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A
B
B
D
D
B
B
Representative
lewis,
representative
lockett
representative
mcpherson
president
in
the
room
representative
meredith
present
remotely
in
the
district
all
right.
Thank
you,
representative
roberts,
president
person,
representative
santoro,
representative
smith,
representative
stevenson,
president
in
the
room
representative,
upchurch
representative
westrom,
co-chair
carpenter,
co-chair
rollins
president
remotely.
Thank
you.
A
We
have
a
quorum
ready
to
do
business.
Appreciate
everybody.
First
item
we
need
to
discuss
or
have
some
acceptance
on
is
approval
of
the
september.
14Th
minutes
have
a
first
and
a
second
all
those
in
favor
signify
by
saying
aye
any
opposed.
The
minutes
are
approved
our
first
item
and
only
item
which
will
probably
require
our
time
here
today
is
pip
the
pip
reform
we've
talked
about
this
many
times.
A
We're
not
sure
if
there's
going
to
be
any
legislation
coming
up
on
this
this
session,
but
we
know
it's
an
important
topic
and
something
that
we
want
to
always
discuss
during
our
interim
time.
So
with
that
being
said,
I
know
we
have
mark
mark
tricia's
here.
We
have
a
whole
list
of
folks
that
are
late,
ready
to
discuss
so
mark.
Are
you
going
to
get
us
started
here?
If
you
want
to
bring
your
guests
to
the
table,
we
can
add
chairs.
A
G
Thank
you,
mr
chairman,
and
I
will
inform
my
fellow
speakers
up
here
that
the
microphones
have
a
little
on
button
there.
When
you
see
the
light
on
you're
transmitting
when
you
don't,
you
are
not
so,
but
do
appreciate
the
opportunity
to
appear
before
you.
I
thought
we
might
start
just
by
way
of
introduction
great
and
then
we'll
get
into
the
presentation
for
the
record.
I'm
mark
trish,
I'm
executive
director
of
insurance
institute
of
kentucky
and
iik
is
the
pnc
and
life
insurance
state
trade.
For
for
kentucky.
G
We
operate
only
in
kentucky
just
deal
with
kentucky
insurance
issues,
try
to
inform
legislators
and
the
general
public
on
those
issues.
D
D
I've
been
I'm
doing
seminars
on
no
fault
since
the
mid
80s
and
have
monitored
it
closely.
It's
actually
been
a
while,
since
I've
done
a
lot
of
practice
with
no
fault,
but
I
keep
up
with
it
and
I
do
want
to
digress
just
for
a
moment.
I've
got
a
young
associate
who
joined
us
this
year.
Who
was
very
excited
to
hear
I
was
going
to
be
here
and
he
said
he
was
going
to
quit.
If
I
did
not
convey
a
message,
robert
jenkins
says
hello.
G
F
Sorry,
my
name
is
john
bush.
I'm
an
attorney
in
louisville
with
the
firm
of
bush
and
osborne.
I've
been
a
practicing
attorney
in
in
the
commonwealth
of
kentucky
since
1978,
with
an
emphasis
on
insurance
defense
ever
since
about
2000
1999
to
2000.
E
Good
morning
my
name
is
owen,
castor,
I'm
the
kentucky
medical
claims
manager
for
progressive
insurance
company.
We
have
three
offices
in
kentucky
in
louisville,
lexington
and
bowling
green
and
I've
been
in
the
insurance
industry
really,
since
I
was
in
college
but
30
years,
plus
at
progressive
25
years
in
my
role
as
the
kentucky
medical
claims
manager.
G
Okay,
thank
you,
mr
chairman.
Oh
in
this
presentation,
what
we
hope
to
do,
as
chairman
indicated
we're
not
bringing
any
legislative
proposals
at
this
time,
but
you
know
given
the
fact
that
a
lot
of
members
are
new
to
this
committee,
many
new
to
the
general
assembly.
You
may
not
have
seen
as
much
on
these
issues.
We
just
thought
it
would
be
good
to
give
some
perspective
on
pip,
and
should
the
chairs
be
willing?
We
would
you
know
you
know,
plan
on.
G
You
know
also
giving
kind
of
part
two
of
this
in
november,
where
we
might
focus
more
on
some
of
the
you
know,
additionally,
on
the
problems
and,
more
specifically
on
fraud
issues,
but
for
now
we
want
to
give
a
little
bit
of
history
of
pip
nationally
and
in
kentucky,
give
a
national
perspective
and
then
talk
about
some
of
the
issues
with
pip
and
so
on,
and
so
without
further
ado
I'll
get
going
here.
So
the
first
question
is:
what
is
pip.
