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Wilton Manors, Florida, Broward County, Florida
2608 NE 16th Avenue Wilton Manors, FL 33334-4319 Telephone: 954-463-3036 Fax: 954-565-5557 www.chiropractorwiltonmanors.com Business Hours: Monday, Wednesday and Friday: 9:00am – 1:00pm and 3:00pm – 7:00pm Tuesday and Thursday: 9:00am – 1:00pm and 3:00pm – 6:00pm Weekends By Appointment 24 HOUR EMERGENCY SERVICE Emergency clients welcome Licensed Chiropractor #MM13657, Insured

Monday, August 22, 2011

Scott, Atwater look to fix or kill no-fault auto insurance, Ft. Lauderdale Chiropractor Troy Lomasky Notes Tampa Tribune PIP Story

FATAL WRECK 7885831.JPG
THE ASSOCIATED PRESS
Florida has one of the highest rates of uninsured motorists.


http://www.tbo.com/

By CATHERINE WHITTENBURG | The Tampa Tribune
Published:  August 21, 2011
TALLAHASSEE -- The number of car crashes in Florida is dropping, yet auto insurers in Florida are paying more every year on personal injury claims -- all told, $940 million more since 2008.

Who else pays? You do, if you're an insured Florida driver.

The main cause: fraudulent personal injury claims, which drive up everyone's premiums, said State Insurance Commissioner Kevin McCarty.

"It comes out of the pockets of Joe and Mary Lunchbox," he said at last week's Florida Cabinet meeting. "And the thing about it is, it's through no fault of your own."

Florida consumers can't afford that, say Gov. Rick Scott and Chief Financial Officer Jeff Atwater, who have suggested it's time either to fix the current system or stop requiring Florida drivers to carry $10,000 in personal injury protection insurance. PIP covers a driver's injuries from an accident regardless of who is at fault.

Lawmakers have tried to reform the system to prevent fraudulent PIP claims, but they continue to pile up.

Studies show that auto insurance would be cheaper if drivers did not have to carry PIP. But Florida also has one of the highest rates of uninsured motorists, and is one of only two states where drivers don't have to have insurance covering injuries they inflict on others.

All of which means that injured drivers without PIP would more likely face covering the cost of their own treatment. That could drive up the cost of health insurance and health care, PIP supporters say. Would repealing the PIP mandate trigger too many unintended consequences?



* * * * *



The number of Florida drivers has remained stable since 2005, while the number of crashes has dropped, McCarty said.

Yet the cost of PIP claims climbed 70 percent from 2008 to 2010, from $1.43 billion to $2.37 billion.

That cost the average two-car family nearly $100 extra last year on auto insurance, even if their driving records were spotless, according to the Insurance Information Institute.

"Some of that increase can be attributed to increased medical costs," McCarty said. "But not 70 percent … fraudsters and hucksters [have] perfected the system of finding the weak points and taking advantage of that."

PIP is part of the no-fault auto insurance system that Florida adopted in 1971. Billed as a way to reduce insurance costs and litigation, no-fault limits an injured motorist's right to sue in exchange for prompt payment of medical bills and lost wages through PIP.

But as government and grand jury reports have shown, PIP fraud has grown exponentially in the form of staged crashes, inflated claims of medical treatment and outright false claims of injury.

South Florida is the state's ground zero for fraudulent claims, though insurers also report a high rate of staged accidents in the Tampa Bay area.

The Legislature reenacted Florida's PIP law with anti-fraud reforms in 2007, but problems continued, prompting more anti-fraud proposals this spring. They failed, in part, because lawmakers comingled anti-fraud provisions with more controversial caps on attorneys' fees.

PIP is one of the most heavily lobbied issues at the capitol, given the high stakes for the legal, insurance and medical communities.

PIP is still a great idea, said Atwater, who hopes lawmakers will pass potent new measures in 2012 to drive down fraud.

Otherwise, he said, "if [PIP] is going to continue to run the route it's going, where it's going to become unaffordable, people are going to go uninsured. I think we have to look at the alternatives."

