Legislative Articles and Issues
DCMA/FMA Legislative Agenda 2012DCMA/FMA 2012 LEGISLATIVE AGENDA
ISSUES TO SUPPORT:
ER SOVEREIGN IMMUNITY
Support legislation that would provide sovereign immunity to physicians who provide mandated treatment to patients in emergency rooms.
TORT REFORM
Support legislation that will permit defendant providers in a medical liability suit to discuss the case with the plaintiff’s other treating providers and that will increase the burden of proof for negligence in cases involving supplemental diagnostic testing in order to reduce costly and unnecessary testing for defensive purposes.
MEDICAID TO MEDICARE
Increase the reimbursement rate for Medicaid to that of Medicare. At the very least seek to ensure that physicians have the opportunity to control the disbursement of Medicaid funds in any type of capitated system.
GRADUATE MEDICAL EDUCATION
Increase state funding for graduate medical education programs in order to preserve access to care in Florida.
PRN
Support a PRN revisers bill that would: allow PRN to provide services to all health care professionals, ensure sovereign immunity coverage for all types of actions, clarify that licensure from DCF as a “treatment center” is not required, address the discoverability of PRN work product, and add first responders to PRN’s scope of service.
CAT FUND
Extend the medical malpractice exemption from any assessments levied on premiums for property and casualty insurance by the Florida Hurricane Catastrophe Fund.
HOSPITAL DEPARTMENT CLOSURE
Give the Agency for Health Care Administration the power to investigate decisions by a hospital to close a particular department and to take action to ensure patients are not left without needed medical care.
TRANSPARENCY IN HEALTH INSURANCE CPT REIMBURSEMENT SCHEDULES
Support legislation that would require all health insurance companies licensed in Florida to give all physicians access, on the company’s website, to the participating physician’s current complete fee schedule.
PROHIBIT ARTIFICIAL PRICE CONTROLS OF NON-COVERED SERVICES
Support legislation that would prohibit Florida insurance companies from forcing contract provisions on health care providers for services not covered by the plan.
MEDICAL EXAMINERS
Support legislation that would allow qualified out-of-state physicians to obtain a certificate to practice as a medical examiner in Florida.
PREAUTHORIZATION FOR MEDICAL TESTING
Support legislation making it unlawful for an insurance company or other third party payer to interfere with a licensed MD/DO’s valid order for a medical test or procedure.
DETERMINATION OF MEDICAL BENEFITS
Support legislation that would require managed care organizations to provide “real time” eligibility for their subscribers and reimburse physicians for any patient services rendered whereby subscriber eligibility has been confirmed prior to the delivery of care.
FLORIDA KIDCARE
Support the efforts of the Florida Pediatric Society to legislatively fix the Florida Kidcare Statute.
PROSTATE CANCER SCREENING
Support legislation that would require health insurers to cover an annual screening for prostate cancer for men over 40.
SB 1986
Support glitch legislation that would fix the unintended consequences of the licensing provisions contained in SB 1986, which passed during the 2009 session.
STUDENT HEALTH INSURANCE
Support legislation that would require health insurance for each student in a state university in Florida.
MENTAL HEALTH PARITY
Support legislation that would require insurance companies to provide the same coverage for mental illness as they do for other health care problems.
USE OF THE TERM “PHYSICIAN”
Support legislation that would prohibit the use of the term “physician” by any person other than an M.D. or D.O.
FETAL ALCOHOL ABUSE
Support legislation that would provide for voluntary admission of expectant mothers for alcohol abuse treatment services. Support legislation requiring that warning signs about fetal risk from the ingestion of alcohol by pregnant women be posted wherever alcoholic beverages are sold.
NICA
Support legislation that would expand NICA coverage to brachial plexus injuries as long as there is no increase in the nonparticipating physician assessment.
DOMESTIC VIOLENCE CME
Support the efforts of the Board of Medicine to legislatively clarify the domestic violence CME time requirements.
LICENSED ATHLETIC TRAINERS FOR HIGH SCHOOLS
Support legislation that would fund and mandate that each public secondary school in Florida with an athletic program employ or contract with a licensed athletic trainer.