G
Probably
many
of
you
are
aware
that
you
have
it
sometimes
there's
a
kind
of
limited
awareness
of
it,
but
pip
is
something
that
must
be
included
in
your
auto
coverage.
Unless
it
is
specifically
rejected,
you
can
reject
it
and
it
is
optional
for
motorcycles,
and
what
I'm
talking
about
here
is
in
general
about
pip.
There
are
some
kentucky
specifics
we
don't
have
in
here.
I
don't
know
whether
other
states,
whether
motorcycles
are
optional,
but
you
know
here
in
kentucky.
It
is
what
pip
usually
covers.
G
G
Until
a
certain
threshold
is
met,
and
in
talking
about
a
couple
of
terms
here,
one
thing
we
talk
about
is
no
fault
states
versus
tort
states.
No
fault
states
sometimes
referred
to
as
pip
states.
Tort
states
can
be
referred
to
as
fault
states
or
at
fault
states
a
no-fault
state.
G
Of
course,
no
provision
for
no
fault
recovery
either,
and
I
mentioned
pip
thresholds.
There
are
two
kinds
of
thresholds:
monetary
threshold,
which
is
a
specified
dollar
amount
in
kentucky.
That's
one
thousand
dollars,
so
you
can't
you
know
once
your
medical
bills
hit
one
thousand,
then
you
would
be
free
to
go
ahead
and
institute
suit.
If
you're
covered
by
pip,
unless
you're
a
pip
rejecter,
then
you
can
do
it
from
dollar
one.
G
Then
the
presence
of
a
serious
injury
as
defined
in
statute
in
that
state,
disfigurement
or
death
resulting
from
a
crash,
would
trigger
you
know
the
ability
to
do
a
lawsuit
when
has
pip
been
enacted
in
various
states
around
the
country.
These
are
all
the
pip
states
here
or
no
fault
states.
G
However,
you
might
notice
that
pennsylvania
enacted
it
in
74
repealed
it
in
84
and
then
reenacted
it
in
1990
and
so
for
any
state
that
has
enacted
pip
for
the
first
time,
then
all
the
that
has
not
happened
since
january
1st
1976
kentucky
was
actually
the
next
to
last
state
to
enact
pip
as
a
first
time
enactor
and
that
went
into
I
was
passed.
I
think
in
the
74
session
went
into
effect
july.
1St
75.
G
florida
is
kind
of
a
special
case,
probably
a
good
way
to
describe
them
as
an
on-again
off-again
state.
They
passed
it
initially
in
1972
repealed
it
temporarily
in
2007
and
then
reenacted
it
in
2008.
Some
of
you
may
have
read.
There
was
recently
legislation
there
that
would
have
repealed
pip
actually
this
year,
but
that
was
vetoed
by
the
governor
and
since
we're
talking
about
repeal
these
are
the
states
that
have
repealed
pip
and
you
can
see
pennsylvania's
listed
there,
even
though
they
reenacted
it.
G
I
didn't
put
florida
in
because
there
are
probably
too
many
to
mention
for
how
much
they've
repealed
it.
This
is
a
pictorial,
representation
or
graphic
graphical
representation
of
the
pip
states.
The
states
in
blue
here
are
tort
states
or
at
fault
states.
The
states
in
the
varying
shades
of
purple
are
the
pip
states,
and
the
verbal
threshold
are
in
the
darker
purple
and
the
monetary
threshold
are
in
the
lighter
purple.
You
can
see.
G
Kentucky
is
a
monetary
threshold
state
and
you
will
also
notice
that,
out
of
all
the
pip
states,
none
of
the
surrounding
states
of
kentucky
are
pip
states.
The
closest
pip
states
to
us
look
like
michigan,
pennsylvania
and
florida,
so
we
are
kind
of
in
a
island
of
fault
states,
and
then
I
mentioned
before
that
it
is
possible
to
reject
pip
and
so,
in
other
words,
in
kentucky
and
a
couple
other
states.
There
is
a
choice
on
whether
you're
covered
by
pip
or
by
a
fault
system
in
kentucky
and
new
jersey
you're.
G
G
D
Thank
you.
First
of
all,
I
think
some
of
you
may
be
interested
to
know
that
I,
while
I
am
an
attorney-
and
I
practice
civil
cases
on
the
defense
side,
often
for
insurers
and
representatives-
I'm
not
here
as
a
retained
attorney
for
the
insurance
institute,
I'm
a
member
now
a
little
counter
disclosure.
I
have
been
reimbursed
for
work
done
on
some
amicus
briefs
with
the
supreme
court,
but
I'm
not
generally
an
attorney
for
irk,
so
I
think
that
makes
a
little
bit
of
a
difference.
