New Jersey PIP reform proposal full of new amendments

by Matthew Glans on January 26, 2012

Reforming the state’s insurance regulations on personal injury protection coverage has been a long and often politically charged process for New Jersey insurance regulators. Their most recent proposal, updated from the original reform proposal presented by the Department of Banking and Insurance last August, contained amendments amounting to 25 percent of the previous version. Many of these changes were designed to respond to comments from concerned parties which were submitted during the public comment period.

From the Insurance Journal:

“New Jersey’s Department of Banking and Insurance has amended some 25 percent of its personal injury protection (PIP) rule proposals, after reviewing and incorporating recommendations from a mountain of public comment letters it has received.

The department said last week its PIP reform proposals had garnered more than 18,000 public comments. “The comment period and review process worked well, as it was intended,” New Jersey Department of Banking and Insurance spokesman Marshall McKnight told Insurance Journal.

The department’s 200-page-plus proposed changes aim to close loopholes that are being exploited by some providers, and cap PIP expenses and control the rising medical costs that insurers pay for auto accident victims. In addition to reviewing public comments, the department also received input from various parties during a heated State Assembly hearing last October.”

The current proposal now enters a 60 day comment period of its own. Department Commissioner Tom Considine believes these new changes cover many of the concerns from the previous version and are a strong step towards positive PIP reform.

“The department’s comment period accomplished what it was meant to do; it produced meaningful feedback from stakeholders and affected parties which we were able to use to clarify and make improvements on our original PIP proposal,” said Department Commissioner Tom Considine.

“The changes included in the notice represent only a small portion of what we proposed in August and we continue to move forward with the reform. This is a significant step forward in the PIP reform process.”

The Insurance Journal highlighted several of the amendments in the new proposal, ranging from changes in the proposed fee schedules to the removal of several references to  workers’ compensation managed care organizations from some of the PIP rules.

New Amendments examine several issues, including:

• Creation of a new Hospital Outpatient Surgical Facility (HOSF) fee schedule that is separate from the Ambulatory Surgical Center (ASC) facility fee schedule

• Amendments of the ASC facility fee schedule fees to eliminate an over-reimbursement for implantable devices that are included in the fees

• Deletion of 117 fees from the physician’s fee schedule for spinal and neurosurgical procedures to allow for further study due to their infrequency and availability of coverage

• Deletion of references to workers’ compensation managed care organizations from the PIP protocols rule, and removal of post-employment restriction on Dispute Relation Professionals (DRP’s).”

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