Florida House And Senate Reach Agreement On PIP

As we previously reported, it appears that Florida’s Senate and House of Representatives has reached an agreement that would reenact Florida’s No Fault law with modifications.  Although a draft bill has not yet been released, we expect one to be released by the end of the day today.  At this time, we do not have any information as to implementation procedures or an effective date, although it is our understanding that legislators may “revive old No Fault” for a period of time until “new No Fault” may be implemented.  It is also unclear whether legislators intend to extend the impending sunset or eliminate the sunset altogether.  According to Chris Kise, Special Counsel to Governor Charlie Crist, the bill will contain the following provisions:

Litigation Control
• Requiring that a provider may be permitted one lawsuit per claimant for disputed services;
• Codifying certain criteria for an attorney to be awarded a contingency fee risk multiplier;
• Requiring non-binding pre-suit mediation.

Fee Schedule
• Creating a fee schedule allowing for 200% of Medicare for emergency transport, in-patient, out-patient and all other medical services;
• Providing that an insurer be required to only pay 75% of billed hospital charges;
• Providing that physicians be entitled to $5,000 of the benefits, but appearing to be silent as regards the administration of this portion of the proposal;
• The bill will not contain a utilization component.
 
Other Various Components To Be Contained In The Bill
• Maintaining that insurers will pay 80% of claims, but removing language allowing insurers to offer a deductible;
• Limiting the types of clinics eligible for reimbursement—that is, only those clinics that have been licensed for three years, have a medical director, or which provide treatment ordered by a Medical Doctor or Doctor of Osteopathic Medicine will be eligible;
• Explicitly allowing the Attorney General’s Office to investigate insurers for unfair and deceptive practices;
• Allocating $2 million for fraud investigators;
• Requiring the Office of Insurance Regulation to create a form for insurers to use in determining whether a provider is eligible for reimbursement.

*Included with this e-mail is a chart comparing the Senate and House PIP reform proposals. 

 

Should you have any questions or comments regarding this information, please feel free to contact this office.