D
What
it
really
reflects
is
that
I
have
no
life,
so
I
get
interested
in
things
like
this,
but
one
thing
that
I
think
it's
important
to
understand
is
that,
while
everybody
sitting
here
has
issues
with
the
way
no
fault
is
now,
I
think
it's
important
to
understand
that
it
was
actually
a
very
from,
and
I
wasn't
there
in
1975.
D
D
Bipartisan
is
not
correct,
because
there's
multiple
there's
more
than
just
two
interests:
it's
not
really
a
republican
democrat
thing.
It's
really
various
people
that
are
involved
with
auto
insurance
and
so
forth
got
together
and
worked
out
compromise
as
best
they
could
in
a
number
of
issues,
borrowing
heavily.
I
understand
it
from
the
florida
statute
and
but
but
all
that
had
to
be
modified
because
kentucky
has
section
54
of
the
constitution.
That
says
the
legislature
can't
eliminate
tort
liability.
D
So
there
was
a
as
I
understand
it,
there's
a
lot
of
last-minute
cutting
and
pasting
that
led
to
some
irregularities.
The
very
first
case
that
discussed
no
fault
1976,
I
believe,
was
fan
versus
mcguffey
and
the
threshold
question
is
because
the
language
was
pasted
from
florida.
D
Well,
we
all
know
that
the
legislature
can't
do
that,
because
the
constitution
says
there's
got
to
be
wrongful
death
claims,
and
that
was
the
first
step
where
the
court
filled
in
gaps
and
they
may
have
whether
they
were
right
or
wrong
about
some
of
the
other
issues.
It's
all
based
on
consent
and
that's
all
subject
to
peculiar
peculiarities,
kentucky
law,
but
any
of
it.
It's
a
trade-off
between
various
interests
and
it's
a
little
bit
like
workers
comp.
In
that
sense,
the
idea
is
that
we're
going
to
do
away
with
frivolous
claims.
D
Small
claims
claims
that
really
shouldn't
be
in
court,
which
generate
nothing
but
defense
costs
and
raise
premiums
and
in
exchange,
the
injured
person
is
going
to
receive
these
benefits
without
regard
to
fault.
That's
really.
The
bottom
line
trade-off
that
was
involved,
and
one
of
the
fundamental
problems
now
is
there's
only
half
of
that
is
still
in
play
for
reasons
we'll
talk
about.
D
So
its
whole
purpose
has
kind
of
shifted
and
that's
created
some
of
the
problems
that
we
see
the
the
way
the
legislature
established.
The
the
doing
away
with
small
claims
was
they
set
up
thresholds
and
mark
just
talked
about
monetary
and
verbal
we've
really
got
both
thousand
dollars
of
medicals
in
in
1975.
D
When
it
comes
to
a
thousand
dollars
of
medicals,
that
was
a
lot
of
medicals,
the
first
commercially
available
cat
scan
was
1972..
D
D
D
D
That
sort
of
thing
death
was,
I
think,
everybody
agreed
was
a
serious
injury
except
for
the
little
mistake
about
leaving
it
out
of
the
not
abolished
section
in
o-6-0,
but
disfigurement
was
one
and
and
the
legislature
intended
serious
disfigurement,
and
the
supreme
court,
though,
decided
that
it
was
sufficient
disfigurement.
If
you
had
a
small
scar,
only
visible
with
a
mic
with
a
magnifying
glass
and
that
basically
busted
the
threshold
until
later,
the
all
the
the
scan
the
technology
became
available
and
more
commonly
used.
D
We
didn't
really
have
the
physical
therapy
existed,
but
it
wasn't
used
the
way
it
is
now
it.
My
memory
is:
is
that
the
common
treatment
for
like
back
problems
was
bed
rest
and
now
they
it's
the
opposite
exercise
and
so
forth.
There's
been
a
lot
of
evolution
just
as
an
example
of
how
much
this
has
changed.
I'm
sure
all
of
you
have
had
a
pulse
oximeter
on
your
finger
that
they
took
off
and
they
threw
away
if
you
haven't
you're
lucky
when
I
was
a
young
pup.
D
My
the
fellow
that
hired
me
represented
a
major
hospital
kentucky
hospital
and
I
distinctly
remember
this
case
where
they
were
suing,
because
this
hospital
only
had
two
pulse
oximeters
that
were
so
expensive
and
they
didn't
have
enough.
They
had
three
peop
three
women
in
maternity
and
they
could
only
use
two
pulse
examiners
and
they
were
blaming
blaming
that.
This
is
something
that's
now
disposable,
that's
how
much
things
have
changed
and
prices
have
been
impacted
by
all
that
too.