Scott, who often speaks about consumer "choice," said earlier this month that he was considering proposing legislation to make PIP coverage optional. Tuesday, he said he would defer to McCarty to hammer out a PIP proposal.

Repealing PIP should be part of the debate, McCarty said after Tuesday's Cabinet meeting. "Many of the things that were thought to be the benefits of PIP have not panned out." One alternative, he said, may be requiring bodily injury liability insurance, which covers other people's injuries or death when the insured driver causes an accident.

Because bodily injury insurance requires assignment of fault, "you're not going to stage an accident," McCarty said. "It simply takes the fraud out of the system." .

Sen. Ellyn Bogdanoff, who sponsored anti-fraud legislation this spring, panned replacing PIP with bodily injury insurance. "When does the hospital get paid? You have to prove a certain level of liability."

Bruce Ruben, president of the Florida Hospital Association, agreed. Bodily injury protection, he said, "requires litigation before the insurance is available."

The medical community is highly protective of PIP. When the mandate sunset in 2007, hospitals and other providers argued that failing to reinstate it would simply shift auto insurers' costs to the healthcare system.

Injured drivers without PIP would rely on their health insurance, Ruben said, potentially raising premiums. The rate of uncompensated care would increase, as many injured motorists without PIP or health insurance would be unable to afford their treatment.

Hospitals and patients who do have health insurance would wind up paying for that, Ruben said.

Cost-shifting is a valid concern, said Michael Carlson, head of the Personal Insurance Federation of Florida, a trade group of auto insurers including State Farm and Allstate.

But Carlson pointed to a 2008 study in Colorado that indicated health insurance rates rose only 1.6 percent when that state dropped its no-fault/PIP system in 2003. Auto insurance rates plunged by 35 percent.

The switch, however, also drove down payments to hospitals, ambulances and other providers by $80 million, the Colorado Springs Gazette reported. "While there have not yet been any major layoffs, some rural hospitals have had trouble finding specialists to serve on trauma care calls for fear they will not get paid."

Colorado lawmakers responded in 2008 by requiring drivers to carry a $5,000 medical payments benefit unless they opt out.

In Florida, where Allstate and State Farm pushed in 2007 to end the PIP mandate, even large insurers have mixed views today, said Carlson. "Our position is that the PIP system is broken and needs to be fixed."

Bogdanoff, R-Ft. Lauderdale, said she plans to introduce PIP legislation again next year. So does Rep. Jim Boyd, R-Bradenton, who sponsored a similar bill. Among the provisions they say are key: requiring in-depth accident reports, as opposed to the current "short form," to prevent people not injured from filing a PIP claim.

"I hope that with the attention being brought to the issue now, and the visibility and exposure, that we get some substantial and meaningful reform this session," Boyd said.


cwhittenburg@tampatrib.com (850) 222-8382

To view this story online, go to:  http://www2.tbo.com/news/breaking-news/2011/aug/21/scott-atwater-look-to-fix-or-kill-no-fault-auto-in-ar-251578/

Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, near Ft. Lauderdale, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions.  Services include:  Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation.  New patients, weekends & same-day appointments available.   (954) 463-3036 or www.chiropractorwiltonmanors.com.  On-call for emergencies 24 hours.  Serving Broward, Miami-Dade and Palm Beach Counties.

Sunday, August 21, 2011

The Florida Current: How can Florida doctors survive in an HMO world? Doctors who want to know how to survive in the new statewide Medicaid managed care marketplace in the coming years can listen to Agency for Health Care Administration Secretary Liz Dudek at a meeting in Orlando next week

Reprinted from The Florida Current
http://www.thefloridacurrent.com/

By Christine Jordan Sexton, 8/18/2011

Doctors who want to know how to survive in the new statewide Medicaid managed care marketplace in the coming years can listen to Agency for Health Care Administration Secretary Liz Dudek at a meeting in Orlando next week.

