June 5, 2008 - View the
FINAL version of SB11
Colorado Governor
Bill Ritter signed
Senate Bill 11 (auto insurance med
pay bill) into law today at noon. In addition, the Governor
signed several other consumer protection bills into law including
HB1389 - the FAIR bill which requires insurance companies to justify
rate increases. View photos from bill
signing.
Senator
John Morse overhauled his bill SB-011
(auto insurance med pay
bill) to include All Licensed Health Care Providers. The
law is
expected to take effect on January 1, 2009 and will apply to auto
insurance policies issued, delivered, or renewed on or after this date.
The bill
provides that insurance companies offer $5,000 of auto
insurance medical payments to consumers. Consumers may then
opt-out of this coverage IN WRITING, if they have other insurance
options. This is similar to the way uninsured motorist coverage
is currently handled in Colorado.
Based on states with
similar statutes, this will increase the percentage of people with
Med-Pay 250% of what we currently have. VIEW a copy of the FINAL version
of SB11.
This
is not 100% of what we wanted - but, it will provide tangible benefits
and may cause up to 75% of Colorado consumers, who do not now have
coverage, to obtain it. This will be good for consumers, emergency
medical providers, hospitals and chiropractors.
Consumers may choose
to purchase a higher level of med pay coverage. A policy may be issued
without med pay coverage, only if the consumer rejects the coverage in
writing and the insurance company must maintain proof of the rejection
for three years.
In order to comply
with the new priority payment system that is contained in SB11, without
compromising existing prompt-pay rules, a 30 day/$5,000 “reserve” was
created. Under the new rules, the first $5,000 of Med Pay coverage will
be held in reserve for 30 days in order to allow provider bills to be
submitted. After 30 days, bills will be paid out according to the
priority created by SB 11 (ie: # 1 licensed ambulance or air ambulance,
# 2 trauma physicians, # 3 level 4 or 5 trauma centers, # 4 level 1, 2,
or 3 trauma centers, # 5 other providers). If higher priority
providers do not submit their bills in 30 days, they will lose their
priority status. Because there is a possibility that a higher priority
provider could use up all available Med Pay coverage, we are
recommending that all doctors continue to have clients sign liens even
after Med Pay coverage is verified.
Here
are some examples of payment scenarios.
The
claim must be paid PROMPTLY, after the initial 30 days, as set forth in
10-4-642. This statute states that an insurance company must pay,
deny, or settle a claim within 30 calendar days after the receipt of
the claim if submitted electronically, and 45 days if submitted by
other means.
There
are still some administrative details to be worked out such as if the
law applies to REAPPLICATIONS for new or updated coverage OR all
policies when they are renewed. We will keep you posted on the
details as they become available.
The pace at the
Colorado Legislature was fast and furious during this
process. CCA Lobbyists Terry Snyder and Erik Groves
tirelessly worked to connect doctors of chiropractic, patients and
staff members with key legislators. Working side-by-side with our
lobbyists, several doctors became regular fixtures at the Capitol,
meeting with legislators face-to-face and garnering support for our
bill. Chiropractors were asked by email and fax to contact their own
Senators, Representatives, and Committee members to urge them to vote
yes on SB11. CCA Lobbyists reported that the legislators told
them they received a good deal of communication from our doctors.
This
was a complicated bill and there were several different voting sessions
on this bill - committees, amendments, floor motions, conference
committees, House, and Senate. We suggest that you write a brief
note to both your Senator and Representative thanking them for their
service during this year’s legislative session.
Why SB11 is a good
bill:
1.
SB 11 is a fair compromise;
2.
No one will be forced to buy
anything;
3.
Everyone will have an informed choice on
whether to waive the protection provided by Med Pay;
4.
This is good for emergency providers who
are in tough circumstances, hospitals, taxpayers, and other licensed
health care providers.
If
you have questions, please feel free to call CCA Lobbyist
Terry
Snyder at 303-629-6360 or terrancesnyder@yahoo.com
THANK YOU to the CCA
Legislative Team and all doctors, staff, and
patients who took the time and energy to contact their
legislators.
It's because of all of YOU that this bill was passed.
View
the FINAL version of SB11.
