Watch Today Live at 9 a.m.: Florida Insurance Consumer Advocate Robin Westcott’s PIP Working Group To Expand Fee Schedule Discussion to Alternative Dispute Resolution, Health Care Clinics, Billing and Payment

Reminder:  This meeting will be Webcast LIVE on The Florida Channel (Web 5) at 9:00 a.m.  To access the Webcast, go to www.FloridaChannel.org.

 

Expanding on Florida’s Personal Injury Protection (“PIP”) fee schedule and how it is susceptible to abuse and fraud, Florida Insurance Consumer Advocate Robin Westcott’s PIP Working Group will contemplate the related role of health care clinics, the billing and payment process, and alternative dispute resolution in its meeting today, September 26, 2011 at 9:00 a.m. in Tallahassee.

The agenda is attached.  To access additional meeting materials, click here.

The meeting also will include discussion on the following topics:

 

Health Care Clinics:

• What are the specific types of healthcare clinics that perpetuate abuse and/or fraud in the PIP system?
• How is the PIP system abused by the identified healthcare clinics?
• What changes are needed to properly address the abuse?
• How will the recommended changes impact healthcare clinic owners, insurers, claimants and/or others?
• What might be an unintended consequence of the recommended changes?

Billing / Payment Process:  

• Are there changes in the billing or payment process that should be considered? If so, please identify the changes.
• How would the changes benefit the medical provider, the claimant and insurer?
• Has the mandatory utilization of the Patient Log deterred abuse or fraud?
• Would medical providers be more willing to take PIP claimants if the billing process was automated?

Alternative Dispute Resolution:

• What is the current process for resolving billing disputes? Is it being abused? If so, what are the common abuses?
• Could mandatory arbitration be a viable option for medical providers and insurers to resolve billing disputes? If not, what would be another alternative other than legal action?
• Should there be a threshold such as a monetary limit?
• What should be done to halt frivolous lawsuits?

 

Also included on the agenda is a presentation on PIP fraud from the Florida Department of Financial Services, a presentation on licensed and exempted healthcare clinics from the Florida Agency for Health Care Administration, and an update from the Hillsborough County Sheriff’s Office on a local ordinance regulating PIP medical providers that was passed this week.

A Colodny Fass representative will attend the meeting and provide a report.

 

Should you have any comments or questions, please contact Colodny Fass.

 

 

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