State Rep. Darren Soto is hosting a meeting at the Florida Hospital in Orlando on Aug. 25 to answer questions from doctors and hospitals about how to play in the new mandatory managed care environment, said Soto, a Democrat from Orlando. This isn’t the first meeting on the statewide Medicaid managed care project, but it may be the first one where the agenda is aimed at answering health care providers’ questions. Soto said providers need to understand how the changes impact their businesses if they want to stay in business.

"This won't be political," said Soto, who actually voted against the sweeping reforms along with the other Democrats in the House of Representatives. "It's an effort for me to help educate the doctors and administrators and others folks who are potentially dealing with Medicaid reform. …. This is geared toward providing information on what would be a huge reform affecting loss of doctors offices."

Agency for Health Care Administration spokesperson Michelle Dahnke confirmed that Dudek -- and not a proxy -- will be at the meeting.

This is not the first time that Soto has hosted meetings in Orlando with agency secretaries. He previously met with former Department of Health Secretary Ana Vimonte Ros and former Department of Community Affairs Secretary Tom Pelham, who addressed autism in the Hispanic community and the foreclosure crisis, respectively.

"If you ask the right way you can get a lot of secretaries to come down," said Soto.
Filed in: Health Care
Tags: Medicaid Reform

Broward County Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions. Dervices include: consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation. New patients & same-day appointments available. On-call for emergencies 24 hours. Serving Broward, Miami-Dade and Palm Beach Counties. Coconut Creek Cooper City Coral Springs Dania Beach Davie Deerfield Beach Fort Lauderdale Hallandale Beach, Hillsboro Beach Hollywood Lauderdale Lakes Lauderdale-by-the-Sea Lauderhill Lazy Lake Lighthouse Point Margate Miramar North Lauderdale Oakland Park Parkland Pembroke Park Pembroke Pines Plantation Pompano Beach Sea Ranch Lakes Southwest Ranches Sunrise Tamarac Weston Wilton Manors

State Representative Bryan Nelson: We need to give fixing Florida PIP one more shot



Above:  Chairman Rep. Bryan Nelson, R-Apopka, guides an Insurance & Banking Subcommittee meeting. Photo Credit: Mark Foley, Florida House of Representatives

Reprinted from The Florida Current
http://www.thefloridacurrent.com/

By Christine Jordan Sexton, 8/18/2011

 As calls for tackling Florida’s personal injury protection (PIP) program grow louder one influential lawmaker has made clear he doesn’t want to scrap the long standing system that pays $10,000 in health care costs regardless of which driver is at fault.

Rep. Bryan Nelson, R-Apopka, said he believes the program can be altered to address some of the problems that have been bedeviling the system if the Legislature were to adopt fee caps and utilization schedules and agree to limit attorneys’ fees, similar to what the Florida Legislature accomplished with workers’ compensation in 2003.

Nelson is chairman of the House Insurance and Banking Committee, which will likely hear any PIP related bills the Legislature tackles in the 2012 session.

“We need to give it one more shot and try to fix it,” Nelson said of PIP. “If we can’t fix it, then we’ll flush it.”

An insurance agent, Nelson said his goal is to reduce insurance premiums for Florida drivers by $1 billion.

Nelson is the latest politician to chime in on whether the state’s no fault system be eliminated or at a minimum retooled. Gov. Rick Scott said earlier this summer he could support eliminating the no fault insurance program but at a Cabinet meeting on Tuesday said he would wait to follow the lead of Insurance Commissioner Kevin McCarty.

McCarty--who has served as insurance commissioner under Govs. Jeb Bush, Charlie Crist and now Scott--said he was going to meet with legislators in the coming weeks to discuss the issue.

McCarty gave a lengthy presentation at the Cabinet meeting showing that PIP benefits paid have increased by more than $500 million since 2008 even though the number of licensed drivers has remained steady and the number of accidents has dropped.

A decision was made in 2003 to allow the program to expire but a coalition made up of hospitals, health insurers companies and some automobile insurance carriers successfully lobbied to modify the program and have it reinstated into law.