New Auto Insurance Study
Supports Mandatory Med Pay
Governor’s
report finds switch to tort auto insurance system injured
providers
and consumers - Cuts in
payments to providers and increased consumer health insurance premiums
quantified in report
View
the FULL REPORT
February, 19, 2008 - A
report released today by Governor
Ritter’s Office of Policy and Initiatives verifies what trauma care
providers
have been saying for four years: the sudden switch from a no-fault auto
insurance system to a tort system left Colorado’s trauma care providers
with
millions of dollars in unpaid costs after providing medical transports
and
treatments. These costs are shifted onto health insurers and consumers
through
higher charges for other services and increased co-pays or deductibles.
The Governor’s office
contracted with BBC Research and
Consulting, an independent research firm, to study the effects of
Colorado’s
change from a no-fault auto insurance system to a tort system in July
2003. The
scope of work for the study was developed through a collaborative
process with
the Trauma Care Preservation Coalition (TCPC) and representatives of
the auto
insurance industry.
BBC’s
key findings are as follows:
Insurance coverage
for medical payments would benefit consumers. If the Colorado
State
Legislature were to mandate that all Coloradans carry medical payments
coverage
(‘med pay’) on their auto insurance policies, it would help consumers
cover
out-of-pocket medical expenses such as co-pays and deductibles (page 16). Contrary to the arguments
of the auto insurers, very few Coloradans have the extremely high level
of
health care coverage that would make a mandatory med pay truly
duplicative of
health insurance.
Many
factors have led
to reductions in auto insurance premiums in the last few years, with
the switch
from no-fault to tort only one factor. The report cites a 35% decrease
in auto
insurance rates, based on auto insurance reports to the state. But the
report
also indicates that auto insurance rates after the switch decreased as
a result
of many factors, including a significant drop in auto insurance
coverage since
no-fault and a statewide decrease in the number of accidents that
result in
injuries or fatalities. Additionally, the report shows actual
expenditures by consumers for their
auto insurance policies does not reflect the same decreases.
Health insurance
premium increases have negated any auto insurance savings for consumers.
Savings that consumers may have experienced in their auto insurance
policies
have been negated by the increases seen in health insurance premiums as
a
result of the switch to a tort system.
Hospitals
are losing
tens of millions of dollars every year for treating motor vehicle
accident
patients. In 2002, hospitals were reimbursed for 60 percent of the care
they
provided to motor vehicle accident patients. But by 2006, after the
switch to
tort, that percentage had plummeted to only 36 percent.
Ambulance
companies
and fire departments have suffered similar declines in reimbursement.
For Colorado’s
first
responders, 18 percent of patient transports from motor vehicle
accidents went
uncompensated in 2002. By 2006, that number had more than doubled,
rising to 37
percent (page 12).
By substantiating a
small portion of the economic losses that Colorado’s
trauma system has incurred since the switch from no-fault auto
insurance to a
tort system, the report demonstrates the unintended consequences.
It is important to note
the report significantly
underestimates the financial impacts on Colorado’s
trauma system. It does not quantify the impacts of unreimbursed
care on physicians who treat auto
accident patients; nor does the report address the majority of
auto
accident patients who are treated in the emergency departments and
discharged
the same day. Researchers were only able to report data that relates to
the
small percent of patients admitted to hospitals.
Additionally,
the report makes the case for all drivers to carry medical payments
coverage on
their auto policies. (The Trauma Care
Preservation Coalition is
advocating this private sector solution for a small, reasonable
med-pay; state
funding solutions are not feasible under current budget and taxing
constraints.) This solution would ensure that their health care would
be fully
covered if they were at fault in a car accident. Currently, bodily
injury
coverage is required in Colorado,
but it only covers the people who are injured by the at-fault driver.
Without
med pay, the at-fault driver has no bodily injury coverage for
him/herself or
any relatives in that car.
Many people don’t
realize that their auto insurance no longer
covers medical expenses unless they specifically elect (and pay for) an
optional
med-pay coverage. Chiropractic clinics
and many other health care providers are treating auto accident
patients, but
resources are being bled away. More and more Coloradans don’t have
health
insurance, and medical bills are not covered by their auto insurance
anymore.
As a result, in more and more cases providers are not paid for our
services,
and are left with no means to recoup those costs. Patients then face
bills they
cannot pay.
For
a copy of the complete report,
visit www.coloradochiropractic.org/headlines/files/AutoInsStudy2_08.pdf