Personal Injury Protection Bill

January 16, 2012

A bill that would force all accident victims to go to emergency rooms instead of their family doctor, even for minor injuries, cleared a House subcommittee today.

The bill (HB 119) was approved 10-5 by the Florida House Banking and Insurance Subcommittee. It aims to cut down the fraud that is rampant in the state’s personal injury protection, or PIP, coverage.

Gov. Rick Scott later came out forcefully for the measure, saying he had no problem with its emergency room mandate.

PIP fraud “is costing us a significant amount of money every year,” the governor said. Scott helped start Columbia Hospital Corporation, which merged with another company to become the world’s largest health care company.

Requiring crash victims to be treated in emergency rooms is “one approach … You know there’s other approaches to license providers and all sorts of things,” he said. “(But) I think that bill is a good bill and I’m very supportive of it.”

The proposed law requires those hurt in a wreck to go to a hospital emergency room or hospital-owned walk-in clinic within 72 hours for PIP coverage to kick in.

The bill’s critics warned that it would make people suffer long waits in understaffed, overcrowded emergency rooms, and would prevent them from seeing doctors or other health care providers who already know their health condition.

But Rep. Jim Boyd, the Bradenton Republican sponsoring the bill, explained that crash victims should first be treated in hospitals rather than pain clinics, for instance.

As to the 72-hour limit, he said people injured in a crash shouldn’t be allowed to “just wander in (for treatment) at some point in the future.” He was, however, willing to lengthen that treatment limit to somewhere between 72 hours and 14 days.

PIP fraud “is a tax on every car driver in Florida,” he told the subcommittee. “It’s time to put money back in constituents’ pockets.”

Lawmakers passed PIP coverage in 1972 to ensure that anyone hurt in an automobile wreck could quickly get money to treat their injuries.

The legislation provided that a driver’s insurance company pay up to $10,000 to cover medical bills and lost wages after an accident — no matter who is at fault. All Florida drivers are required to carry no-fault insurance.

But over the years, fraudsters have turned Florida into the top state for staged accidents, particularly in the Miami-Dade and Tampa areas. Some racketeers have even turned it into a profit center, reports show.

The Insurance Information Institute predicted that PIP fraud could approach $1 billion in the state this year, and those costs are passed on to customers through increased premiums. In some sections of South Florida and the Tampa Bay area, that can mean hundreds of extra dollars per year.

State investigators recently found a number of Miami-Dade medical clinics that only treat auto-accident victims and bill primarily for massage therapy.

Investigators also found many clinic owners who had no prior health care experience. Some of them said they had opened auto-crash clinics only because they heard they could make a lot of money.

Rep. Ritch Workman, who has his own version of a PIP overhaul bill, questioned whether hospitals would also learn to abuse the system.

“How long is it before hospitals figure out that PIP equals $10,000?” the Melbourne Republican asked Boyd. “Hopefully never,” Boyd answered with a smile.

Democratic Rep. Evan Jenne of Dania Beach, who voted against the bill, asked why lawmakers would want to limit people’s choice of medical professionals.

“It seems a little Romney-ish,” he added, a dig at the GOP presidential candidate.

Dr. Steven Kailes, who represented the Florida College of Emergency Physicians, said his group didn’t believe that every PIP case needed to come into an emergency room, but understood why it was in the bill.

“The evidence is that PIP fraud is not happening in (hospital) emergency rooms,” he told a reporter. “And yes, not every accident victim needs immediate attention, but those that do, get it.”

In public comments, plaintiffs’ lawyers generally opposed the bill and business and insurance interests supported it.

The bill will next be considered by the House Civil Justice subcommittee. Other PIP overhaul measures are pending in the Senate.

By The Associated Press
Published: January 11, 2012

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