But
you,
of
course
you
get
treatment
for
it.
D
Now
the
coverage
minimum
is
ten
thousand
dollars.
So,
if
you
don't
reject
pip,
you
get
ten
thousand
dollars
of
basic
reparation
benefits.
Another
little
amusing
thing
about
the
courts
is
you'll
find
lots
of
opinions
that
refer
to
it
as
pip.
We
all
refer
to
it
as
pet
personal
injury
protection.
D
D
If
you
look
at
the
list
of
purposes
for
the
original
enactment-
and
this
is
the
source
of
a
lot
of
the
confusion
with
the
courts-
everybody
put
their
interests
in
there,
so
there
you've
got
a
long
list
of
purposes
for
the
act
that
represent
actually
conflict
with
each
other
one
set
of
purposes
prompt
payment
of
medical
bills,
one
so
purposes
is
to
do
away
with
frivolous
cl
and
small
claims.
D
Another
purpose
is
to
to
take
the
burden
off
the
injured
person
to
get
medical
bills
paid
without
a
lot
of
dispute
as
part
of
that
the
legislature,
I'm
so
sorry.
D
G
A
D
So
the
the
legislature
set
up
a
presumption
that
bills
would
be
considered
reasonable
and
we'll
talk
about
that
in
a
minute
about
how
that's
gone
awry,
but
they
set
up
penalties
for
slow
pay
and
the
penalties
are
basically
an
extra
interest.
If
it's
just
delayed
without
a
reasonable
foundation,
it
you
get.
Also,
you
can
get
attorneys
fees
and
a
higher
interest
rate
that
eliminated
what
we
refer
to
in
other
tort
contexts
as
extracontractual
or
bad
faith
claims.
They
don't
apply
to
no
fault.
It's
got
a
vexation
type
statute.
D
I'm
probably
taking
more
time
than
I
was
supposed
to,
but
so
it
was
very
effective.
Initially.
D
I
remember
as
a
young
pup
talking
to
older
lawyers
like
oscar
gerald's,
guys
that
did
almost
nothing
but
auto
and
he
was
a
master
he
could
win,
he
could
win
rear
end
cases
he
he
thrived,
trying
auto
cases,
and
particularly
in
fayette
county,
but
also
surrounding
counties,
but
there
were
plaintiffs
lawyers
who
were
heavily
invested
in
auto,
and
there
were
defense
lawyers
who
were
heavily
invested
in
auto
that
you
would
hear
talking
at
the
family
affair
or
in
the
courthouse
about
how
they
were
afraid
they
were
going
to
go
out
of
business.
D
That's
how
effective
the
threshold
was
initially
and
a
lot
of
the
early
cases
are
cases
where
the
court's
trying
desperately
to
allow
somebody
to
bring
a
claim
where
they
testified.
I
didn't
get
a
rejection
form,
they
said.
Well,
you
can
bring
the
claim,
no
matter
how
small
it
is,
and
so
the
courts
were
a
little
bit
resistant
about
enforcing
that
part,
while
they
were
very
lenient
in
enforcing
the
benefits
portion.
D
But
in
my
seminar
a
lot
of
plaintiff's
attorneys
come
to
the
seminar.
I
don't
really
do
it
anymore,
but
I
always
like
to
tell
them.
I
says
if
you've
got
a
case
and
you
cannot
find
a
thousand
dollars
of
medical
bills,
then
you
should
put
your
eno
carrier
on
notice,
because
one
trip
to
the
er
will
do
that
and
they'll
laugh
and
and
and
it's
true
it
really.
There
is
no
threshold
at
this
point,
so
half
of
the
deal
is
gone
now.
D
This
is
the
the
the
setup
on
how
medical
expenses
are
handled
has
generated
a
number
of
problems
with
respect
to
how
some
medical
providers
handle
these
claims
and
and
and
john's,
probably
going
to
say
a
little
bit
more
about
this
and
there's
probably
differences
of
opinion
about
some
of
it.
But
the
reality
is:
is
that
it's
with
it
set
up
so
that
you
can't
challenge?
You
really
can't
challenge
bills,
it's
the
last
bastion
of
what
we
refer
to
as
retail,
but
I
always
think
of
it
as
leonard
cox
prices.
D
I
don't
know
if
those
of
you
are
familiar
with
1980s
lexington,
but
leonard
cox
was
a
clothier
who
would
have
bi-weekly
bankruptcy
litigation
sales
and
with
50
60
off
it
was
still
25,
30
percent
higher
than
any
suit.
You
could
buy
anywhere
else.
So
what
I
call
retail
price,
what
we
call
retail
prices
are
really
just
prices.