BOOSTER SEATS / CHILDREN
Support legislation that requires all children 4 to 7 years of age and 4’9” in height or less to be placed in a properly restrained booster seat when riding in an automobile.
COLON CANCER SCREENING
Support legislation that would require health insurers to cover colon cancer screening tests.
PODIATRY
Support legislation that would conform current state statutes to the anatomical training and expertise of podiatrists, thereby limiting their treatments to the foot and ankle.
TANNING BEDS
Support legislation that would prohibit minors from using tanning beds.
NERVE CONDUCTION / EMG
Seek legislation that would limit the performance of nerve conduction studies and needle EMGs in outpatient facilities to situations where the licensed allopathic or osteopathic physician who is interpreting the study is onsite at the time the study is performed.
HIV TESTING
Support legislation that would make Florida consistent with CDC recommendations and guidelines concerning routine HIV screening, and would increase testing rates and improve the cost effectiveness of screening.
ESOPHAGEAL CANCER AWARENESS
Support HR 1343 and promote April as National Esophageal Cancer Awareness Month.
TEXTING WHILE DRIVING
Support legislation banning drivers from manually texting or emailing while operating a motorized vehicle.
APPROPRIATE PAYMENTS FOR VACCINES/VACCINE ADMINISTRATION
Seek legislation to ensure commercial insurance payment for all vaccines be not less than 25% above the vaccine cost on the CDC Vaccine Price List and that payment for each billed age-specific and non-age specific vaccine administration CPT code be not less than Medicare rates.
MARCHMAN ACT
Seek legislation requiring that Involuntary Evaluation and Treatment Orders shall be administered with full force and effect across county lines.
SCOPE OF PRACTICE OF NON-PHYSICIAN PROVIDERS
Seek legislation that will result in a change of standing for all future attempts at expansion of practice through the regulatory process by non-physicians.
DOCTOR-NURSES REPLACING PHYSICIANS
Seek legislation to make it unlawful for a nurse to represent him or herself as a physician (MD/DO), and include such activity under the definition of the unlicensed practice of medicine with felony-level penalties for such representation.
MANDATORY PARTICIPATION IN HEALTH NETWORKS
Seek legislation that prevents the linkage of physician licensure to the acceptance of any government or private insurance, public health care system, forced public service initiatives or mandatory ER coverage.
PAIN CLINICS
Seek legislation to require physicians who own or are employed by registered pain clinics to seek peer consultation of an Addiction Medicine Specialist when signs or symptoms of substance abuse or addiction occur, including impairment, apparent dose acceleration, and/or positive drug screen for illicit substances.
SECOND HAND SMOKE / LOCAL JURISDICTIONS
Support legislation to allow local jurisdictions to promote further restrictions on second hand smoke such as in bars, parks and other venues which currently allow smoking and cause excess morbidity and deaths for Floridians and visitors from second hand smoke.
Payment for Non-Contracted Physician Hospital Care
Seek legislation that ensures prompt payment from all contracted Medicaid HMOs for all inpatient hospital care provided by physicians, who are not participating physicians with the plan, but must provide care as a condition of their hospital staff credentialing and/or membership, including, but not limited to newborn care.
Notification when Terminating MEDICAID HMO County Coverage
Support legislation requiring that a Medicaid HMO must give at least 6 months written notice to all of their patients and contracted physicians and hospitals, or face a significant monetary fine, prior to the Medicaid HMO terminating coverage in a county.
MEDICAL HOME
Seek legislation to promote the establishment of the Medical Home Model of healthcare statewide as passed out of the House Health Policy Council in the 2010 Legislative Session and actively advocate that equitable payments to physicians must be not less than the 2009 Medicare reimbursement per CPT Code.
AUTOMATIC SUBSTITUTION OF BIOSIMILARS
Support legislation that would enact statewide guidelines on the substitution of “biosimilars.”
RETURN TO PLAY AFTER SUSPECTED CONCUSSION
Support the adoption of requirements that student athletes under age 18, who are suspected by a coach, trainer, administrator, or other individual responsible for the health and well-being of athletes of having sustained a concussion, are prohibited from returning to play or practice without prior written approval from an M.D or D.O.; and also support an educational program for young athletes, parents, and coaches regarding concussions so that they can recognize the symptoms of a concussion and know when to seek medical attention.
