HB 587: A Limit to the Consumer's Ability to Choose Physicians

Feb. 21, 2013 - PRLog -- Matthew A. Dolman, Esq. issued an open letter on February 21, 2013 explaining HB 587, a thinly veiled attempt by the insurance industry and their well-heeled lobbyists to make the treatment of personal injury victims as cost prohibitive as possible.  The original letter can be found by visiting http://www.dolmanlaw.com/hb-587-limit-consumers-ability-choose-physicians/.

For those of you not aware of what a letter of protection is, please allow me to explain. A letter of protection (hereinafter referred to as an “LOP”) is a legal document executed by either the injury victim or their attorney (sometimes both) that forestalls all collection efforts until the pendency of the case and allows the individual to treat with a physician or medical provider in the absence of insurance or benefits (i.e., personal injury protection). The LOP is an agreement by which the physician’s bill will be satisfied upon settlement of the claim and in consideration the physician/medical provider will not attempt to collect the bill until the claim is resolved.

The obvious benefit of an LOP is that it enables an injury victim to obtain medical care in the absence of health insurance. Further, even if the individual has health insurance, many policies have high co-pays or are restrictive on the physicians you may see.

HB 587 as it presently stands states “Limits recovery of damages for medical or health care services to amounts actually paid if no balance to provider is outstanding; limits recovery of such damages to amounts customarily accepted by providers in same geographic area if balance to provider is outstanding; requires medical or health care services to be medically necessary in order to be recoverable.” In other words, the proposed House Bill will seek to ensure that physicians who provide medical treatment under an LOP can only be reimbursed based on a fee schedule as opposed to the physician setting their own fees.

It is important to note that many personal injury actions are not resolved swiftly as a result of the insurance industry’s mode of operation, to deny, delay and defend claims. Thus, the physician or medical provider that renders treatment or service in accordance with an LOP is taking a risk. They must be willing to sit on that paper with the possibility that the case may not successfully resolve for a number of reasons. Thus, since they are taking such a risk and are the only party to have any “skin in the game” it would only make logical sense that they can set their own price.

HB 587 is a thinly veiled attempt by the insurance industry and their well-heeled lobbyists to make the treatment of personal injury victims as cost prohibitive as possible. In turn, it is their goal to force even more good physicians out of the picture. The pool of physicians whom are willing to treat auto accident and motorcycle accident victims is already small. Many physicians simply do not desire to deal with the scrutiny from insurance carriers that come with the territory of treating personal injury victims. Such physicians are often subjected to spending considerable time defending their treatment notes and billing practices in depositions conducted by insurance defense lawyers. Recent caselaw has provided more liberal discovery for insurance defense lawyers who now seek to overwhelm treating physicians with subpoenas concerning standard billing practices and their relationships with the plaintiff attorney.

By forcing private physicians and medical providers to adhere to a set fee schedule when services are provided under an LOP, the effects will be chilling. It is difficult to fathom that any private physician or medical provider would be willing to forestall collection efforts and wait oftentimes in excess of two years in order to possibly be reimbursed and accept payment based on a fee schedule. Why would any physician in their right mind take this risk?

Limiting the Consumer’s Right to Choose

The result of HB 587 will be a far more limited pool of physicians willing to see injury victims under an LOP. As a result, Florida consumers will have less talented physicians to choose from and will face much longer periods of time before they can obtain an appointment with a specialist (i.e., Surgeon, Neurologist, etc.). In turn, Floridians who do not have health insurance will be stuck in the unenviable position in which they may not be able to find a physician willing to evaluate or treat them under an LOP. Physicians willing to still take the risk of sitting on an LOP for an extended period of time and adhere to a fee schedule are likely to be very young Doctors devoid of much experience and those with limited reputations that are likely desperate for business. It is doubtful that even those physicians would be willing to take such risk.

It has become abundantly clear that Governor Rick Scott and his cronies care very little for Florida consumers and specifically the middle class. Many Floridians lack health insurance. Those who fall into the lower socio-economic class and the poor generally do not have health insurance. Does Rick Scott care about such individuals? How about Representative David Hood (the sponsor of this inane bill)? When you are super wealthy like our Governor, you get to pick and choose from a bevy of physicians to treat with. However, when you lack health insurance and suffer physical injuries as a result of negligence exhibited by a third party, Governor Scott and Representative Hood are letting you know that they simply do not care one bit about your healthcare.

Amounts Customarily Accepted

HB 587 as it is presently written seeks to limit the private physician to accepting amounts that are usual and customary in the geographic region. However, how is it fair to force a physician willing to take a risk on waiting an extensive period to be paid to take the same fee as a physician who is billing insurance and will be paid within 90 days of service? I would contend that those who perform medical services under an LOP are not performing a usual and customary service and should not have to adhere to a usual and customary charge as defined by the insurance industry. There must be some benefit to physicians willing to take the risk. The benefit is the ability to set your own charge.

- Matthew A. Dolman, Esq.

Dolman Law Group can be found online by visiting http://www.dolmanlaw.com.