PIP Reform…A Big Week!

Last Wednesday CS/HB-119 cleared its second hurdle passing 10 to 5 out of the House Civil Justice  Committee. In doing so, and with the possible exception of outright repeal, it became Florida’s best hope in the fight against a $1 billion criminal industry. Better than all the other approaches, it scalpels only the malignancies directly responsible for hundreds of seedy criminal enterprises across our state.

Those who may have been sitting this one out should get involved. Learn what you can about CS/HB-119,  and the background underlying its provisions, then contact your elected representatives.

In essence it attacks core problems with two categories of reform. The first replaces PIP coverage with Emergency Care Coverage (ECC)–identical with respect to persons covered, the amount of mandated coverage ($10,000), and wage loss benefits, it makes medical coverage dependent upon severity and immediate care after an accident in a hospital emergency room.

While ECC  eliminates provider problems and over-utilization, the second category of reform in CS/SB-119, dealing with the fee’s and practices of attorney’s, will insure the new system doesn’t backslide into an ocean of fraud like original PIP has. It caps attorney fees and class action suits, eliminates the contingency multiplier, enhances an insurer’s ability to conduct examinations under oath and much more.

Those who doubt the emergency room concept should consider the testimony. When asked to explain how “more expensive” emergency room care  could possibly bring down costs the answer given by the bills prime sponsor, Representative Jim Boyd, not only disposed of the issue but it was testament to the razor approach of his proposal.

Average charges for PIP providers are lowest for emergency rooms at $1,613 per visit. Meanwhile, the most expensive care comes from the usual suspects: chiropractors $3,482, acupuncturists  $3,674, and, get this… massage therapists at $4,350. It’s this unconscionable largesse that’s caused the number of new massage therapists to increase almost 75% from 2,843 to 4,892 in just one year. This, while the percentage of claimants visiting chiropractors increased from 30% to 43% over ten years and emergency room visits went down.

And, don’t be mislead. ECC will not overcrowd emergency rooms. Just the opposite. Only those with injuries will seek care. Not those who are charged nearly three times more for massages or a dozen pin pricks; neither of which, in a large number of cases, they actually received anyway!

Signaling this is a top down reform effort, after the bill passed out of the Civil Justice committee, it was immediately pulled from one of its two remaining committee’s and the Governor and the Florida Chamber of Commerce sponsored a large press conference attended by over 100 people. On hand were lawmakers, members of the cabinet, Insurance Commissioner Kevin McCarty, law enforcement organizations, nonpartisan public policy think tanks and major business groups.

“Florida’s auto insurance system has been infiltrated by a circling pool of vicious sharks looking to make their millions off the backs of consumers,” CFO Atwater said.  He’s been the prime mover of PIP reform and should be commended for having the courage to point fingers in all the right directions.

After all, his bureau of fraud knows PIP is far beyond the usual insurance crisis marked merely with spikes in pricing and loss of availability.  Wearing masks to protect their identities, undercover detectives told the media they had arrested 127 accident fakers and patient brokers and closed seven criminal enterprises which were not only established solely to defraud insurers but turned away the truly injured merely because they weren’t complicit in their schemes.  Worse, these thugs use their one-stop crime shops for theft rings, human trafficking, witness intimidation and money laundering.  All of it initially funded by PIP fraud!

In summary, last week’s news, while hopeful, is only a small part of a very long legislative session. We’ve been this far before, even further.

For Floridians to actually receive the reforms they deserve, the Senate must be far more bold than is indicated with the provisions in SB-1860 sponsored by Senator Negron or those in Senator Mike Bennett’s bill SB-254.  Good efforts, but…not good enough to eradicate nearly two decade’s worth of  well-organized crime.

After years of posturing, it’s time to finally solve the problem by passing CS/SB-119.

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