When the insurance industry supported organization the National Insurance Crime Bureau released a report earlier this year revealing the percentage of questionable PIP claims in Florida rose 34 percent from 2008 to 2010 legislators once again re-examined the program in 2011. The NICB rated Miami, Tampa and Orlando among the top five cities in the nation for questionable claims.

The Office of Insurance Regulation also released the Report on Review of the 2011 Personal Injury Protection Data Call, which showed that costs in the PIP system are increasing and that PIP payouts have gone from about $1.5 billion in 2008 to approximately $2.5 billion in 2010. The OIR report also showed that Florida PIP claims involve about twice as many medical treatments than the average and the costs are $4,000 higher than the average costs.

Florida is one of ten states to have no fault automobile insurance program.

This past session PIP was just one of a whole long list of insurance related the Legislature tackled including sinkholes, homeowners and medical malpractice. In the end, the legislation fell by the wayside.


PIP isn’t expected to compete with other insurance issues in 2012 though, Nelson said.

“This is a huge issue and hopefully we’ll address it in a meaningful way, not a superficial way,'' he said.


Filed in: Insurance
Tags: Personal Injury Protection

Tuesday, August 16, 2011

From the South Florida Sun-Sentinel's House Keys Blog: Push for legislation to fight auto insurance and PIP fraud already underway

From the Sun-Sentinel's "House Keys" blog today, August 16, 2011:



About five months before the start of Florida’s 2012 legislative session, efforts are already underway to promote policies that could fight personal injury protection insurance fraud.

Only a few provisions in bills proposed this year cleared the state Legislature. At a Cabinet meeting Tuesday, Insurance Commissioner Kevin McCarty, Gov. Rick Scott and Chief Financial Officer Jeff Atwater expressed support for new PIP legislation.

Atwater said the state should “stop throwing consumers to the wolves” and Scott urged McCarty to meet with legislative leaders to “have something happen this session.”

Robin Westcott, the state's new insurance consumer advocate, announced recently that she plans to develop PIP legislative proposals by December. She'll issue recommendations after meeting with a working group of legislators and others.

Personal injury protection, or PIP, pays medical bills for policyholders injured in auto accidents, regardless of which driver is at fault. It's intended to protect Floridians who don't have health insurance and to avoid lawsuits and their costs for minor injuries. Florida drivers are required to carry $10,000 worth of coverage.

The proposed legislation this year would have, among other things, made it more difficult for people to file claims and for lawyers to collect huge fees. A broad coalition including insurers supported most of the proposed changes. But legal and healthcare industry representatives pushed only for those changes that they felt wouldn't hurt people with legitimate claims.

McCarty provided information from a report his office did to support the need for legislation. He said:

PIP claims payouts increased more than 50 percent from under $1.5 billion in 2006 to about $2.3 billion in 2010 even as the number of licensed drivers has increased only slightly and the number of crashes have dropped.

To view this posting online, click here.

Ft. Lauderdale Chiropractor Troy Lomasky Notes Florida Insurance Commissioner Kevin McCarty's Personal Injury Protection (PIP) Presentation at August 16 Florida Cabinet Meeting


Florida Insurance Commissioner Kevin McCarty made a presentation on Personal Injury Protection (known as PIP or No-Fault Insurance) to the Florida Cabinet this morning, August 16, 2011. He reviewed the various types of auto-related insurance coverages available in Florida and discussed the issue of statewide fraud.

To view his presentation, click here.

Type of auto insurance:

Liability – Coverage for all sums the insured is legally obligated to pay due to an
accident
• Bodily Injury (BI) – Provides coverage for death or serious and permanent injury to
others when you are legally liable for an accident involving your automobile.
• Medical Pay (Med Pay) – Provides coverage for medical treatment for the insured
or resident family member resulting from an auto accident, regardless of fault, as
well as any person occupying the covered auto.
• Personal Injury Protection (PIP) – Provides coverage for medical benefits, lost
wages and funeral benefits for insured or resident family member when injured in
their own vehicle, in someone else’s vehicle, as a pedestrian or as a bicyclist.
• Property Damage (PD) ‐ Coverage in the event that negligent acts or omissions of
an insured result in damage or destruction of another’s property.
• Uninsured Motorist (UM) – Coverage provided to the insured, resident family
members and any other person occupying the covered automobile for bodily
injury resulting from an accident involving an uninsured or underinsured driver.

