Dynamic Chiropractic – May 6, 2012, Vol. 30, Issue 10

Florida PIP Reform Limits Driver Benefits, Including Chiropractic

On March 9, the last day of the Florida legislative session, just two hours before adjournment, state lawmakers gave their final approval to a package of PIP / no-fault auto insurance reforms identified as CS/CS/HB 119.

The last-minute deal struck between Governor Rick Scott, Chief Financial Officer Jeff Atwater, and leadership in the House and Senate was drafted earlier in the afternoon behind closed doors, then unveiled and quickly rushed through both chambers.

The "compromise measure,"; as it was sold to members on the Senate floor, makes major changes to the role that all providers, including doctors of chiropractic, will have in treating future accident victims, while completely denying access to massage therapy and acupuncture services. Despite a rigorous lobbying effort by the Florida Chiropractic Association lobby team and membership, in concert with coalition associations representing other providers and the legal profession, a number of pro-insurance industry proposals were adopted that further enhance the industry's ability to reduce, delay and deny payment of legitimate provider claims, while likewise reining in the fees attorneys can recover in complex cases.

Effective on policies renewed or issued after Jan. 1, 2013, Florida drivers will still be required to carry at least $10,000 in PIP coverage; however, many of the current key provisions of the benefit will change. The full $10,000 benefit becomes available only to accident victims who are diagnosed with an extreme "emergency medical condition,"; a determination that cannot be made by DCs per HB 119. In these situations, follow-up care may be provided by a DC upon referral, provided the care is consistent with the original diagnosis.

Additionally, a new tiered benefit of up to $2,500 is alternately available for patients diagnosed with a non-emergency medical condition. This $2,500 diagnosis/treatment benefit is available to DCs, MDs and DOs. In both scenarios, patients must present themselves for care within 14 days of the accident or there is no PIP coverage.

Leading up to and throughout the 60-day session, an insurance industry-funded PR campaign costing millions of dollars was mounted to convince the legislature and Floridians that they were paying a "billion-dollar fraud tax"; through their PIP premiums. Soft- tissue injuries were isolated as the "number-one cost driver in PIP."; The governor and CFO, in numerous press conferences, parroted the insurance industry's selling points for reforms aimed primarily at health care providers and attorneys' fees, rather than at fraud and the criminal element.

The House first passed a bill that would have completely eliminated access to chiropractic, massage and acupuncture services and created a new system whereby access to coverage began only at a hospital emergency room or other emergency facility. The Senate unanimously passed a reform package that aimed directly at fraud and the criminal element, while preserving patient choice of provider. The wide disparity between the House and Senate versions of PIP reform set the stage for the last-minute crafting of HB 119. The Senate voted to concur with the House, which had passed the bill 80-34, but by a much closer vote of only 22-17. As of press time, the governor's signature of approval is anticipated.

"While direct access to chiropractic was preserved in HB 119, the omission of DCs from diagnosis of emergency medical conditions in this bill is unacceptable and inconsistent with our full diagnostic scope of practice in Florida,"; said Dr. Craig Newman, president of the 3,900-member FCA. "The FCA attorneys are currently working with attorneys of coalition partners to investigate options for legal challenge. We will not cease in our efforts to overcome the effects of this legislation to restrict Floridians' freedom of choice for care of auto accident injuries."

Article exclusive to DC courtesy of the Florida Chiropractic Association


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