Fla. OIR Developing Guidelines for PIP Reform

The Florida Office of Insurance Regulation is moving ahead with developing guidelines designed to tighten personal injury protection (PIP) rules in the state, and the National Association of Independent Insurers (NAII) expressed confidence that the reforms will help combat fraud in that state.

“The industry, the department and medical representatives are working to formulate a list of excluded tests that everyone can agree on,” said James S. Taylor, southeastern regional manager for the NAI).

The State Board of Medicine held a workshop this week to discuss excluded diagnostic procedures, with insurance industry and medical associations in attendance. Insurers agreed that a number of tests should no longer be covered by PIP, including procedures on a list created by New Jersey in its auto reform efforts. Such tests include diagnostic spinal ultrasound, nerve conduction velocity tests, reflexology and digital range of motion studies.

After receiving input from medical associations and the Board of Chiropractic Medicine, the State Board of Medicine found that the groups see no medical necessity or value for many common PIP diagnostic tests.

In other action, the Office of Insurance Regulation has developed a revised PIP sworn disclosure form that requires a signature from patients stating that they have actually received the medical services being claimed.

“Although the details are still being developed, we are confident that these methods will help reduce the problem of PIP fraud in Florida,” Taylor noted.