senate concurred with amended House language and passed strong PIP reform - a compromise version negotiated among House and Senate sponsors and the Governor's office.

The final language of HB 119 is currently only in amendment form at amendment number 941519. The House's summary of changes from the Senate bill is contained in a House Message Summary.

For more on PIP and other insurance bills passed by the Legislature, go to 2012 Key Insurance Bills tab.

This summary was prepared by Perry Cone and posted at TallyInsLaw.com.

Legal Notice and Disclaimer

Week 8, 2012; action shifts to Senate; one week to go

It’s finally here! The last week of Florida’s 2012 legislative session. No insurance bill has yet to pass both the House and Senate.

Seventeen bills have been passed by the House and are ready for Senate floor action. Some will pass, some will fail. Which way they fall by Friday, March 9th (end of session) is anyone’s guess right now.

Below is an update on three highly-controversial insurance measures (including PIP), followed by a summary of the quiet ones.

PIP renamed "MCC" in reform bill ready for full House following week 7, 2012

The House's controversial new coverage to reform PIP was renamed "Medical Care Coverage" (MCC), passed its final committee, and is ready for action in the full House.

The revised House bill, HB 119, retains the emergency care coverage that was part of the original bill and adds a carve-out of $1,500 for non-emergency care in a doctor's office within the first 72 hours of an accident.

PIP week 6, 2012 – not quiet, not moving

Neither the House nor the Senate moved on PIP reform this past week (week 6 of the 2012 Florida legislative session). But PIP wasn't out of sight or mind either.

Governor Scott, CFO Atwater, and support groups kept the issue alive, as reflected below:

Mid-session report - week 5, 2012

The middle of week 5 marked the mid-point of Florida’s 2012 legislative session. Of the 30 or so insurance measures I have been following, 11 inched forward last week.

There are now four weeks left to go, with the session scheduled to end on March 9, 2012. Below is a combined week 5 update and mid-term report on a select dozen insurance matters – four of the more controversial issues still kicking around, four bills that seem poised for passage (eventually), and four that appear dead for the session.

PIP, Citizens, aliens highlight Week 4, 2012 session

PIP and Citizens reform were at the top of measures that advanced during week 4 of Florida's 2012 legislative session. Alien insurers, annuities, commercial lines transfers, and other matters also received favorable votes. Here is a summary of the past week's action in Tallahassee:

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.

Week 3 insurance recap (2012 session): bad faith fails; but advancement on large list, including PIP, Citizens, title insurance, warranty, Medicare, commercial, property, and motor vehicle

With one very notable exception, this was a good week for insurance legislation in Tallahassee, Florida. Below is a summary of committee action on 9 important and minor measures during week 3 (2012 legislative session).

Week 1 - 2012 Florida Legislature: rapid start for PIP, Citizens depop, captives

The 2012 legislative session got off to a rapid start – from an insurance perspective – with important and minor bills moving through the committee process.  Here’s a summary of week 1 action:

• PIP in the House – Emergency Care Coverage substituted for PIP.  The House Insurance and Banking Subcommittee approved HB 119, an aggressive reform package that would replace personal injury protection (PIP) motor vehicle insurance with new Emergency Care Coverage (ECC).  Under this initial version of the House bill, ECC would provide hospital emergency room treatment within the first 72 hours following an accident.  After the emergency, covered treatment would be confined to a very limited group of health care providers (medical physicians, osteopathic physicians, dentists, physician assistants, and registered nurse practitioners).  Also in the package are significant legal reforms, including caps on attorney fees.  This House bill is highly controversial and likely to go through many changes.  For further detail, see House Staff Analysis of HB 119 (Jan. 10, 2012). 

Has PIP become unconstitutional?

A few provisions of Florida's PIP statute have been held unconstitutional over its 40-year history.  But PIP itself has withstood the constitutional test of time. 

The cover story of this month's Florida Bar Journal suggests that cumulative reforms to the PIP statute beg a new question:  Has the entire statutory scheme has been rendered unconstitutional?  See The Advent of Paper IMEs in No-fault Claims: Will They Be a Solution or a Problem? 

The author acknowledges that the Legislature passed various statutory amendments – in 1998, 2001 and 2003 –  to  “curb . . . abusive practices,” such as bulk billing and skirting the IME requirement.  And today, “Florida is facing a crisis in PIP with alarming concerns” about staged accidents, and patients solicitation and brokering, among other current abuses.

Happy (belated) 40th birthday, Florida PIP

Did you know?  Florida’s PIP law was first enacted just over 40 years ago.  On June 4, 1971, the Florida Legislature passed “The Florida Automobile Reparations Reform Act” or “no-fault law” as Section 627.736 of the Florida Statutes.  The no-fault law became effective January 1, 1972, so look forward to another birthday announcement in about five months.

Week 6: "busy" week for Florida insurance reform legislation

Six of the key insurance bills I'm following had action in the House or Senate (or both) last week -- Week 6 of the Florida 2011 Legislative Session.  So I think that it's fair to say that last week was a "busy" one.  Next week (Week 7) will be relatively quiet, as the Senate is in recess all week for the Easter/Passover Holidays, and the House meets only on Wednesday (April 20) and Thursday (April 21).  

When the Legislators return, only two weeks (8 & 9) will remain in the Regular Session (unless extended).  There are still many differences to resolve between House and Senate versions of the bills, and most bills contain highly controversial provisions.

Here is a summary of action last week:

PIP reform snagged in Senate

Bills to reform Florida's personal injury protection (PIP) insurance came to an unexpected halt after more than an hour of testimony and debate before the Senate Banking & Insurance Committee, during week 5 of the Florida Legislative Session.  Both the PIP fraud bill (S 1930) and the PIP legal reform bill (S 1694) were scheduled for the meeting, but only one (the fraud bill) was vetted, and no votes were taken.

Key bills scheduled for week 5 of Florida Legislative Session

Florida legislative committees are set to hear key insurance bills during week 5 of session:

• Monday, April 4:
• Bad Faith (H 1187) is scheduled for its first hearing in the House, before the Civil Justice Subcommittee.
• Medical Malpractice (S 1590) is scheduled to be heard in the Senate Health Regulation Committee.

Couldn’t Treat “Your Dog,” Says DIF Director About PIP Clinics; PIP Reform Bills Keep Moving

“When people have broken bones and they are bleeding, they don’t go to these clinics. You wouldn’t take your dog to these clinics.”  This was part of the passionate testimony by Col. John Askins, Director of the Division of Insurance Fraud (DIF), Department of Financial Services.

Askins testified this past Wednesday, before two House subcommittees, in support of reforms to Florida’s personal injury protection (PIP) insurance laws. His remarks also included his belief that: “It’s all 100 percent fraud. …It is clinic driven…It’s like trying to get rid of the drug problem. It’s that pervasive.”

PIP Reform Makes Headway in Week 2 of 2011 Florida Legislative Session

A bill that would limit plaintiff attorneys fees in PIP litigation, HB 967, was approved by the House's Insurance and Banking Subcommittee during week 2 of the 2011 Florida legislative session.