As South Florida PIP lawyers we understand the difficulty medical practitioners are going through. We understand that the new PIP laws are causing anxiety and uncertainty. Many practitioners are pondering what to do and if they will be able to keep their practice open. The Florida legislature has given little time for businesses in the PIP field to adapt. Similar laws have taken years to take effect in the past. They usually gives people or corporations in the industry time to adapt and prepare for the new changes. This courtesy was not granted here.
We have received numerous calls regarding the date in which the new Florida PIP law takes effect. Certain parts of the law take effect January 1, 2013 and others on July 1, 2012. Either way, change is coming fast.
On July 12, 2012 the following provisions take effect:
[A]n insurer may limit payment as authorized by this paragraph only if the insurance policy includes a notice at the time of issuance or renewal that the insurer may limit payment pursuant to the schedule of charges specified in this paragraph. A policy form approved by the office satisfies this requirement.
So what does this mean in practice? Here we are talking about fee schedules. The schedules refer to a list of maximum fees for providers who work on a fee-for-service basis. Insurance companies can use, “Medicare coding policies and payments methodologies of the federal centers for Medicare and Medicaid services, including applicable modifiers, to determine the appropriate amount of reimbursement for medical services…” In other words, Insurance companies will be able to apply fee schedule reductions as of July 12, 2012. Some companies like Progressive and Geico may be bound to 80% of bills due to limitations imposed by their policies. However, these limitations may become moot on January 1, 2013.
All other pertinent parts of the new Florida PIP law take effect on January 13, 2012. This includes issues pertaining to the new emergency medical condition (emc) standard discussed in previous blogs. These are the most troublesome sections of this law. Although, allowing insurance companies to apply Medicare and Medicaid payment standards can be troublesome as well. This essentially will incorporate a public assistance standard on private industry. This is surprising coming from many legislators who vociferate the importance of private industry and less intrusion by the government.
Other sections that will take effect on January 1, 2013 include matters of initial care. We are referring to the section requiring a patient to seek care within fourteen (14) days or risk losing his right to seek benefits under his policy. Sections excluding massage therapy and acupuncture will also take effect on January 1, 2013. For more detailed discussion of the new standards taking effect in January 1, 2012 please see previous blogs.
As of now, the Governor has not yet signed the New Florida PIP standards into law. It almost certain he will do so as he was the main driving force behind these changes. His intention was to reduce fraud and reduce premiums for Florida policy holders. We hope that these goals are attained by this new law. However, as South Florida car accident attorneys we are concerned with the rights policy holders and medical providers have lost.
If diminished rights means lower premiums, then perhaps this is not a bad outcome. However, the lowering of premiums is not a guarantee. It is true that PIP premiums are high in Florida. Certainly, fraud has had an effect on premiums. Nonetheless, the rise in premiums is almost certainly also a result of the downturn in the economy. Insurance companies make profits by investing premiums. If their investments are unsuccessful, then a rise in premiums will result. Insurance companies tend lower premiums when the economy is doing well. This provides the insurance companies with more funds to invest.
Miami personal injury attorneys are here to assist you 24/7. We can be reached at 305.764.9907 or 1.888.413.8353.