TALLAHASSEE –In an effort to curb fraud, the Legislature has set out to reform Florida’s Personal Injury Protection (PIP) system. Both chambers have offered legislative reforms, but the two proposals widely vary. More than half a dozen advocacy groups representing a broad range of interests held a press conference Thursday to voice their support for the Senate proposal and highlight the major differences between the two PIP solutions.
“Floridians who pay for insurance coverage deserve more than a chain that binds them to government-mandates for healthcare and treatment time limits,” said Bill Newton, Executive Director of the Florida Consumer Action Network. “Proponents of the House bill are using the facade of fraud prevention to pass a bill that offers no new benefits, binds consumers to arduous regulations and makes it more challenging to collect legitimate PIP claims; all so insurance companies can line their pockets with greater profits.”
Supportive organizations, including the Florida Consumer Action Network, Florida Medical Association, Florida Justice Association, Florida Chiropractic Association, Florida CHAIN, Florida Public Interest Research Group and Florida Osteopathic Medical Association, outlined reasons why the sensible Senate bill is better postured to prevent fraud and drew sharp contrasts with Rep. Jim Boyd’s (R-Bradenton) HB 119, which was characterized as an insurance industry “wish list” that will limit consumer choice.
“The insurance companies have written the House bill in their favor so they can charge high premiums and not pay for the benefits,” said Paul Jess of the Florida Justice Association. “By limiting PIP coverage under the guise of fraud prevention and consumer protection, they are pulling the wool over the eyes of Florida drivers.”
After receiving input at numerous stakeholder workshops, Sen. Negron’s SB 1860 cracks down on perpetrators by imposing harsher penalties, tightening regulations on medical providers and giving law enforcement the enforceable tools needed to address PIP fraud. Speakers at Thursday’s press conference stated HB 119 is devoid of true fraud prevention and enforcement measures. The House PIP proposal would also limit auto accident victims’ options for treatment and severely reduce the window of time in which they must seek care.
“For the doctors we represent, their primary concern is the health and recovery of their patients. For those who have been injured in a car accident, we want them to be able to seek the care they need, from the provider of their choice, without having to worry about whether or not they’ll be able to pay their medical bills. That’s why Personal Injury Protection was originally created,” added Jack Hebert with the Florida Chiropractic Association. “Sen. Negron’s bill provides drivers with the protection they need while taking the right steps to eliminate fraud. The respectability of the medical profession is critical to our members. With this legislation, we can ensure the unscrupulous parties are taken out of the equation.”
Serious concerns were raised about a provision within HB 119 that requires auto accident victims to seek initial treatment at an emergency room within 72 hours – further driving up high health care costs at overcrowded facilities. Additionally, in order to receive PIP benefits, patients must also be diagnosed with the ambiguously defined “emergency medical condition” with injuries of “sufficient severity.” Opponents of the House bill believe that health care insurance rates will inevitably rise to cover what the auto insurer denies. However, one of the biggest criticisms was the lack of true fraud fighting measures in the House’s PIP proposal in comparison to the Senate.
“The Senate’s PIP legislation sends an important message to those who would stage accidents or file false PIP claims: you will be caught and you will pay for your crimes,” continued Newton. “If you’re a medical professional, you will lose your license and your ability to practice. If you’re a business owner, you will lose your ability to conduct business and therefore your livelihood. If you’re a citizen involved in PIP fraud, you can not only go to jail, but will have to pay a minimum fine of $5,000 if found guilty.”
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The supporting organizations also noted the Senate bill closes a loophole that has led to a proliferation of unlicensed, non-physician clinics that seems to correlate with the increased number of reported PIP fraud cases in the last five years. If passed, the fraud prevention measures in SB 1860 would also reduce costs of PIP coverage by up to $125 million a year.