Re: What’s Driving the New Florida PIP Law

[Guest guest]

In a year-end press release, the IRC reported on trends, stating that PIP costs

in Florida increased 62% from 2008 to 2010.

http://www.insurance-research.org/sites/default/files/downloads/2011TrendsNR_0.p\

df

This suggests, to me at least, that any effort in Oregon to prevent loss of

chiropractic benefits in personal injury insurance must include demonstrable

cost savings from chiropractic. Can we demonstrate that?

J. Burke, D.C.

>

> The following link to an Insurance Research Council (IRC) press release from

2011 may provide some insight to factors underlying recent changes in their PIP

statutes. To quote from the press release:

>

> Almost one in every three no-fault auto insurance claims closed in Florida in

2007 appeared to involve the exaggeration of an injury or to be inflated by

unnecessary or excessive medical treatment, according to a new study from the

Insurance Research Council (IRC). In addition, as many as one in ten no-fault

claims appeared to be fraudulent, with material misrepresentation of some or all

aspects of the claim, such as claims based on fictitious accidents.

>

> The IRC is an independent research organization. Data from their reports has

been cited by leading chiropractors including Arthur Croft and Larry Nordhoff.

Here's the link to the press release:

>

>

http://www.insurance-research.org/sites/default/files/downloads/IRCFloridaPIP_02\

0911.pdf

>

> J. Burke, D.C.

>

[Guest guest]

Here is the link to their website which shows where they get funding and what they are all about. http://www.insurance-research.org/aboutJamey Dyson, DC



Wikipedia has nothing on "Insurance Research Council." Can't find out who funds them and where/HOW they get their "statistics"...(which, we all know how reliable STATISTICS are).

(;-)

M. s, D.C.

Re: What’s Driving the New Florida PIP LawTo: oregondcs Date: Wednesday, March 28, 2012, 4:09 PM

In a year-end press release, the IRC reported on trends, stating that PIP costs in Florida increased 62% from 2008 to 2010. http://www.insurance-research.org/sites/default/files/downloads/2011TrendsNR_0.pdfThis suggests, to me at least, that any effort in Oregon to prevent loss of chiropractic benefits in personal injury insurance must include demonstrable cost savings from chiropractic. Can we demonstrate that? J. Burke, D.C. >> The following link to an Insurance Research Council (IRC) press release from 2011 may provide some insight to factors underlying recent changes in their PIP statutes. To quote from the press release:> > Almost one in every three no-fault auto insurance claims closed in Florida in 2007 appeared to involve the exaggeration of an injury or to be inflated by unnecessary or excessive medical treatment, according to a new study from the Insurance Research Council (IRC). In addition, as many as one in ten no-fault claims appeared to be fraudulent, with material misrepresentation of some or all aspects of the claim, such as claims based on fictitious accidents.> > The IRC is an independent research organization. Data from their reports has been cited by leading chiropractors including Arthur Croft and Larry Nordhoff. Here's the link to the press release:> > http://www.insurance-research.org/sites/default/files/downloads/IRCFloridaPIP_020911.pdf> > J. Burke, D.C.>

[Guest guest]

