Pending No-Fault Issue Generates Media Coverage

The pending no-fault legislation in both the Florida House of Representatives and Senate has generated continuing editorial and news coverage from around the State. Below are three recent articles on the no-fault/personal injury protection sunset issue.

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“This is the kind of procedure and bill that insults this process, because to a certain extent, people expect us to have the thoughtfulness to worry about them and worry about what the impact would be on them.”–Dan Gelber, House minority leader.

Florida House Republicans offered their first glimpse at how they want to rewrite the state’s mandatory automobile insurance laws by pushing a bill through a committee that doesn’t normally deal with policy.

The House bill would do away with the current mandated personal injury protection policies that pay $10,000 worth of health care benefits regardless of who is at fault.

In their place would be a new kind of mandatory coverage: $15,000 worth of coverage paid for emergency care or hospital-owned clinics, regardless of who is at fault.

The biggest difference between the systems is that under the House bill, the trigger for coverage would be an emergency room visit.

Currently, any health care claim, from a chiropractor to a physical therapist, can trigger the coverage.

If the Legislature does nothing, the state’s mandatory personal injury protection will disappear on Oct. 1, primarily due to concerns about fraud.

A House rules committee passed the bill 10-6 along party lines, with only Democrats opposing it, saying it needed more vetting.

“This is the kind of procedure and bill that insults this process, because to a certain extent, people expect us to have the thoughtfulness to worry about them and worry about what the impact would be on them,” said House Minority Leader Dan Gelber.

House Democrats protested that Republicans hadn’t given them more notice about the bill or even the meeting, while some hospital associations and health insurance lobbyists acknowledged the bill’s sponsor, Republican Whip Ellyn Bogadanoff of Fort Lauderdale, had shown a draft on Saturday.

The new type of hospital-centric coverage would disappear in 2012.

The House bill is different from the Senate automobile insurance plan that would keep the current no-fault system but cap the amount automobile insurers would have to pay in car crashes to no more than 200 percent what an insurer must pay, by law, for Medicare or workers’ compensation claims.

The House bill would also create certain types of medical caps on payments, but some caps are far more generous, requiring insurers to pay 75 percent of what a hospital emergency room, doctor or dentist bills.

 

Legislature 2007: South Florida Sun-Sentinel Editorial Board, April 23, 2007

ISSUE: The clock is ticking on PIP.

It seems like a replay of last year when state lawmakers, facing an overriding demand to fix property insurance in the waning days of the session, gave short shrift to reforming no-fault auto insurance.

They instead passed an extension, which then-Gov. Jeb Bush vetoed. Fast forward to the present and once again lawmakers face a looming deadline to fix no-fault vehicle insurance while confronting another overriding demand from voters — reform property taxes.

In the remaining weeks of this session, the Legislature would be wise not to come up with a sequel. No-fault, also called personal injury protection, or PIP insurance, will expire later this year. It shouldn’t, but neither should it be allowed to exist as is.

Florida adopted the mandatory coverage to avoid the delay and expense of using the courts to determine who was responsible for an auto accident. The 1971 reform promised to reduce the cost of auto insurance and provide faster payment for medical expenses and lost wages to deserving victims.

No-fault has helped curb litigation and has produced easier payments for claims. Unfortunately, PIP has become a magnet for fraud — most notably a rash of dubious medical procedures performed in fly-by-night pain management centers — which has prompted major insurers, like Allstate and State Farm, to oppose renewing the mandatory coverage.

Allowing PIP to expire without any equivalent replacement coverage would create other problems for Floridians, particularly in the area of health care.

Hospitals could face a loss of roughly $350 million in PIP payments, according to the Florida Hospital Association. About 40 percent of individuals injured in Florida traffic accidents have no health-care coverage but are covered by no-fault auto insurance.

Lawmakers should consider legislation that re-enacts PIP with fee schedules for medical care or other controls that limit coverage to legitimate services performed in hospitals, outpatient and trauma centers.

BOTTOM LINE: Re-enact PIP with new restrictions to curb fraud.

 

Car policies headed for an overhaul

Editorial From the St. Petersburg Times

Published April 19, 2007

Florida requires all motorists to insure themselves against physical injury and vehicle damage, but lawmakers are about to steer off this road. Without quick agreement on a no-fault law set to expire in October, the state could end up with a decidedly callous policy toward car crashes: Insure the fender but not the rib cage.

Such statutory priorities would be indefensible, which is one reason lawmakers can’t let the law expire without at least providing a realistic alternative. The other reason is that financially pinched safety-net hospitals stand to lose $350-million a year on care that likely would go unpaid if the no-fault system collapses under the weight of rampant fraud in South Florida and inaction in Tallahassee.

The no-fault system was adopted in 1971 with the intent of avoiding lawsuits and delays in compensation for most accident injuries. Unfortunately, it has become such a magnet for con artists and a quagmire for the legal system that legislators voted four years ago to kill it.

As the deadline approaches, the fight over the “personal injury protection” portion has been complicated by the competing interests. Insurance companies are fed up with clinics that recruit crash victims and find ways to bill up to the full $10,000 policy limit, and they also claim hospitals bill too much for services. Doctors and hospitals say fee schedules won’t compensate their real costs and ignore the fact that the $10,000 limit hasn’t changed in three decades.

One result of this infighting is that the House is just now introducing its own bill, only two weeks before the session is scheduled to conclude, and the Senate has yet to bring a bill to the floor.

Senate Banking and Insurance Committee Chairman Bill Posey, R-Rockledge, would postpone the deadline for 15 months while submitting the PIP system to a series of cost-containment and antifraud measures. But it is unclear whether his approach is sufficient to stem the fraud, and his fee schedules are meeting with broad opposition. Late as it is, then, the House’s plan may be more practical. It abolishes PIP, but replaces it with mandatory medical insurance targeted specifically at emergency hospital care.

Emergency medical insurance would not cover the types of long-term soft-tissue therapies that have led to so much fraud in PIP, but it would cover the hospitals and emergency rooms that often save the lives of injured motorists. Now about 40 percent of the people who are rushed from roadside accidents to an emergency room are not covered by basic health insurance. If no alternative were provided to PIP, those hospitals, most of them nonprofit charity institutions with financial challenges, would be forced to treat such motorists with no hope of reimbursement.

The proper limits of emergency care policies can be negotiated, but the approach at least recognizes that emergency rooms are on the front lines of protection. The motorists who are injured, and the hospitals that attend to them, deserve no less.