Personal Injury Protection
BACKGROUND
On August 29, 2007, the Department of Banking and Insurance ("DOBI") filed with the Office of Administrative Law its adoption of the PIP Fee Schedule proposed last September. DOBI did not modify the physician or ASC fee schedule it originally proposed at all. The physician fees in the final regulation are generally set at 130% of Medicare with various adjustments in the 130% to 800% of Medicare range. ASC fees remain at 300% of Medicare as originally proposed.
Immediately following the DOBI adoption, MSNJ and other physicians challenged the Department through the legal system. On Friday, September 28, the Appellate Division granted the physician's request to stay the implementation of the new PIP fee schedule rule.
MSNJ and the law firm of WolfBlock Brach and Eichler are now litigating the claim because the Department of Banking and Insurance failed to implement the fee schedule in accordance with New Jersey law. The length of the stay and the timing of the litigation will be in accordance with a schedule set by the Appellate Division. It is likely that the appeal will proceed on one of two tracks: either 1) in the normal course, which will mean briefs will be filed over the next approximately 3-5 months, after which oral argument will be scheduled, most likely in the spring; or 2) on an expedited basis, in which case we can expect oral argument in 2-3 months.
Until further order of the court there will be no modification to the current PIP fee system.
LEGISLATIVE STRATEGY
We have been lobbying for adoption of legislation (Assembly Bill 3073 and Senate Bill 2402) that would simply require the Department to do what the Legislature told it to do over ten years ago: Adopt a fee schedule that mirrors 75% of reasonable and prevailing fees.
In February, 2007, the Assembly bill was released from the Assembly Financial Institutions Committee. On December 3 the Senate Commerce Committee released the bill. We are lobbying hard for the bills to be voted on by the full Assembly and Senate - before they adjourn the current Legislative session on January 7.
Time is tight - and your action is needed now! The insurance lobby is working hard to kill these bills - the health care community must work harder to make sure the legislators hear the support from the physicians and others.
ACTION NEEDED TODAY!
Call, fax or email your NJ State Legislators today! Our pre-drafted talking points that you'll see when you follow these links include the following:
- Post the PIP bill for full chamber vote;
- Quality patient care depends on physicians being available to serve our emergency rooms;
- Hospitals are currently having trouble getting specialists to volunteer to serve in Emergency Rooms;
- support the PIP legislation to ensure that physicians are adequately compensated for their medical services rendered to injured victims of automobile accidents;
- Office expenses, malpractice premiums and staff salaries are ever rising, yet DOBI wants physicians to be paid less than they were guaranteed by the New Jersey Legislature in 1990, seventeen years ago;
- support the PIP legislation to ensure that accident victims have access to care; and, resist the pressure of the automobile insurance industry to under-compensate physicians while the carriers enjoy financial prosperity. Why must the costs of medical treatment be shifted to physicians?
Just click on the link to call or to fax or email -- provide your zip code and express your support for A-3703 and S-2402, when it comes before them on the Assembly and Senate floor for a vote. Then personalize your call or message by talking to them about your concerns for quality patient care should the PIP fees get cut. Also if your Legislators are sponsoring these measures, be sure to add your THANKS:
- Assembly Bill 3703, sponsored by Assemblymen Cohen, Caraballo, Bramnick and Panter
- Senate Bill 2402, sponsored by Senators Scutari, Sarlo, Bark and Weinberg
Information Links: