1/19/2012
By: Claude Hanuschak
Diagnostic Professionals, Inc.
For months now, Floridians have been showered with
grandiose assessments by the insurance industry and its
pals in Tallahassee about how fraud in the personal
injury protection system is pushing mandatory premiums
skyward.
This despite the industry’s patent refusal to cough up
hard data that prove the runaway fraud scenario is fact,
not a smokescreen to disguise padded profits. Even some
of the state’s most knowledgeable officials, CFO Jeff
Atwater and Insurance Consumer Advocate Robin Westcott
among them, have rapped insurers for failing to submit
the numbers as requested.
And yet, the industry not only continues to get away
with its intransigence, its exaggerated fraud picture
reigns in Tallahassee as a top issue of legislative
concern. Surprised? You shouldn’t be. A credible,
independent study completed in December by a Florida
State University professor found that state leaders are
too cozy with the insurance industry and are relying on
flawed data in pushing for PIP reform.
It is this toxic climate that has allowed Rep. Jim Boyd,
R-Bradenton, to advance through the Florida House
committee process a potentially crippling measure that,
if passed, would ruin the business climate for
legitimate medical providers, lead to the loss of
thousands of jobs in the health care field, and cripple
accident victims’ access to quality health care.
HB 119’s most ballyhooed provision is its proposal to
require accident victims to report to a hospital
emergency room within 72 hours to quality for the PIP
coverage they paid for, even if they suffered only minor
injuries. Such as senseless mandate takes legitimate
business away from trusted medical professionals with
whom many patients have built a longstanding
relationship; providers whose practices are set up to
handle this important patient load. And
since symptoms of many accident injuries can take weeks
to show up, Floridians would have to seek treatment
under high-deductible medical plans, making them pay
twice for the same coverage.
Worse, putting the onus on ER doctors to confirm
injuries resulted from an accident would easily
overwhelm an already-crowded emergency system, and
subject ailing patients to long, unnecessary emergency
room waits. It’s a disaster in the making.
But that's just the beginning of HB 119’s parade of
horribles. By capping attorney fees, for consumers and
medical providers but not deep-pocketed insurers, and
requiring onerous site inspections and deposition-like
examinations of medical providers, the measure is an
attempt to eliminate Florida consumers’ most effective
advocates. There’s a reason Boyd’s bill has been dubbed
"the insurance industry's wish list": It does nothing to
target fraud and everything to protect the industry's
bottom line.
Thankfully, on the other side of the Florida Capitol,
Sen. Joe Negron, R-Stuart, has filed a more sensible
measure that truly seeks to combat fraud. Not only does
SB 1860 establish an organization to support, prosecute,
investigate and prevent fraud, it holds both
unscrupulous insurers and doctors accountable. Insurers
that fail to pay valid PIP claims would be subject to
new action for unfair and deceptive practice, and
doctors convicted of fraud would lose their license for
five years and be barred from submitting a PIP claim for
10 years. That’s fair.
Negron's bill isn't perfect, but if fraud is truly the
target for reform, his effort would get the job done
long before Boyd’s pro-industry “fix.” Which measure
carries the day may very well determine whether accident
victims have access to quality medical care, and whether
medical providers will be able to continue to do
business in a toxic environment. Florida can't stomach
any more industry-friendly wish lists. Insurers have had
their way in Tallahassee long enough.