Committee advances PIP reform to subject personal-injury protection to workers’ comp fee schedule; physicians warn of access risks
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Summary
House Bill 6 27 would subject PIP claims to the workers’ compensation fee schedule, shorten billing windows to 180 days, prohibit balance billing and raise funeral/weekly benefits; sponsors say it combats fraud, while physician witnesses warned it could reduce access and shift costs to hospitals and public payers.
The House Banking and Insurance Committee reported House Bill 6 27 favorably after hearing sponsor remarks, stakeholder summaries and opposition testimony.
Representative Josh Bray, sponsor, and Dustin Miller, a retained legislative agent for State Farm, said the bill carries forward four core reforms from last year: subjecting PIP claims to the workers’ compensation fee schedule (with an exception for hospital services), requiring providers to submit bills within 180 days rather than the current two-year window, prohibiting providers from balance billing consumers or reporting unpaid balances to credit, and increasing certain benefits for funeral services and weekly wage payments.
"It subjects PIP claims to the workers' comp fee schedule with the exception of hospital services," Miller said, and the substitute clarified that the existing workers' comp fee schedule would function as a floor so future reductions would fall back to that level.
Opponents urged caution. Jason Lewis, a Louisville physician who identified himself as representing independent pain-management practices, testified in opposition and said the fee schedule would “impose a drastic reduction in fees for medical services rendered by medical providers outside the hospital setting” while exempting hospitals, a disparity he said would push patients to higher-acuity settings and limit access to independent providers. "I especially request that you vote against the PIP reform bill, House Bill 6 27," Lewis said, arguing the change could shift costs to Medicaid and Medicare and drive some providers to refuse PIP patients.
Sponsors and some committee members said the bill targets fraudulent actors and includes new enforcement tools; the substitute also gives the attorney general concurrent jurisdiction to prosecute insurance fraud alongside county and commonwealth attorneys and requires the Department of Insurance to produce an annual insurance fraud report. Several members asked technical questions about why PIP lacked a fee schedule historically; witnesses said PIP dates to 1975 and had not previously used a fee schedule.
Representative explained the motion to adopt the substitute and, after roll call, the committee reported the bill with a favorable recommendation to the House floor. Several members noted reservations but said the committee process allows amendments on the floor.
The committee advanced the bill; sponsors indicated they expect continued negotiation about hospital exemptions and fee-level questions on the House floor.