PRESCRIPTION DRUG MONITORING DATABASE
Support the sustainable funding of Florida’s prescription drug monitoring database.
NON-MEDICAL TESTING WHEN TERMINATING PREGNANCY
Support the repeal of Florida law which requires non-medical testing of those seeking to legally terminate a pregnancy.
DEFINING EXPERT TESTIMONY
Support legislation that would require Florida courts to interpret and apply principles of expert testimony in conformity with the Daubert standard, as set forth by the United States Supreme Court.
ENSURING PAYMENT FOR NEWBORN CARE
Support legislation so that a newborn's medical care is covered under the mother's health insurance for the first 30 days of life and that the newborn's insurance be active at the time of birth with no additional costs for the policyholder during the first 30 days and regardless of whether or not the child is registered.
BENEFITS MANAGEMENT
Seek legislation that would require the following: any physician who makes health insurance coverage recommendations regarding approval or disapproval of any patient care decisions be licensed in the state of Florida and be a member of the same specialty as the ordering physician; all benefits managers to be considered as “practicing medicine” when taking action to approve or disapprove a benefit for a patient; benefits managers to disclose, upon request, the guidelines used to make a negative recommendation; and that ordering physicians be compensated for their time at market value when interacting with benefits managers hired or engaged by any third party.
PAYMENT FOR PREVENTATIVE SERVICES
Seek or support legislation so that comprehensive preventive medicine CPT codes (99381-99387, 99391-99397) are paid at least at “Medicare” rates, as calculated by using RVU’s obtained from the Centers of Medicare and Medicaid Services (CMS); and also seek or support legislation so that vision screening, hearing screening, VEP (visual evoked potential), and recommended age-appropriate laboratory procedures and tests are required to be paid independently when performed along with a comprehensive preventive medicine CPT code (99381-99387, 99391-99397).
APPROPRIATE PAYMENTS BY AHCA FOR VACCINES / ADMINISTRATION
Work with the Agency for Healthcare Administration (AHCA) or seek legislation to increase vaccine payments to at least 25% above the vaccine cost, as listed on the CDC Vaccine Price List, for patients with MediKids or Healthy Kids insurance; encourage AHCA to update their vaccine fee schedule for MediKids and Healthy Kids patients on the first day of every quarter on their website; and work with AHCA or seek legislation to increase vaccine administration payments for all patients covered by Florida KidCare (Medicaid, MediKids, Healthy Kids, Children's Medical Services) to the Maximum Regional Charges for Florida ($16.06) as established by the US Department of Health and Human Services.
TIMELY AND APPROPRIATE PAYMENTS FOR NEW CPT CODES
Seek or support legislation to ensure that, beginning January 1st of each year, health insurance companies recognize and pay physicians for all current-year CPT codes billed.
APPROPRIATE PAYMENT FOR VACCINE PRICE INCREASES
Seek or support legislation so that health insurance companies increase vaccine payments by an amount at least equal to the manufacturer vaccine price increase(s) beginning on the day the price increase(s) goes into effect.
DISCIPLINING OUT-OF-STATE EXPERT WITNESSES IN CHILD ABUSE CASES
Support legislation that requires non-Florida licensed physicians called to testify in criminal or civil cases involving medical issues such as child abuse cases be required to obtain an Expert Witness Certificate from the Florida Department of Health.
NEWBORN SCREENING FOR SEVERE COMBINED IMMUNODEFICIENCY DISEASE (SCID’S)
Support the allocation of state funds to institute screening for Severe Combined Immunodeficiency Disease (SCID’s) in the state of Florida.
LIMITING MALPRACTICE HEDGE FUNDS
Help draft and support legislation that would make medical malpractice hedge funds illegal in the state of Florida.
CMS VERBAL ORDER AUTHENTICATION REQUIREMENT
Collaborate with the Florida Hospital Association and the Florida Society of Hospital Physician Executives to effect legislative change to FS 395.3025(12) as follows, “Verbal or telephone orders for hospital services must be authenticated within 30 days from the date of patient discharge. The hospital must maintain the written authentication or documentation of the efforts made to obtain such authentication as part of the medical record.”