Nobody
pays,
except
for
a
pip
insurer
and
that
that's
at
the
heart
of
a
lot
of
the
problems.
D
I
think
that
it's
important
to
realize-
and
I
understand
how
that
can
be
beneficial
for
providers,
and
I
understand
that
the
various
federal
statutes
that
have
been
enacted,
along
with
the
the
incredible
bargaining
power
of
large
health,
insurers,
hospitals,
doctors,
clinics,
they're,
all
starving
for
cash,
to
cover
the
fact
that
they're
not
really
being
paid
properly
on
these
other
programs
and
that's
a
that
started
out
as
a
balloon
and
the
medicare
squeezed
the
balloon.
What
popped
out
everywhere
else?
D
Well,
then,
the
healthcare
providers
came
in
and
they
squeezed
the
balloon
a
little
bit
and
now
you've
just
got
this
little
bubble.
That's
no
fault!
Even
uninsured
people
don't
pay
the
retail
amount,
they
negotiate
it
down.
Unless
they
just
have
a
lot
of
money,
they
may
pay
it,
and-
and
so
there's
a
certain
unfairness
to
why
no
fault
is
put
in
that
position.
But
I
want
to
point
out
that
this
really
hurts
the
injured
person,
the
beneficiary
and
I'll.
D
So
it
actually
works
against
the
injured
person
and
really
doesn't
benefit
the
plaintiff's
bar.
As
far
as
I
can
tell
I'm
not
an
expert
on
the
plaintiff's
bar,
but
so
that's
something
that
really
needs
to
be
either
eliminated
or
addressed
in
some
way.
D
The
court
has
really
created
a
lot
of
the
problems
that
we
have,
and
I
want
to
try
to
do.
Tell
me
if
I'm
running
I'm
running
too
long,
but
because
I
get
to
talk,
and
I
can't
stop
the.
As
I
mentioned
before,
the
legislature
set
up
a
presumption
of
reasonableness
in
kentucky.
D
The
law
is
pretty
well
settled
that
a
presumption
is
gets
you
to
the
burden
of
proof.
In
other
words,
it
shifts
the
burden
of
proof
to
the
other
side,
but
once
the
other
side
has
some
proof,
the
presumption
disappears
and
then
the
other
side
has
to
come
in
and
rebut
whatever
rebutted
the
presumption.
D
D
This
is
proof
that
it's
reasonable,
which
is
rather
circular,
and
that
causes
it
to
be
when
you
combine
that
with
case
cases
that
make
it
very
difficult
to
challenge
or
to
investigate
medical
expenses,
no
matter
how
suspicious
they
are,
it
makes
basically
gives
a
free
pass
to
the
providers,
and
I
want
to
emphasize
some
abuse
that-
and
this
is
particularly
true
in
louisville-
and
I
think
with
at
at
this
point.
D
I
would
point
out
that
that
I,
I
think,
the
the
the
the
the
way
that
medical
bills
are
handled
also
and
probably
increases
premiums,
but
I'm
not
an
insurance
person.
I'm
a
lawyer
so
but
but
this
has
led
to
certain
different
kinds
of
fraud
and
I'm
going
to
defer
this
point
to
john
bush,
who's
kind
of
specializes
in
fraud
cases
for
insurers
and
to
kind
of
elaborate
on
how
these
issues
have
have
been
a
problem,
particularly
in
louisville.
F
Thank
you
ron.
As
I
mentioned,
I've
been
a
practicing
attorney
in
the
commonwealth
since
1978..
F
F
I
am
a
member
of
the
iik,
but
I
do
not
represent
the
ik,
not
an
attorney
for
them,
but
but
I've
they've
been
kind
enough
to
ask
me
to
come
and
and
hopefully
offer
a
few
things
of
interest
today
on
the
issue
of
pip
and
in
particular,
as
as
it
has
become
pip
fraud
in
too
many
cases,
as
ron
mentioned,
when
pip
was
first
adopted
in
1975,
it
was
a
great
idea
and
the
intentions
were
really
really
good,
but
unfortunately,
because
it
is
now
the
last
bastion
of
where
the
a
medical
provider
can
get
paid,
basically
a
hundred
cents
on
the
dollar
of
their
bill.
F
So
it's
important
that
you
all
understand
what
the
economic
incentive
is
for
people
to
to
abuse
this
system
and
part
of
that.
That
has
become
exacerbated
by
the
fact
that
we've
now
had
some
decisions
by
the
courts
that
have
taken
away
the
the
tools
that
the
industry
came
up
with.
