PIP sponsors say Gov. Scott will sign bill despite potential glitch delaying payments to some providers

in Uncategorized by

Two key lawmakers behind Florida’s no-fault insurance reform package said Thursday they expect the governor to sign the new law Friday despite a potential glitch that could delay payments to some health providers.

House sponsor Jim Boyd, R-Bradenton , and his Senate counterpart Joe Negron, R-Stuart, said they’ve been assured that potential loopholes in portions of HB 119 will be plugged by agency rulemaking, or if that doesn’t work, an executive order during a six-month window that has been highlighted as a potential problem.

“I think the legislative intent is clear.” Negron said.

Lawmakers earlier this year passed the measure to make changes to personal injury protection insurance, a $10,000 medical benefit that critics say is rife with fraud, overutilization and litigation.

During the back and forth between chambers, authors overlooked the fact that a potential six month gap in coverage exists. While the new payment requirements kick in Jan. 1, other portions of the bill become effective six months earlier.

The gap raised red flags among some providers, who worried that insurers following the letter of the law would not have to make payments for a long list of health services.

State insurance regulators say they have been in contact with carriers over what they consider an obvious oversight and have been assured that insurers will continue to pay claims during that window.

Jack McDermott, spokesman for the Florida Office of Insurance Regulation, said the agency expects few if any glitches in payments to providers.

Just in case, the Agency for Health Care Administration, which licenses health providers, is drafting language to clarify that payments to qualified providers will continue to flow.

“The purpose of the bill was not to create a six month gap,” McDermott said. “AHCA has publicly said they are going to issue rules to clear this up. We’ve encouraged insurers privately that PIP providers should be paid.”

The no-fault coverage, known as PIP, has come under fire from insurance industry representatives who say that staged crashes and skyrocketing use of non-emergency medical treatment have caused premiums for the coverage to rise dramatically.

PIP reform became a legislative priority for Gov. Rick Scott, who applauded lawmakers for coming together during the session’s final days to hammer out a compromise.

The law’s major provisions kick in Jan. 1, 2013 and include a detailed framework for which medical providers are eligible for reimbursement under PIP coverage. The list included physicians, hospitals, and chiropractors.

Other provisions of the law however, kick in six months earlier, leaving the potential that insurers would not be required to reimburse providers during that period. Sponsors, however, say such a potential is not expected to keep Scott from signing the bill Friday.

“If it comes to that I think there will be an agency rule to make it clear what we’re doing,” Boyd said. “But I don’t think it is going to come to that.”

Material from the News Service of Florida’s Jim Saunders was used in this post.

Peter Schorsch is the President of Extensive Enterprises and is the publisher of some of Florida’s most influential new media websites, including SaintPetersBlog.com, FloridaPolitics.com, ContextFlorida.com, and Sunburn, the morning read of what’s hot in Florida politics. SaintPetersBlog has for three years running been ranked by the Washington Post as the best state-based blog in Florida. In addition to his publishing efforts, Peter is a political consultant to several of the state’s largest governmental affairs and public relations firms. Peter lives in St. Petersburg with his wife, Michelle, and their daughter, Ella.