Saturday, August 13, 2011

Ft. Lauderdale Chiropractor Dr. Troy Lomasky Notes Florida Surgeon General Issues Emergency Suspension of Daytona Practitioner

Insurance fraud is a big problem in Florida and gives good chiropractors a bad name.  If you are a victim of fraud, or suspect insurance fraud, report directly to the Florida Department of Financial Services, Division of Insurance Fraud by clicking here.


Florida Surgeon General suspends chiropractor's license; order claims insurance billing fraud By LYDA LONGA, STAFF WRITER 
August 13, 2011

http://www.news-journalonline.com/
Daytona Beach News Journal

DAYTONA BEACH -- The state surgeon general in suspending the license of chiropractor Joseph Wagner blasts the 61-year-old as an irresponsible practitioner who flouted the law by billing insurance companies for services he never performed and treating at least two patients with controlled substances.

Dr. Frank Farmer, the surgeon general for the Florida Department of Health, said Friday that issuing the emergency suspension order for Wagner's license was the "best way to resolve the issue."

"Dr. Wagner's actions demonstrate such a propensity to inappropriately exceed the scope of his license and to mislead third parties ... and make it clear that Dr. Wagner will continue to practice in violation of Florida law unless action is taken to prevent him from doing so," the order states.

In the 14-page document issued late Thursday, the Department of Health details how Wagner submitted fake insurance reimbursement claims to Geico insurance company for treatments he supposedly gave two patients identified in the order as "KR" and "JR."

The order also claims that Wagner called in prescriptions for both patients under the name of another doctor who never evaluated or even met the individuals.

The license of that doctor, John P. Christensen of West Palm Beach, was suspended by Farmer on Aug. 4. That same day, the FBI, the Florida Department of Law Enforcement and other law enforcement agencies raided the Wagner Chiropractic & Acupuncture Clinic at 542 N. Ridgewood Ave., confiscating patient records.

The seizure of records was in connection to the Christensen matter, FDLE officials said; two other clinics were busted that day, as well -- one in West Palm Beach and one in Port St. Lucie.

In addition, Wagner's son, John Wagner, who is also a chiropractor with a separate clinic on Mason Avenue, is implicated in the same investigation, Department of Health and FDLE officials said.

John Wagner was placed on probation by the state's Board of Chiropractic Medicine in April, records show, because he erroneously diagnosed a patient. The patient is one of six that were seen by either Joseph Wagner or John Wagner in a two-year-period and were prescribed medications under Christensen's name, records show.

Joseph Wagner's other son is Volusia County Councilman and personal injury attorney Josh Wagner. Neither Joseph Wagner nor Josh Wagner returned phone messages left Friday.

The door to the Wagner clinic was locked Friday morning.

In the order issued against Joseph Wagner on Thursday, it states that he saw the two patients for only minutes at a time each week, yet he billed Geico a total of 53 times for extensive services that he never performed. Wagner claimed that he gave the patients various chiropractic treatments, in addition to 30-minute counseling sessions, the order shows.

"Dr. Wagner's egregious and inappropriate coordinated effort to submit insurance claims for chiropractic services not rendered demonstrate exceptionally poor judgment," the order states. "And his behavior is the antithesis of what is required and expected of chiropractic physicians."

As for the controlled substances that the Department of Health details Wagner as having prescribed, those included hydrocodone, Xanax for anxiety and the muscle relaxant Soma.

Patient "KR" told investigators that the doses Wagner prescribed to her were "excessive" and she took the medication only as needed. Wagner prescribed 40 hydrocodone, 21 Xanax and 21 Soma each, to "KR" and her husband "JR," weekly, the order shows.