To
try
to
be
able
to
investigate
and
to
challenge
these
claims
short
of
actually
having
to
have
an
ime,
an
independent
medical
exam
done.
Okay,
the
statute
provides
for
an
independent
medical
exam
to
be
done
when
you
can
show
quote
good
cause
good
cause.
F
These
days
is
done
mostly
by
getting
a
chart.
What's
called
a
chart
review
or
a
paper
review
done.
I
think
the
statute
uses
the
word
peer
review,
but
that's
not
really
that
peer
review
is
a
term.
That
means
something
else
in
the
in
the
medical
industry
really,
but
but
using
a
chart
review
to
show
that
that
there's
a
need
for
an
independent
medical
exam
to
be
done,
but
short
of
that
there's
no
other
way
really
for
us
for
the
insurance
industry
to
be
able
to
investigate
questionable
claims.
F
At
this
point,
we
used
to
try
to
use
the
chart
reviews
as
ways
to
shift
that
burden,
and
things
like
that
and
the
court
has
taken
that
away
so
when,
when
there's
little
opportunity
realistically
without
going
to
it's
tremendous
expense,
to
have
an
ime
done
to
you
know
when
those
other
opportunities
to
investigate
and
defend
against,
questionable
claims
have
been
taken
away.
You
have
that,
plus
you
now
have
a
system.
That's
set
up
that
there's!
No
there's
no
governance
on
it.
F
The
only
governance
in
the
pip
statute
on
medical
charges
is,
they
are
supposed
to
be
quote
reasonable,
but
nowhere
in
the
statute
is
reasonable
defined
and
it's
in
the
the
net
effect
is
realistically.
Today,
a
provider
can
bill
almost
anything
that
he
she
or
it
wants
to
build,
and
it's
going
to
be
covered
by
pip.
Okay.
F
For
somebody
you
know
reasonable
amount
at
least
initially,
and
by
the
way,
not
only
is
there
the
ten
thousand
dollars
of
basic
reparations
benefits
or
brbs.
The
statute
also
provides
for
you
can
buy
additional
layers
of
benefits,
reparations
benefits
that
are
called
additional
reparations
benefits
or
additional
arbs
or
additional
pip.
You
can
buy
them
in
ten
thousand
dollar
increments.
F
For
a
total,
I
believe
it's
either
total
of.
I
think
you
could
add
four
more
layers
for
a
total
of
fifty.
It
may
be
off,
it
might
be
60,
but
you
can
you
can
you
know,
ask
your
insurance
agent
they'll
be
glad
to
sell
you
an
additional
layer
of
it,
but
up
to
40
or
50
000
total,
but
most
people,
the
vast
majority
people
just
have
the
arb
or
the
the
brbs
of
the
basic
pip
that
is
provided
when
you
get
when
you
get
your
policy.
F
So
what
what
the
system
right
now,
though,
is
doing
is
it
has
enabled
the
unscrupulous
medical
providers
to
get
together
with
personal
injury
attorneys
and
again,
I'm
talking
about
a
relative
few
in
both
professions,
but
to
allow
them
to
get
together
to
use
this
system
to
game
the
system?
Where
did
this?
First
start?
This
really
didn't
start
in
kentucky.
F
So
back
when
I
first
started
getting
heavily
involved
with
pip
and
pip
investigations,
it
was
1999
or
2000.,
and
I
had
a
major
carrier
made
in
the
state
came
to
me
and
said:
is
there
anything
we
can
do
about
pip,
I'm
being
told
by
other
attorneys?
It's
like
workers.
Comp
just
have
to
see
the
claim,
pay
the
claim
whatever
and
I
said.
No.
I
don't
think
that's
right,
but
I
said
we
need
to
set
up.
F
You
know
to
do
things
properly
and
in
a
fair
way,
which
is
what
we
tried
to
do
with
the
charter
viewing
and
things
like
that,
and
some
of
the
other
tools
that
have
now
been
taken
away.
But
what
we
saw
happening
at
that
time
was
a
lot
of
the
pip
fraud
that
is
taking
place
in
this
state
was
imported.
Okay,
it
was
exported
primarily
from
florida.
We
had
a
statute
initially
if
you
were
to
go
back
to
the
to
the
beginning
of
our
statute
in
75,
and
I'm
not
sure
when
the
florida
statute
was
passed.
D
F
F
They
didn't
work
there
despite
the
best
of
intentions
and
they
all
but
did
away
with
pip
this
last
time,
if
the
governor
hadn't
decided
for
what,
whatever
reason
to
veto
the
bill,
that
we
would
have
that
florida
would
no
longer
be
a
pip
state
today,
but
so
they've
tried
some
major
reforms
down
there.
