As talks continued in Tallahassee Monday on ways to reform Florida's controversial no-fault auto insurance law, agreement is emerging on capping fees for medical care after an auto accident.
Finding an acceptable method to contain these costs has been a major sticking point for lawmakers eager to preserve the no-fault law.

The current law, which expires Oct. 1, requires drivers to buy $10,000 of personal injury protection, or PIP, which pays their medical bills after an auto accident. PIP's critics contend the current system breeds fraud and endorses excessive billing by health providers.

Some initial consensus seems to be forming around a bill proposed by Sen. Bill Posey, the Rockledge Republican, which includes a fee schedule that would limit the pay for most hospital and emergency services at 200 percent of Medicare's current payments.

''There's a possibility to do something meaningful for the first time on PIP,'' House Speaker Marco Rubio said on Monday. Containing medical costs is ``one of the things that has been standing in the way.''

Rubio sounded optimistic about a possible deal to keep intact Florida's no-fault insurance, saying he was encouraged by the Senate bill that contained fee schedules and by the involvement of the governor's office.

Monday's daylong gathering, hosted by Gov. Charlie Crist's legislative staff, included representatives from Florida's hospital and medical associations, various physician groups, health insurers, HMOs, auto insurers, insurance agents, clinic owners and trial attorneys. No legislators were in the meeting.

Another meeting is set for Wednesday. These stakeholders also met last week.

Agreement on a fee schedule would be a major milestone, said Rep. Julio Robaina, a Republican from Miami who has been monitoring the talks in the state capital. Until recently, doctors, hospitals and other healthcare providers were adamantly against any kind of fee controls. Several participants in Monday's meeting said these groups have started to shift from their traditional position.

MAJOR INSURERS

Insurers, especially major ones such as State Farm and Allstate, have long argued for adding fee schedules and utilization controls to the no-fault system to curb abuses. Without such reforms, these insurers would prefer to eliminate the no-fault system entirely.

A grand jury that investigated the problems with the state's no-fault system in 2001 recommended a fee schedule as a way to help control fraud problems.

''Now that's it's about to sunset, people are starting to be reasonable,'' said Sen. J.D. Alexander, the Lake Wales Republican who helped put the Oct. 1 repeal of PIP into law after he was unable to reach a deal between warring special interest groups during the regular legislative session.

But Rubio stressed he doesn't care about the ``food fight and the industry people poking each other in the eye.''

The House Speaker said all he wants is legislation that would crack down on the fraud that goes on in the personal injury protection insurance market.

When asked about whether lawmakers could take up a no-fault bill during the special session next month that will deal with budget cuts, Rubio said that no one has ``talked to him about timing.''

''You don't call a special session until you know what you are going to do,'' said Rubio.

There was talk Monday that a special session could be called for late next week to discuss and pass a no-fault bill if there was substantial agreement on all the major components of such legislation. But there was no confirmation of that possibility late Monday.

FRAUD CONCERNS

Yet despite Rubio's enthusiasm that the Senate legislation now included a fee schedule, Rep. Ellyn Bogdanoff, a Fort Lauderdale Republican and lead negotiator on auto insurance legislation for the House, said she wasn't sure the Senate bill did enough to curb fraud. ``I don't believe a fee schedule gets rid of fraud . . . it's fraud-lite.''

Chief Financial Officer Alex Sink on Monday again called on Crist, Rubio and Senate President Ken Pruitt to revamp the no-fault law before it expires because she feels it's necessary to keep the current mandatory auto insurance requirements in place.

Sink, like many others in this auto-insurance tug of war, believes a medical fee schedule and utilization controls are needed. Also needed are more resources to help law enforcement officers fight fraud.

The trial attorneys are one of the few groups still willing to let the no-fault law die.

Paul Jess, executive director of the Florida Justice Association, said his group would prefer to have mandatory bodily injury liability coverage for Florida drivers, which would pay medical bills if they caused an accident.

Jess, like some insurers, believes the mandatory PIP coverage is redundant for drivers who already have health insurance.

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BY BEATRICE E. GARCIA AND GARY FINEOUT

© 2007 Miami Herald Media Company. All Rights Reserved.

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