IDENTIFY INTERVENTIONAL PAIN MEDICINE AS THE PRACTICE OF MEDICINE
Support legislation that identifies interventional pain medicine as the practice of medicine by medical and osteopathic physicians and specifies that only physicians licensed under Chapter 458 or Chapter 459 may perform interventional pain medicine techniques.
HMO’S BAIT AND SWITCH
Support legislation that would require HMOs to allow any policyholder to continue to utilize the services of any physician who was on the list of preferred providers as of the date of the policyholder’s enrollment for no less than one year from the date of enrollment.
ISSUES TO OPPOSE:
MEDICAID REFORM
Oppose the statewide expansion of the Medicaid Pilot Project that would effectively move almost every Medicaid patient into a Medicaid HMO. Oppose any effort to mandate Medicaid participation as a condition of physician licensure.
BALANCED BILLING
Oppose the imposition of any new restrictions on the ability of a physician to bill patients directly for the costs of care not fully covered by their insurance policy.
PERSONAL INJURY PROTECTION (PIP)
Oppose the repeal of the no-fault PIP system, and any changes that would hinder the ability of physicians to receive full payment for services rendered.
SCOPE OF PRACTICE EXPANSIONS
Continue to oppose all scope of practice expansions including naturopaths, ARNPs, pharmacists, optometrists, psychologists, podiatrists, direct access to physical therapists, audiologists and speech language pathologists.
AUTONOMY IN MEDICAL DECISION MAKING
Oppose any legislation that would infringe on physician practice autonomy and the doctor/patient relationship.
PROTECT ABILITY TO SELF INSURE
Oppose legislation that will take away a physician’s ability to self insure or that will make it more difficult for a physician to meet the financial responsibility requirements for licensure.
WRONGFUL DEATH
Oppose any expansion of Florida’s Wrongful Death Act.
VACCINATIONS
Oppose any vaccine legislation that would deviate from evidence-based recommendations and guidelines of the Centers for Disease Control and Prevention, the Advisory Committee on Immunization Practices, the American Academy of Family Physicians, and the American Academy of Pediatrics.
CARDIOLOGY SERVICES
Oppose legislation that establishes protocols for the assessment, treatment, and destination selection and transportation of suspected cardiac patients to include a destination selection criterion for suspected STEMI patients.
FOREIGN PHYSICIAN LICENSURE
Oppose any legislation that allows a physician to practice in Florida without meeting the same requirements as all other applicants.
PHYSICIAN PROFILE ISSUES
Oppose any legislation that makes the laws relating to profiles more onerous.
HEARING INTERPRETERS
Oppose any legislation that increases the cost of hearing interpreters.
FABRE CHANGES
Oppose any legislation changing current law relating to the Fabre doctrine.
PHYSICIAN SUPERVISION ISSUES
Protect advances we have made relating to physician supervision of nurses and PAs.
ARBITRATION
Oppose any changes to the statutes/rules governing arbitration that would jeopardize the effectiveness of the FMA created physician-patient arbitration form.
MANDATORY PARTICIPATION IN HEALTH NETWORKS
Oppose legislation that would tie physician licensure to mandated participation in any health care network, insurance plan or public health care system, forced public service initiatives, mandated emergency room coverage, or affiliation with any public or private third party payor organization.
LIMITS ON PHYSICIAN / PATIENT CONVERSATIONS
Oppose any legislation that would seek to interfere with the scope of conversations a physician can have with their patients or patient’s guardian.
DOH LICENSURE SUSPENSION
Oppose legislation that would broaden the medical license suspension powers of the Florida Department of Health based only on the arrest of a physician.
ARNPs should not practice independently or prescribe narcotics
Florida Medical Association
FACT SHEET
ARNPs should not practice independently or prescribe narcotics
FMA Position: Oppose bills that would grant authority to ARNPs to practice independently or prescribe narcotics. These proposals will not achieve meaningful cost savings or allow greater access to care, and could compromise patient safety.
