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Senate amends and passes SB 166 to limit no‑fault medical reimbursements; physicians warn of price‑control precedent
Summary
After testimony from the Utah Medical Association and extensive floor debate, the Utah Senate adopted an amendment and passed Senate Bill 166, which ties no‑fault (PIP) reimbursements to a relative‑value survey (the 75th percentile). Physicians warned the change could amount to state price controls; sponsors and the insurance commissioner said the measure implements an existing statutory survey and aims to stretch the $3,000 no‑fault benefit.
The Utah Senate voted to amend and pass Senate Bill 166 on third reading after extended debate over whether the measure sets de facto price controls on physicians’ no‑fault (personal injury protection) charges.
Mister Sorensen, speaking for physicians, told the Senate the Utah Medical Association supports an insurance‑department relative‑value study but opposes a provision that would cap physician charges at the department’s 75th‑percentile survey amount. "We feel it's a dangerous precedent to set to begin to control prices for physicians," he said, arguing that the proposal would allow the insurance department to set a maximum amount a physician could charge to an injured consumer.
Supporters, including the Insurance Department commissioner, said the bill implements an existing statutory relative‑value mechanism and aims to preserve limited PIP benefits. The commissioner explained the mechanics of the survey — which samples providers (with Salt Lake County used as the high‑cost reference) and sets a benchmark at the 75th percentile — and noted the statutory $3,000 PIP medical cap. He said the intent is to "stretch that $3,000 as far as it will go" so consumers receive the maximal benefit under current law.
Senators questioned practical effects on rural providers, administrative burdens, insurer negotiations, and whether capping reimbursements would drive market behavior. Opponents warned that if the benchmark is publicly advertised, providers across the state might converge their billing toward the survey ceiling; proponents noted the relative‑value study already exists in statute and is updated every two years.
During floor consideration the Senate went into a Committee of the Whole to hear outside testimony and later returned to the floor where an amendment deleting a portion of the bill was offered and adopted. The amendment passed on a standing count after debate. Several senators disclosed potential conflicts of interest (affiliations with hospitals or insurers) before the final roll call. The third‑reading vote on SB 166 recorded 25 ayes, no nays, and 7 absences; the bill was advanced for final processing.
The action follows other related committee work noted in the day's session, including earlier committee reports and consideration of multiple House bills. The Senate adjourned and set the next floor session for Thursday, Feb. 21.
