Having failed to kill much-needed reform of Florida’s PIP auto-insurance system in the legislature last spring, medical providers in the Sunshine State have turned to the courts to get the new law thrown out.
A widely anticipated lawsuit was filed recently by chiropractors, massage therapists and acupuncturists — whose services either were curtailed or eliminated for PIP reimbursement. Chiropractic treatment can be reimbursed under PIP only if referred by a physician, and then only up to $2,500 unless deemed to be emergency treatment. Massage therapy and acupuncture no longer are reimbursable under PIP.
The lawsuit says the new law is unconstitutional on several fronts. By restricting reimbursement for their services, the law violates their equal protection rights and denies them due process, these providers say. Pretty standard stuff for such lawsuits.
Two provisions in the lawsuit, though, caught my eye. One is the contention that the new law isn’t needed because supporters failed to properly document the extent of fraud and abuse. Not sure what level of proof would satisfy them, but any rational person who reviews the data likely will conclude the state is a cesspool of medical fraud and abuse.
The lawsuit also suggests massage therapists should not be excluded from the system because not everyone of them has been proven to be a fraud. Great logic.
The argument that may hold some water contends that in accepting the initial no-fault law, consumers gave up their right to sue in exchange for assurances that their medical bills would be paid promptly and fully (at least up the the $10,000 limit). The suit contends the state has reneged on that promise.
While it’s doubtful this action will be deemed unconstitutional, it is a cogent argument that could hold sway in the court of public opinion.
The real test of PIP reform will not be in the courts, but whether the new law achieves its intended goal of placing downward pressure on auto premiums while providing adequate treatment to accident victims. If it fails to do those two things, the court might as well toss out the reforms.
About the author: Dennis Jay is executive director for the Coalition Against Insurance Fraud.