ARNPs are not adequately prepared or trained for such expansions in their scope of practice
|
|
Medical Doctor |
ARNP |
Graduate Training |
4 years in Medical School |
1.5 – 3 years in nursing program |
Post Grad Training |
1 year Internship; 3+ years Residency |
None |
Pharmacology and Diagnostic Training |
Extensive coursework and clinical training on diagnosing and treating disease. |
Many programs have no separate course in the diagnosis of illness. |
Patient Contact Hours |
15,000+ hours |
500 – 1,500 hours |
- Nurses admit their training is inadequate for independent practice or the prescribing of narcotics.
- A 2004 study of NPs found: 51% felt their training made them “only somewhat or minimally prepared to practice”. For pharmacology, 45% felt they were not “generally or well prepared”.
- A 2003 survey of NPs found: 72.8% did not believe practicing outside one's scope of practice was necessary for effective pain management; and 65.5% felt that exceeding their scope of practice could result in potential harm.
- In states where nurses prescribe narcotics there is a greater frequency of controlled substance-related emergency room visits per year, per capita; and more Schedule II drugs in circulation.
- Studies from other states have shown nurses tend to prescribe more controlled substances than physicians. Overprescribing has extensive costs, not only to patients, but to the state as a whole.
These proposals would not improve patient access to care
- Research shows that in states where nurses can practice independently, physicians and nurses continue to work in the same urban areas and that shortages in rural areas continue to persist.
Estimates of cost-savings are based on impossible assumptions and deceptive data
- TaxWatch’s estimates are based on the unrealistic assumption that 100% of primary care visits in Florida would be conducted by nurses without supervision by a doctor. This is not even close to reality, and certainly not the standard of care Floridians expect or deserve.
- Supporters routinely misrepresent findings from an Institute of Medicine report. That report found savings within physician-supervised models of care – not independent practice by ARNPs.
ER Sovereign Immunity Factsheet 2012
Florida Medical Association
FACT SHEET
Extend sovereign immunity to physicians who provide emergency care
FMA Position: Support HB 385 (Gaetz), which extends the state’s sovereign immunity to ER physicians.
Background: Florida’s Emergency Workforce Shortage & Sovereign Immunity
-
Physicians who provide emergency care provide a critical public service. State and federal law mandate that emergency rooms are open to all, regardless of injury or ability to pay. Often ER physicians must make split second decisions without knowledge or access to a person’s health history.
- Florida has a critical shortage of specialists in emergency rooms, leaving patients waiting and vulnerable. In 2009, Floridians spent an average of nearly 4.5 hours waiting in an emergency room before being seen, which was longer than the national average.
- Only 33% of Florida physicians take call or work in an emergency department. Of these, 36% work less than 4 days per month and 11% have reduced their number of hours.
- These shortages are the direct result of the increased exposure to liability that physicians face when serving the public in the risky and unpredictable emergency setting.
- Florida’s medical liability climate is the #1 reason given by physicians for leaving critical need specialties such as emergency medicine or for retiring prematurely.
- HB 385 builds on established precedent. Several other types of medical providers are protected currently by sovereign immunity, including physicians at teaching hospitals and those who provide health care to inmates, regional poison control centers, and publicly funded facilities.
Access to Emergency Care and the Medical Liability Climate in Florida
From the National Report Card on the State of Emergency Medicine |
Florida |
Nation |
Access to Emergency Care Grade |
F (2nd worst in US) |
C- |
# of insurers writing medical liability policies per 1,000 physicians |
2.1 |
9.2 |
Average medical liability insurance premium for specialists |
$171,231 |
$65,489 |
Bottom line: Florida’s medical liability climate has hindered the public’s access to emergency health care. ER physicians who are required by law to treat ER patients are essentially acting as “agents of the state” and should be entitled to the state’s immunity. HB 385 is good policy because it would remove the primary disincentive for physicians to provide ER services and thus improve Floridians’ access to emergency health care.
Pharmacists should not administer more vaccines
Florida Medical Association
FACT SHEET
Pharmacists should not administer more vaccines
FMA Position: Oppose HB 509 (Logan)
- Allowing pharmacists to administer additional vaccines is unnecessary and potentially harmful to Floridians.