F
It
hasn't
worked
because
they've
been
addressing
some
of
these
same
issues,
but
what
happened
down
there
is
an
industry
developed
of
a
fraud
for
it
to
buy
down
there
and
the
and
then
once
some
of
the
florida
people
down
there
got
the
bright
idea.
Well,
kentucky's
a
pip
state
they're
like
florida
used
to
be,
let's
go
up
there,
and
so
they
exported
some
of
that
fraud.
F
Here
it
first
started
in
eastern
kentucky
with
one
medical
provider
who
I
will
not
name,
but
I
know
the
name
I'll
tell
you
later,
I'm
not
going
to
mention
it
here
in
public,
but
you
came
to
eastern
kentucky
and
started
bringing
in
mobile
diagnostics.
Okay,
he
was,
they
were
bringing
in
equipment
with
techs.
You
know
not
physicians,
but
text
providing
you
know
doing
in
nerve,
conduction,
velocity
studies
and
emgs
and
engs,
and
then
they
began
to
come
in
with
mobile
mri
units
and
that
type
of
thing
and
they
were
charging
exorbitant
amounts.
F
Okay
and
then
then
next
thing
you
know
here
come
the
other,
the
other
unscrupulous
medical
providers
from
florida
started
coming
in
then
the
law
firms
in
florida
who
were
engaged.
You
know
who
were
involved
with
those
people.
They
started
opening
up
offices
in
particular
in
louisville,
and
and
so
they
just
became
kind
of
an
extension
of
their
their
fraud
departments.
Where
you
want
to
call
their
fraud
units
in
florida
came
up
here
and
then
we
had
some.
You
know
non-floridians
some
of
our
you
know,
fellow
citizens
who
decided
gee.
F
F
So
what's
the
what's
the
benefit,
then,
on
the
legal
side
of
this
on
the
legal
professions
side,
the
benefit
is
the
key
to
any
personal
injury
case.
The
key
to
it
almost
always
is
your
medical
specials,
because
you
can
talk
about
pain
and
suffering
to
a
jury,
and
you
can
try
to
get
an
injury,
a
jury
excited
about
that
or
not,
but
that's
that's
kind
of
amorphous.
We
got
medical
bills
here.
These
came
from
a
physician.
These
came
from
some
kind
of
a
health
care
provider
here,
ladies
and
gentlemen,
the
jury.
F
Well,
if
the
proper
amounts
have
been
able
to
be
charged
that
the
proper
medical
services
have
been
able
to
be
charged
and
only
those
charges
only
those
performed,
you
know
the
clearly
the
amount
of
the
medicals
that
there
that
is
used
as
the
basis
for
a
claim
to
try
to
settle
it
or
try
to
get
a
ver
jury
verdict
is
less
and
therefore
the
verdicts
would
almost
assuredly
be
less.
So
what
happens
is
not
only
are
these
benefits
expended
and
expended
many
of
them
improperly
and
they
use
up.
F
You
know
in
the
old
days
before
the
affordable
care
act,
what
they
did
was
they
used
the
only
medical
benefits
that
a
lot
of
people
had
available
to
them.
Okay
and
they
consumed
them
wrongly,
and
they
were
these
people
weren't
really
looking
out
for
the
citizens
of
this
state
and
further
even
for
their
clients
or
their
patients.
But
then
again,
I'm
talking
about
a
relatively
few
in
both
professions,
but
they
all
they
wanted
to
do
is
get
that.
F
F
Whichever
way
it
worked
was
willing
to
go
along
because
it
increased
the
medical
specials
that
they
could
use,
then
to
try
to
negotiate
a
higher
settlement
than
otherwise
would
have
been
owed
or
to
try
to
convince
a
jury
to
pay
more
on
a
claim
than
than
they
otherwise
would
have
been
able
to
do
so.
F
Those
are
some
of
the
problems,
and
it's
in
in
louisville,
where
I
I
am
it's,
it
is
rampant.
I
think
you
all
are
going
to
hear
from
somebody
from
nicb,
maybe
next
month
or
the
month
after,
I'm
not
sure
which
a
fellow
named
tim
lynch
who
is
very
familiar
with
all
these
problems
I
mean
nationally,
but
especially
in
kentucky,
and
I'm
not
sure
if
louisville
still
holds
the
number
one
spot
for
for
pip
fraud
in
the
in
the
the
country.
F
But
if
not,
I
can
guarantee
you
we're
number
two
probably,
and
so
we
have
a
huge,
huge,
huge
problem
of
this.
We
have.
We
have
had
lots
of
cases
where
there
have
been.