Thank you, Minga, for sharing your insights with us. We all seem to know on some level that all of our PIP cases are part of a larger insurance industry data base, and that our individual PIP practice habits are patterned into cost analyses, establishing each doc's expenses to the industry"s bottom line. We are not independent agents, nor the final authority on the most appropriate care for our PIP patients. We're all subject to best evidence, charting that details treatment needs, and progressive outcomes. The insurance industry is right to push for such uniformity of care, both for it's client/patient welfare, and the health of the industry itself. Private insurance is the majority health care delivery system in America; we need them to "treat" it's contracting providers in the same sense patients need providers to "treat" them for optimum well-being. Insurers are trying to push providers toward best practices, just as we're trying to manifest best outcomes for patients. At best, we're all trying to provide the best care for those injured.Those providers that fail to understand this interdependent relationship with PIP insurers are working against the best interests of patients and our profession. Providers need to be so informed. The resolution, within the current system, is to join forces with the OCA and to bring individual voices into the collective voice. Further, we need to encourage more participation in this forum. Just understanding that you are being watched in all your PIP cases should be enough to make outliers think twice about what they're doing. Sears, DC, IAYT1218 NW 21st AvePortland, Oregon 97209v: f: www.docbones.com Dr. Dyson, thanks for that link. It looks like every board member governing the IRC is a paid employee of an insurance agency. There are no lay public members assisting in the governing process. In addition, the money to do the research comes from insurance companies. Information about the IRC clearly states that 'none of the information obtained through research will be used to make or recommend any policies'. However, it doesn't stop those paying for the research to use the information in any way they choose. It only means that the actual IRC won't create policies based on the research they generate. I think some of the information gathered should be looked at critically. However, I'm under no illusion that there is a vested interest in 'how' the information is reported and used. It would be easy to report part of the findings, creating a scenario that ignites controversy. For example; showing a 50-60% rise in fees over the last 4 yrs can be very damaging when one doesn't take into consideration the increased cost to do business. The rise in utility costs, cost of goods, salary increase, medical ins, building liability, malpractice, and more over the last 5 yrs has been astronomical. My personal health insurance has risen over 150% in 3 yrs. Operating costs fluctuate between 45-55% for my office now. I've had a couple months of 60% overhead when too many pieces of equip break. I traveled the country meeting with other state board presidents and agents from other countries representing chiropractic and listen to reports covering fraud trends on a national level, I'm more familiar with Oregon's rates. I feel it's a small minority of DCs causing this perception in Oregon. However, the amount of money they generate isn't small. I'm not saying there aren't isolated problems in our profession. However, I see them in other professions as well. When I met with FBI medical fraud I heard some eye openers that crossed professions. I would like it if everyone out there reading this would look at any charts/ bills reviewed from other offices and note how many times you see an MVA patient transferred to your care, where another provider has maxed out the PIP in 6 months and the patient still has symptoms requiring diagnostic evaluations that were never done. Or look at cases where the PIP is maxed and the patient is released. Not because they were well, or medically stat, but because the PIP was exhausted (again in a relatively short time frame). This is the kind of information we should gather. I may be in a somewhat unique situation in that I've reviewed large quantities of files, more than I can count. (For law firms; in order to testify as the expert witness; even though I wasn't the primary treating DC) (for the OBCE when I was a member - thousands of files) and I've seen a handful of DCs who treat EACH and EVERY patient with the same plan. 3 times a week for 8 weeks; 2 times a week for 8 weeks etc, every patient gets x-rays of all spine areas; every patient gets 3-4 therapies per appointment. It's not just one or two isolated patient files. I've seen as many as 10 files from one doctor with electronically generated charts. You could switch the patient name and the charts are 99% identical. I sat in a room with over 6 docs and we each held a different patient chart from the same doctor and read in unison for seveal pages. How can so many patients be 99% identical? This problem was brought to my attention by the national ins. crime bureau (NCIB) the first time. Sadly, I've seen it on other occasions. Most docs think the OBCE can handle this, or why doesn't the ins. agency challenge it? My answer is this, they are handling it and Florida PIP is their answer. This type of billing doesn't serve the profession. The NICB red flags those doctors and all docs who associate with the clinics in the hopes of eventually building a fraud case. These things take time. It might seem tempting to new docs or to some who've been around the block to bill as high as the law allows and take as big a slice as possible before the 'cash cow' is gone. This is the mentality that will crush our profession. I honestly don't know if relating this will do any good. I only know that on the OBCE it's exceedingly difficult to stop this type of problem. If you care to ask me why, you can call. I hate to print why it's so difficult. I can only say that eventually cases are built and made against clinics that do this. It's very time-consuming and expensive. Perhaps the insurance companies have decided to band together with the ACA and all the other medical professions umbrella-ed under them in effort to plug part of the problem. The other professions are served by seeing us topple. The insurance companies can then pick the next weakest link ....Maybe I'm too cynical. One thing I know for certain, if enough of us join together under our state association, we are at least safer and will have the strength of numbers to stay on the right track for a healthy and ethical profession. Minga Guerrero DC abowoman@... Re: Re: What’s Driving the New Florida PIP Law Here is the link to their website which shows where they get funding and what they are all about. http://www.insurance-research.org/about Jamey Dyson, DC  Wikipedia has nothing on "Insurance Research Council." Can't find out who funds them and where/HOW they get their "statistics"...(which, we all know how reliable STATISTICS are). (;-) M. s, D.C. Re: What’s Driving the New Florida PIP Law To: oregondcs Date: Wednesday, March 28, 2012, 4:09 PM In a year-end press release, the IRC reported on trends, stating that PIP costs in Florida increased 62% from 2008 to 2010. http://www.insurance-research.org/sites/default/files/downloads/2011TrendsNR_0.pdf This suggests, to me at least, that any effort in Oregon to prevent loss of chiropractic benefits in personal injury insurance must include demonstrable cost savings from chiropractic. Can we demonstrate that? J. Burke, D.C. > > The following link to an Insurance Research Council (IRC) press release from 2011 may provide some insight to factors underlying recent changes in their PIP statutes. To quote from the press release: > > Almost one in every three no-fault auto insurance claims closed in Florida in 2007 appeared to involve the exaggeration of an injury or to be inflated by unnecessary or excessive medical treatment, according to a new study from the Insurance Research Council (IRC). In addition, as many as one in ten no-fault claims appeared to be fraudulent, with material misrepresentation of some or all aspects of the claim, such as claims based on fictitious accidents. > > The IRC is an independent research organization. Data from their reports has been cited by leading chiropractors including Arthur Croft and Larry Nordhoff. Here's the link to the press release: > > http://www.insurance-research.org/sites/default/files/downloads/IRCFloridaPIP_020911.pdf > > J. Burke, D.C. >