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Florida Senate Panel Clears PIP Fraud-Fighting Bill

JAMES L. ROSICA, Associated Press
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(Photo credit: RICHARD DREW/AFP/Getty Images)

(Photo credit: RICHARD DREW/AFP/Getty Images)

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TALLAHASSEE, Fla. (AP) — A Senate panel on Thursday cleared a bill aimed at cutting down the massive fraud plaguing the state’s personal injury protection, or PIP, coverage program.

The Senate Committee on Banking and Insurance passed the PIP fraud-fighting bill (SB 1860) by a vote of 9-0 on Thursday.

Sen. Joe Negron’s bill requires more detailed police reports after a wreck and places tighter restrictions on pain clinics. State investigators say many clinic owners have no prior health care experience and some even opened pain clinics because they heard they could make a lot of money.

The bill also requires that health care providers found guilty of fraud will lose their license for five years and will be barred from PIP reimbursements for 10 years after that.

PIP fraud results in higher costs passed on to customers through increased premiums. In some areas, that translates into hundreds of extra dollars per year.

According to Chief Financial Officer Jeff Atwater’s office, a 40-year-old safe driver in Miami was paying $582 in PIP premiums in 2008. By 2010, the same driver was paying nearly $1,050 for the same coverage — an 80 percent increase.

This week, his office announced the arrest of a Miami-Dade man on a charge of submitting fraudulent PIP claims from his unlicensed pain clinic.

Gov. Rick Scott and Atwater have championed PIP overhaul this legislative session. Scott, though, has publicly favored a House bill requiring those hurt in a wreck to go to a hospital emergency room or hospital-owned walk-in clinic within 72 hours for personal-injury coverage to kick in.

Negron said his bill balances the interests of insurance companies and medical providers without penalizing accident victims.

“They’re just trying to get better and get back to work,” the Stuart Republican said.

But alternative medical providers take a significant hit in his measure; Negron’s bill eliminates massage therapy and acupuncture as treatment that PIP will pay for after an accident.

He cited statistics that the average payment demand for massages increased from $2,887 in 2005 to $4,350 five years later. The number of hours of massage billed to PIP has quadrupled, Negron said.

Janet Mabry, a lobbyist for the Florida State Massage Therapy Association, said the suggestion that massage is fraudulently billed is a “misconception.” Massage therapists can’t take PIP clients without a doctor’s referral, she told the committee.

“It’s not that they’re coming to our offices right off the road,” Mabry said.

Lawmakers passed PIP coverage in 1972 to ensure that anyone hurt in an automobile wreck could get medical treatment.

The legislation mandated that a driver’s insurance company pay up to $10,000 to cover medical bills and lost wages after an accident — no matter who’s at fault. All Florida drivers are required to carry no-fault insurance.

Over the years, however, fraudsters turned Florida into the top state for staged accidents, especially in the Tampa and Miami-Dade metropolitan areas. Some estimates show PIP fraud nearing $1 billion in the state this year, though Negron called that “hyperbole,” saying it was more like $100 million to $125 million a year.

Consumer advocates were happy that the bill leaves out the legal procedure known as “examinations under oath” that insurance companies wanted. Such quasi-legal hearings let insurance company lawyers question accident victims and others suspected of fraud.

In fact, the public comment period became something of a love fest, with representatives of insurance companies, business interests, physicians, chiropractors and trial lawyers all saying they supported the bill.

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Follow James L. Rosica on Twitter: http://twitter.com/jlrosica

 Copyright 2012 The Associated Press.

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