By Ryan Sanders, Esq.
Lubell & Rosen
The Law Firm of Lubell & Rosen is closely monitoring the progress of House Bill 837. If HB 837 passes, it will have sweeping effects on doctors attempting to collect their medical bills against insurance companies. The bill contains a provision eliminating attorney’s fees on such cases. If this bill passes, attorneys will no longer have any incentive to pursue these claims, which are usually over amounts too small to be taken on a contingency. See Link to prior article : http://southfloridahospitalnews.com/house-bill-837-a-bad-law-that-will-effectively-end-physician-lawsuits-against-insurance-companies/
As of March 14, 2023, HB 837 is still on a fast track to become law in the State of Florida. Political insiders have indicated the law will be on Governor DeSantis desk in less than 10 days, and all indications are that he will sign the bill. The latest version has offered a few concessions worthy of note. In its most recent form, the proposed legislation will still allow attorney’s fees in a small subset of cases. These are in the situation in which a carrier claims there is no coverage and the insured is required to sue to prove coverage exists. These are known as coverage disputes. But coverage disputes are rare. A coverage denial is the exception, rather than the rule for most insurers. Most commonly, physicians are being denied for reasons relating to the way a bill was coded, medical necessity, or exhaustion of benefits. Accordingly, even with this concession, insurers will be permitted to deny and underpay claims by physicians with relative impunity.
The Florida Senate recently amended its version of the bill (Senate Bill 236) to provide a similarly narrow exception to the abolition of attorney’s fees in actions against insurers. However, in addition to narrowing the exception for attorney’s fees to cases involving coverage disputes, the Senate would eliminate any actions for attorney’s fees that are predicated upon an assignment of benefits. Thus, categorically, any medical provider, even in a case involving a coverage dispute, who sues pursuant to an AOB, would not be permitted to recover their attorney’s fees.
The legislature is clearly grappling with how to control frivolous litigation while at the same time providing a realistic avenue for aggrieved individuals to bring a case against big insurance. Unfortunately, these amendments to both the House and Senate bills fall short of striking the appropriate balance. The reality is that the appellate courts provide the best mechanism for determining what is frivolous, and which cases lack legal merit. Additionally, the abolition of second-tier certiorari review has fast tracked the resolution of complex issues for both sides.
Furthermore, medical providers are already required to give insurance carriers a 30 day pre-suit demand. This gives carriers an opportunity to cure any mistake or error with no penalty. Attorney’s fees only come into play in the situations where carriers continue to deny the claim improperly despite two chances to pay the bill.
At present, attorneys are compensated for their time when they bring litigation involving a good faith legal dispute, that is one that has not previously been ruled upon adversely at the appellate level. Given the speed at which appellate issues are being resolved, there is simply no need to curtail litigation over non-coverage issues. It seems clear that special interests are more concerned with creating an uneven playing field that will give unfettered discretion to big insurance to the detriment of the average medical provider and their attorney. Even with the threat of attorney’s fees, carriers deny or underpay valid medical bills. Without the threat of attorney’s fees as a penalty, insurance carriers will deny a higher percentage of bills and medical providers will have little to no recourse against such abuse.
We are continuing to closely monitor this litigation and will provide more updates as they become available.
If you would like to more information on this pending legislation, contact Ryan Sanders at Lubell Rosen, 954 880 9500
Ryan Sanders & Steven Lubell are partners at the firm Lubell & Rosen, with its main office in Fort Lauderdale, Florida. The firm represents hundreds of doctors throughout the state of Florida. Areas of practice include PIP collection, out-of-network medical bill collection and medical malpractice defense litigation. For more information about the authors of this article or Lubell & Rosen, please visit www.lubellrosen.com.