Background
- Many vaccinations are contraindicated for people with certain illnesses or conditions. Pharmacists are not trained to assess or diagnose a person’s condition before administering vaccinations.
- Retail businesses are seeking legislation to allow pharmacists to give vaccines for Shingles and Pneumonia. Unlike the Flu vaccine, the Shingles and Pneumonia vaccines are targeted for people over 60. Seniors are especially vulnerable to adverse reactions from vaccinations.
- Moreover, obtaining these vaccines from a physician is important for seniors who might not otherwise see a doctor regularly. This point of contact allows these individuals to receive timely interventional diagnosis and care that might not otherwise happen.
Compared to physicians, pharmacists are not sufficiently trained or educated to evaluate patient health, suitability for vaccination, or evaluate the potential for and treatment of potential adverse reactions.
|
|
Medical Doctor |
Pharmacist (data as of 2009) |
Graduate Training |
100% of physicians have spent 4 years in Medical School after completing a Bachelors Degree |
66% have NO graduate training – only a Bachelors Degree11% have a Master’s Degree22% have a Pharm.D. (Doctor of Pharmacy) |
Post Grad Internship |
1 year |
None |
Post Grad Residency |
3+ years |
23% sought residency, lasting up to 2 years. |
Clinical Patient Hours |
15,000 – 16,000 before diagnosing or prescribing for patients independently |
1,500 hours, typically obtained during school. There are no accreditation standards in pharmacy curriculum regarding direct care to patients. |
Bottom Line: this proposal is not really about access to care – it is about retail establishments seeking to generate additional customer traffic in their stores.
- No data shows that Floridians are under-vaccinated or have trouble accessing vaccinations. In fact, Florida is below the national average in flu vaccinations, which are given by pharmacists. Florida is above the national average for pneumonia vaccinations, which cannot be given by pharmacists.
- These proposals are designed to benefit retail establishments that employ pharmacists at the expense of compromising the safety of thousands of Floridians.
Optometrists should not prescribe oral medications
Florida Medical Association
FACT SHEET
Optometrists should not prescribe oral medications
FMA Position: Oppose HB 261 (Caldwell) and SB 718/SB 788 (Bennett)
Optometrists are not trained to prescribe oral drugs. Expanding their scope of practice to do so will endanger patients without improving access or the cost of care.
Background
-
There are major differences between topical and oral drugs, which affect the whole body and can result in serious adverse reactions. Topical drugs are sufficient for all but the most serious eye conditions. If you have an eye problem serious enough to warrant oral drugs, you need a physician.
-
Seniors are especially vulnerable due to the higher volume of meds they are on. Various oral medications can interact and cause adverse reactions.
-
Many eye meds – especially those used to treat glaucoma – are contraindicated for people with diabetes, heart conditions, or asthma – all conditions that are more prevalent among the elderly.
-
HB 261 (Caldwell) would authorize optometrists to prescribe oral medications approved by a formulary committee, without further restriction or physician supervision.
Optometrists do not have sufficient education and training relating to oral medications, their effect on body systems, and drug interactions.
|
|
Medical Doctor |
Optometrist |
Graduate Training |
4 years in Medical School |
4 years in a College of Optometry |
Post Grad Training |
1 year Internship; 3+ years Residency |
< 10% of complete a 1 year residency |
Pharmacology Training |
Extensive coursework and clinical training in pharmacology |
Pharmacology curriculum is inconsistent, ranging from 1-3 courses |
Patient Contact Hours |
15,000+ hours |
Average of 2,000 hours |
Other states with expanded scope recognize optometrists’ limitations of training, education and experience
- The majority of states that do permit optometrists to prescribe oral drugs have restrictions on the types of these drugs, the duration of their prescription, and the types of patients who may be treated. HB 261 does not impose such restrictions.
Expanding scope will not improve access to care or lower costs for consumers
- Florida has the 6th-highest ratio of ophthalmologists in the nation, and these doctors are well-distributed throughout the state. In 6 of Florida’s more rural counties, ophthalmologists already see a higher ration of patients than optometrists.
