Kentucky

Introduced by Rep. Jim Gooch, Jr on February 6, 2008, a medical bill shall not be considered reasonable if the cost exceeds the customary charge in cases not involving insurance or the medical bill does not follow the Physicians' Current Procedural Terminology or the bill is not submitted within a certain timeframe.
http://www.kentuckyvotes.org/Legislation.aspx?ID=58850

KLB COMMENT:  This legislation is anti-consumer, pro-insurance, and pro-big business and hospital.  It was tried last year, and did not make it. 

Although the title and purpose of this legislation appears innocuous enough.  It is obviously designed to turn the Kentucky No Fault Act on its ear since it addresses PIP automobile payments and benefits. 

If this bill passes, medical bills would no longer be presumed reasonable.  Hospitals would automatically get the first PIP payments, changing the law that allows an injured person the ability to designate PIP payments.  It requires bills to be submitted within 45 days or they will not be paid by the PIP carrier and requires the injured person to submit to a DME without a court order as the law now provides. 

Currently, the law provides that the medical bills are presumed reasonable, and permits the injured claimant to coordinate his health, auto, and disability insurance to get the full benefits of all the coverages that he has paid.  There are only $10,000 to cover medical expenses and lost wages.  Not everyone has disability benefits to cover wage loss, but many have health insurance. 

If Rep. Gooch and the health insurance industry have their way, the initial treatment to the hospital will be paid first (and at their full value and not at the value that the health carriers have per their schedules) and regardless of the fact that the claimant needs to use his health insurance to cover these bills and use PIP to cover a long period of convalesence!

Worse yet, the claimant would be required to pay FULL CHARGES for all car accident expenses even though he has health insurance which has payment schedules more favorable to him or her.

Furthermore, compulsory insurance company examinations of the claimant are now only permitted if there is "good cause".  With this change, there is no reasonable or objective standard behind the insurance company's decision.

Finally, a 45 day window for submission to PIP insurance for payment means that a dilatory insurance processor at the doctor's office could result in a loss of coverage and a requirement that the insured now pay for the total cost.

I encourage all to contact their elected representative on this legislation and express your non-support.  It is an anti-consumer piece of legislation that denies the citizens of the benefits of their premiums. 

If you do not want a loss of benefits or coverages, then you are encouraged to contact your representative to OPPOSE HB 478.

You can call the Legislative message line at 1-800-372-7181 to voice your support or opposition. 

You may also call your legislator directly at 502-564-8100.  If he or she is not available, leave a message for him/her to call you back.