PIP Sponsors Say Governor Will Sign Bill Despite Glitch

May 4, 2012

Two key lawmakers behind Florida’s no-fault insurance reform package said Thursday they expect the governor to sign the new law Friday despite a potential glitch that could delay payments to some health providers.

House sponsor Jim Boyd, R-Bradenton , and his Senate counterpart Joe Negron, R-Stuart, said they’ve been assured that potential loopholes in portions of HB 119 will be plugged by agency rulemaking, or if that doesn’t work, an executive order during a six-month window that has been highlighted as a potential problem.

“I think the legislative intent is clear.” Negron said.

Lawmakers earlier this year passed the measure to make changes to personal injury protection insurance, a $10,000 medical benefit that critics say is rife with fraud, overutilization and litigation.

During the back and forth between chambers, authors overlooked the fact that a potential six month gap in coverage exists. While the new payment requirements kick in Jan. 1, other portions of the bill become effective six months earlier.

The gap raised red flags among some providers, who worried that insurers following the letter of the law would not have to make payments for a long list of health services.

State insurance regulators say they have been in contact with carriers over what they consider an obvious oversight and have been assured that insurers will continue to pay claims during that window.

Jack McDermott, spokesman for the Florida Office of Insurance Regulation, said the agency expects few if any glitches in payments to providers.
Just in case, the Agency for Health Care Administration, which licenses health providers, is drafting language to clarify that payments to qualified providers will continue to flow.

“The purpose of the bill was not to create a six month gap,” McDermott said. “AHCA has publicly said they are going to issue rules to clear this up. We’ve encouraged insurers privately that PIP providers should be paid.”

The no-fault coverage, known as PIP, has come under fire from insurance industry representatives who say that staged crashes and skyrocketing use of non-emergency medical treatment have caused premiums for the coverage to rise dramatically.

PIP reform became a legislative priority for Gov. Rick Scott, who applauded lawmakers for coming together during the session’s final days to hammer out a compromise.

The law’s major provisions kick in Jan. 1, 2013 and include a detailed framework for which medical providers are eligible for reimbursement under PIP coverage. The list included physicians, hospitals, and chiropractors.

Other provisions of the law however, kick in six months earlier, leaving the potential that insurers would not be required to reimburse providers during that period. Sponsors, however, say such a potential is not expected to keep Scott from signing the bill Friday.

“If it comes to that I think there will be an agency rule to make it clear what we’re doing,” Boyd said. “But I don’t think it is going to come to that.”

By The News Service of Florida

Comments

3 Responses to “PIP Sponsors Say Governor Will Sign Bill Despite Glitch”

  1. Ben Thar on May 4th, 2012 10:35 am

    Yes, here’s a law that’s designed to protect the consumer. I’m sure that premiums will come down now.

    Or is it possible that this law is designed to protect the insurance companies? We can’t have an insurance system where the consumer actually uses their insurance benefits, can we?

    If they have evidence that crashes are staged, then I think we have laws that already address that.

  2. Jane on May 4th, 2012 5:23 am

    Here we go again…another law that leaves loopholes. I still believe the old adage “do it right the first time and you won’t have to re-do it, which is always more work”.

  3. EJ on May 4th, 2012 5:07 am

    “I think the legislative intent is clear.” Negron said.
    Nothing is CLEAR to a politician or lawyer.

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