PIP Debate Narrowing Focus: Negotiations Continue in Tallahassee to Revamp the State's No-Fault Auto Insurance Law to Limit Fraud and High Medical Costs

By Beatrice E. Garcia, The Miami Herald

Sep. 20--While efforts to find common ground on reforming Florida's no-fault auto insurance law intensified Wednesday, the debate focused on limiting medical costs after accidents.

Another meeting is set for Friday.

Since early this week, stakeholders in the negotiations over whether to revamp and extend the no-fault law or let it expire as planned on Oct. 1 have reached agreement on some proposals to limit fees charged for medical care that's provided to auto accident victims.

A bill drafted by Sen. Bill Posey, a Republican from Rockledge, proposes limiting payments to 200 percent of what Medicare pays for most in-hospital, doctor and healthcare services to people involved in auto accidents. Hospitals would collect 75 percent of what's billed for emergency room services.

Hospitals as well as many doctors and chiropractors are willing to accept these limits.

"We're fully supportive of the fee schedule that's in Sen. Posey's bill," said Ralph Glatfelter, a lobbyist for the Florida Hospital Association.

Yet, some recent progress may have eroded a bit.

While many insurers and legislators have long suggested that fee limits are needed to contain medical costs for accident victims, and thus losses for insurers, some insurers believe that some of the suggested limits in the Senate proposal might be too high.

State Farm, the largest auto insurer in the state and an aggressive proponent of letting no-fault sunset, believes these limits "are too little, too late," said Mark Delegal, the insurer's main lobbyist in Tallahassee.

Alison Jones, a spokesman for a State Farm-backed group, said the company could accept fees capped at 200 percent of Medicare as long as they are across-the-board for all services with no carve-out for emergency room care.

"It's not a real fee schedule unless it's across the board. That's what we would like to see in an ideal world," said Jones.

The current law requires drivers to purchase $10,000 in personal injury protection, also known as PIP, which pays medical bills and some lost wages after an auto accident.

Critics say the no-fault law leads to excessive billing by hospitals, clinics and some doctors because there are currently no fee limits or utilization controls.

Rep. Julio Robaina, a Miami Republican, was more optimistic about Wednesday's meeting.

He noted the Posey bill would require all clinics to be doctor-owned, a factor that could help stamp out some of the fraud now seen by auto insurers and state investigators.

"If you have a fee schedule and require doctor-owned clinics, you can knock out a large part of the fraud," said Robaina.

Curbing the fraud has been high on the agenda for House Speaker Marco Rubio, who along with Senate President Ken Pruitt would make the call to bring lawmakers to Tallahassee -- possibly next week -- to debate an auto insurance bill.

House Democratic Minority Leader Dan Gelber, of Miami Beach, continues to urge Rubio that possibly the best course is to just extend the no-fault law for another year and then tackle substantial changes during the regular session next spring.

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