Investigators said Wagner would call in the prescriptions and they would be issued under Christensen's name.

"Dr. Wagner's egregious and inappropriate prescribing of potentially addictive and dangerous drugs, through the use of Dr. Christensen's medical license and DEA number, to chiropractic patients, constitutes a breach of the trust and confidence that the Legislature placed in him," the order says.

According to state records, Wagner, graduated with a business degree from Bethune-Cookman College in 1972. He went to chiropractic school at the Cleveland Chiropractic College in Kansas City from 1973 to 1977.

A native of Daytona Beach, Wagner graduated from Father Lopez High School in 1968. He became a chiropractic physician licensed in Florida in 1978 and studied to be a doctor at Universidad Federico Henriquel, the same now-defunct school in the Dominican Republic that Christensen attended.

-- Staff Writer Jay Stapleton contributed to this report.

Ft. Lauderdale Chiropractor Troy Lomasky Notes Orlando Sentinel Editorial on PIP: Fix PIP, but don't kill the no-fault program

Orlando Sentinel Editorial: Fix PIP, but don't kill the no-fault program

August 7, 2011
Gov. Rick Scott suggested late last month that it's time Florida scrapped its requirement that motorists carry personal-injury protection, which pays medical benefits for injuries suffered in automobile crashes no matter who's at fault.

The state would be better off if Scott instead worked with the Legislature to reform PIP, while keeping it mandatory. Making it optional or getting rid of PIP would likely cause more problems than it would solve.

That's not to say PIP hasn't been a headache, even after the Legislature passed a bill in 2007 intended to scale back abuses in the system. Lawmakers required that participating health care providers charge customary fees, which lawmakers said should prevent hospitals and clinics from charging exorbitant rates, which had caused auto insurers to increase premiums.

Lawmakers also gave prosecutors more resources to pursue questionable medical claims associated with staged accidents.

But PIP's problems have persisted or worsened. A report from Florida's chief financial officer, Jeff Atwater, indicated that the number of PIP claims jumped 40 percent since 2006, even though the number of traffic accidents in Florida fell by 33,000 between 2005 and 2009.

Atwater also reported that questionable auto insurance claims rose in Florida by 34 percent from 2008 to 2010. The heightened claims, Atwater suggested, are causing insurers in many cases to double PIP premiums in hopes of covering their costs.

So, scrap PIP or make it optional? That, we've said, would only make things worse. For decades, PIP has limited auto accident lawsuits, which were choking courts and delaying payments to legitimate health-care providers. Rip up PIP and the courts will gridlock.

Remove the PIP requirement and motorists will pay substantially more for their health insurance, which increasingly would cover auto injuries. More deadbeats also will drive without insurance, forcing others to pay for their care after accidents.

Some auto insurers also would love to replace a diminished PIP system with one mandating more expensive — and more profitable — bodily-injury protection.

Better, then, to retain PIP but curb its excesses. Scott and legislators could make health providers that handle PIP claims part of a registry that subjects them to review and reprimand. They could limit the times some health providers and schemers try billing insurers to game the 2007 restrictions on fees they can charge.

Scott and legislators say they're all about fighting fraud. They should work to free PIP of it, not bury the state's flawed but worthy personal-injury-protection program.

Copyright © 2011, Orlando Sentinel




Ft. Lauderdale Chiropractor Dr. Troy Lomasky heads Coast Chiropractic of Wilton Manors, Florida. A graduate of the famed New York Chiropractic College, he specializes in quickly treating pain from a variety of conditions. Services include: Consultation, X-ray, spinal adjustments & massage therapy, physiotherapy, spinal decompression for disc problems; spinal and muscular rehabilitation. New patients, weekend & same-day appointments available. (954) 463-3036 or www.chiropractorwiltonmanors.com. On-call for emergencies 24 hours. Serving Broward, Miami-Dade and Palm Beach Counties.