THE NEWS SERVICE OF FLORIDA: PPO, State Farm Insurance Bills Advance
Apr 7, 2009
By MICHAEL PELTIER
NEWS SERVICE OF FLORIDA
THE CAPITAL, TALLAHASSEE, April 6, 2009… After giving a little something to everybody, the Senate Banking and Insurance Committee approved a measure Monday that would require managed care insurers to directly bill outside-of-network providers but not until critics added a provision to limit the amount of fees those physicians could charge.
By a 6-2 vote, the panel approved SB 1122 but not until an amendment was added over the objections of the bill’s sponsor that limits payment of out-of-network doctors to 80 percent of the Medicaid rate.
With the amendment, insurance companies angered over the original bill reluctantly acknowledged their tentative approval. Backers of the less restrictive original bill also gave a reluctant nod with the hopes that the amendment would be stripped in subsequent committees. The House has a similar proposal (HB 855)
“All this does is allows insurers to directly pay (out-of-network) physicians,” said Sen. Don Gaetz, R-Fort Walton Beach, citing language in the bill he says limits fees to what they would get from network physicians. “That’s all it does.”
Critics don’t agree. Earlier in the day, a coalition of groups spoke out against the measure, saying it would raise premiums for policyholders remaining in PPOs, including thousands of state employees now covered by managed care plans.
“This is going to raise costs for a lot of workers,” said Walter Dartland, of the Consumer Federation of the Southeast. .
In other action, the panel approved a measure that would allow State Farm Insurance Co. and other big insurers to raise premiums without the consent of the Office of Insurance Regulation, which earlier this year denied the company’s request for a 43 percent increase.
Under the measure, sponsored by Sen. Mike Bennett, R-Bradenton, State Farm and other large insurers could charge any premiums they want in exchange for not being part of the state’s contingency funds in the event of a storm.
Insurance officials have argued that allowing some policyholders to leave Citizens Property Insurance Corp and pay higher State Farm rates would make it more expensive for those Citizens policyholders who remain. Bennett countered that Citizens rates are in many cases much higher than State Farm even if the company would be allowed to raise premiums significantly.
“We think that you as a consumer should be able to say, yes, I’ll pay that other 30 percent,” Bennett said.