- The costs of seeing ophthalmologists and optometrists are generally identical.
Chiropractors should not treat traumatic brain injury
Florida Medical Association
FACT SHEET
Chiropractors should not treat traumatic brain injury
FMA Position: Support HB 291 (Renuart) and SB 256 (Flores) and do not accept amendments that would allow chiropractors to clear youth athletes to return to play following a concussion.
Background
-
Concussions are traumatic injuries to the soft tissue of the brain and can have serious immediate and long-term impacts, including death, permanent disability, and degenerative cognitive problems.
- Chiropractors are an important part of Florida’s health care team, including the treatment and care of youth athletes, but they are not trained to treat head trauma, particularly concussions.
- There are cases where chiropractors have caused harm to high school athletes due to this lack of expertise. “At least 4 of every 10 high school athletes who have concussions return to action too early.” St. Pete Times, 7/29/2010
- Medical doctors are uniquely qualified to assess and treat concussion. Athletes who sustain a head injury or concussion must be assessed by a medical doctor before returning to play.
- Allowing chiropractors to perform this duty will give students and parents a false sense of security when dealing with head injuries.
Huge Differences in Education and Training
|
|
Medical Doctor |
Chiropractor |
Undergraduate Training |
4 year baccalaureate degree |
90 hours of baccalaureate-level coursework |
Graduate Training |
4 years in Medical School |
4 years in a College of Chiropractic |
Post Grad Internship |
1 year |
None required |
Post Grad Residency |
2-8 years, depending on specialty |
None required |
Bottom Line: Don’t Needlessly Endanger Youth Athletes
Physicians have years of education and specific hands-on training to identify, treat and manage brain injuries. Chiropractors do not.
“You have to have more than a surface knowledge of concussions. Otherwise you’re going to hurt somebody.” Dr. Michael Cordas, Chairman, Pennsylvania Interscholastic Athletic Association Sports Medicine Advisory Group. Pittsburg Post-Gazette 11/28/2010
PIP "Fraud" Reform Should Not Be Used as a Pretext to Impose Restrictions on Physicians' Ability to Treat Injured Patients
Florida Medical Association
FACT SHEET
PIP “Fraud” Reform Should Not Be Used as a Pretext to Impose Restrictions on Physicians’ Ability to Treat Injured Patients
FMA Position
Any legislative changes to PIP should be limited to addressing fraud. Fraud should not be used as a pretext by insurance companies to obtain unfair advantages that hurt patients and physicians.
Background
- Every Florida motorist is required to obtain a minimum of $10,000 in Personal Injury Protection (PIP) insurance coverage. PIP coverage guarantees that injured drivers and passengers can receive medical care without waiting for costly and lengthy litigation to determine fault. It ensures that health care professionals providing treatment to injured persons are compensated promptly and fairly.
- PIP fraud in Florida is on the rise. In short, criminals and unscrupulous health care providers fabricate auto accidents and injuries to generate fraudulent PIP claims. They order unnecessary medical tests and ineffective treatments, and then discharge patients when PIP funds are depleted.
-
These instances of fraud are best addressed by enforcing laws that are currently in place and perhaps by closing a few loopholes in current law relating to certain clinics that treat auto accident victims. The FMA supports legitimate efforts to address fraud.
-
Some insurance companies are using PIP fraud as a pretext to obtain other changes that have nothing to do with fraud. They want to change the law in ways that will hurt motorists who have legitimate injuries by limiting their access to appropriate medical care and diagnoses. These proposals are also bad for lawful physicians who treat these patients. Insurance companies want the ability to deny valid claims without penalty.
- The FMA opposes proposals by insurance companies that prevent physicians from addressing legitimate patient injuries, including the following:
- eliminating attorneys fees for physicians who are forced to sue an insurance company to recover on a claim that has been wrongfully denied;
- forcing physicians to practice “cookbook” medicine through the imposition of utilization protocols; and
- imposing new fee schedules for physician services.
Bottom Line
Changes to PIP laws should fix fraud; not discourage law-abiding physicians from treating car accident victims, or allow insurers to deny valid claims with impunity.
DCMA & FMA - Your Organizations Working For YOU
