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House approves compromise PIP package

by Dara Kam | March 9th, 2012

The House has signed off on a last-ditch effort to close out a deal with the Senate on personal injury protection reform, one of Gov. Rick Scott’s top priorities.

But despite frenzied lobbying by insurance company representatives and Scott, it remains unclear whether the deal has enough support in the Senate to get the 21 votes needed to pass. Scott and Chief Financial Officer Jeff Atwater have made PIP fraud one of their primary focuses of the legislative session.

The compromise, passed with a party-line 80-34 vote late this evening, would require patients to seek care within two weeks of a crash, a concession from the House’s original seven day requirement.

The House also agreed to allow up to $10,000 for emergency service coverage as determined by a physician, osteopath, dentist, physician’s assistant or registered nurse practitioner. Of that, $2,500 could be used for non-emergency medical care. Visits to chiropractors would be covered up to $2,500 for certain types of injuries, but would require a referral from one of the other health care providers for others. Acupuncturists and massage therapists would no longer be covered by PIP.

The deal also did away with the House’s original proposal that would have required initial care to take place only at a hospital or emergency room. Instead, injured patients would also be allowed to be seen by private physicians.

And the compromise would require insurance companies to notify claimants within 30 days if they suspect fraud, and gives another 60 days to investigate. One of the more controversial parts of the deal would require those whose claims are being investigated to submit to examinations under oath if their insurance companies ask.

And, in what could be a sticking point for the Senate, the deal would require insurers to roll back rates 10 percent by October and 25 percent by Jan. 1. 2014, or else give a “detailed explanation” to insurance regulators for why the rates were not reduced. The Senate had sought a 25 percent rate reduction.

House Democrats blasted the last-minute amendments, accusing the GOP sponsors of the measure (HB 119) of being pusillanimous and caving to insurance industry pressure, especially over the rate roll-back, which critics said has no teeth.

The measure includes no penalties for insurers who fail to meet the rate reductions, Rep. Scott Randolph, D-Orlando, objected.

“The fraudsters are the big insurance companies that wrote this amendment and that are continuing to say now, give us more profit and we’ll give you a Post-it note at the end of the day explaining why we can’t reduce rates,” Randolph said.

Insurance lobbyists huddled into the wee hours Friday morning crafting the measure and were back at it early the same day, with time running out to seal a deal with the Senate that Scott would approve.

With hours until the 60-day session was scheduled to end, Scott stepped up pressure on lawmakers, calling them and ordering them into his office. Scott also pleaded his case through the media with appearances on at least seven radio talk shows before 8:30 a.m. Friday morning.

Scott pushed lawmakers to “get it done” and threatened to call a special session if they did not pass a comprehensive PIP reform.

“If I had to I would (call a special session later on the issue) but there’s no reason we can’t get it done today,” Scott said on WFLA 540 AM in Orlando. “I’m very comfortable they’ll do the right thing.”

Scott’s advisors have said the House would not pass a package the governor did not approve.

“The House has some good provisions,” Scott said. He said he hoped they would “send it back to the Senate and I hope we get it passed today.”
- The News Service of Florida contributed to this report.

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