In an effort to crack down on the potential for auto insurance claims fraud perpetrated by so-called “pain clinics,” a subcommittee of the Florida House of Representatives has approved a proposal to require accident victims to be seen in an emergency room within 72 hours to be eligible for personal injury protection benefits.
Proposed committee statute HB 119 sailed through the House Insurance and Banking Subcommittee by a 10-5 margin Jan. 11 and will next be considered by the House Civil Justice Subcommittee. The Florida Legislature convened its 2012 regular session Jan. 10 and is set to meet for 60 days.
Understandably, there are concerns the measure could overwhelm already flooded emergency rooms and could simply move the locus of fraud from independent clinics to hospitals.
Bill sponsor Rep. Jim Boyd (R-Bradenton) was quoted by Insurance Journal as saying he was flexible on extending the treatment time frame to as much as 14 days, but his intent was that accident victims shouldn’t “just wander in [for treatment] at some point in the future.”
The measure has support from at least some segments of the insurance industry, with the American Insurance Association—which supports complete repeal of Florida’s PIP system—saying HB 119 would “curb escalating systemic fraud and abuse.”
Gov. Rick Scott (R), a founder of Columbia Hospital Corp., has given the measure a qualified endorsement, noting there are “other approaches to license providers and all sorts of things.” He added, “I think that bill is a good bill, and I’m very supportive of it.”
New Standards Set
One of those other approaches is HB 523, filed in November by Rep. Ritch Workman (R-Tallahassee). Workman’s bill would set new standards for investigating crash reports and would implement more stringent licensure for health care clinics authorized to submit PIP claims for payment. The bill also would divert revenues from driver’s license fees to operate an Automobile Insurance Fraud Strike Force.
More recently, state Sen. Joe Negron (R-Stuart) introduced legislation that also includes more stringent clinic licensure and providing for a long-form incident report. In addition, Negron’s bill, which has support from state Senate President Mike Haridopolos (R-Merritt Island), would set a fee schedule for reimbursements and give hospitals priority standing in PIP claims.
In a report issued in October, the Property Casualty Insurers Association of America estimated fraudulent claims have cost Florida drivers more than $800 million.