You
know,
car
accidents
that
have
been
staged,
things
like
that,
and
then
they
jump
on
the
pip
and
they
use
the
pip
to
try
to
you
know
ramp
it
up
in
the
manner
that
I've
talked
about.
F
At
this
point
it
is,
it
has
unintentionally,
created
the
catalyst
for
the
unscrupulous
medical
provider
to
get
together
with
an
attorney
to
try
to
use
that
to
their
advantage,
but
at
the
to
the
additional
cost
of
the
the
com,
the
citizens
of
this
commonwealth-
and
this
doesn't
just
result
in
additional
pip
premiums
being
incurred,
because
when
they
use
that
money,
then
to
try
to
extract
a
higher
settlement
or
a
higher
verdict
that
comes
out
the
liability,
coverages.
Okay,
so
you're
going
to
be
paying
more
in
liability.
F
Coverages
on
your
claims,
then
you're
going
to
have
to
as
a
carrier
you're
going
to
have
to
figure
that
into
your
rates,
which
is
going
to
increase
the
cost
of
the
liability
coverages
as
well
as
the
pip
coverages.
So
those
are
some
of
the
types
of
problems
that
that
I
have
seen
in
my
practice
that
I
know
are
out
there
and
while,
while
my
practice
at
this
point
is
focused
more
on
louisville
than
other
parts
of
the
state,
I
know
that
this
occurs
in
other
parts
of
the
state
as
well.
F
D
The
consuming
the
10
000
pip
there's
another
way
that
this,
I
think,
injures
claimants.
D
But
but
it's
perfectly
you
know
legal
as
far
as
best
I
can
tell
is
that
if
you
have
somebody
who's
entitled
to
pip,
but
don't
have
health
insurance,
the
the
pip
becomes
a
draw
to
get
them
into
that
clinic
or
service.
D
They
enter
into
what's
called
a
letter
of
protection,
and
this
is
a
deal
where
the
it's
a
little
bit
like
the
loan
services.
D
D
They
would
argue
that
well,
but
without
this
letter
of
protection
they
can't
get
this
treatment
and
it
is
a
little
bit
unfair
to
ask
the
attorneys
to
make
judgments
about
whether
they
need
a
surgery,
although
I
think
a
lot
of
times
attorneys
at
least
feel
like.
They
know
that
it's
really
not
necessary,
but
but
it
creates
an
incentive
and
I'm
a
big
believer
in
incentives
and
disincentives
and
the
real
problem.
D
If
you
want
to
overarch
it
is
the
the
pip,
the
pip,
the
this
no
fault
statutes
have
evolved
into
a
big
set
of
bad
incentives,
and
people
are
responding
to
those
there's
dishonesty
also,
but
some
of
it's
just
responding
to
the
incentives
that
are
in
the
act
and
with
that,
since
I
wasn't
supposed
to
say
anything
more,
I'm
just
going
to
shut
up.
F
I'm
sorry
just
one
more
thing:
if
you
don't
want,
if
you
don't
believe
that
this
happens
as
you're
driving
into
your
community,
I
don't
care
how
large
it
is,
or
almost
how
small
it
is.
Take
a
look
at
the
signs
for
the
health
care
providers
who
are
out
there
providing
personal
injury
types
of
services.
F
You
will
see
on
almost
all
of
them
their
their
advertising,
auto
injury.
We
will
treat
auto
injury
patients,
okay
and
they
they
want
that
business
because
they
they
made
the
sign,
may
say
other
things,
but
usually
that
auto
injury
thing
the
signage
will
be
a
little
larger
than
the
others.
It's
prominent.
They
want
that
business,
because
this
is
the
only
place
they
can
get
paid
a
hundred
cents
or
close
to
100
cents
on
the
dollar.
That's
an
incentive
that
shouldn't
be
there
for
the
reasons
I've
discussed
it.
Thank
you
for
letting
me
add
that.
A
A
E
Morning,
time
go
ahead,
I
I
won't.
I
won't
need
a
tremendous
amount
of
time
you
see
on
the
on.
The
screen
here
has
pip
out
lived
at
truthfulness
in
kentucky
and
that's
kind
of
an
existential
question,
but
it's
a
question
worth
having,
because
literally
every
state
has
a
culture
of
how
they
do
auto
accidents.
Every
state
in
the
united
states
has
a
unique
way
that
they
deal
with
the
misfortune
of
someone
having
an
auto
accident,
particularly
if
you're,
injured
kentucky
is
very
unique
in
how
we
deal
with
that
through
our
our
motor
vehicle
reparations
act.
E
And
it's
telling
that,
as
you
saw
in
previous
slides,
that
no
state
has
adopted
a
no-fault
scheme
for
over
30
years,
several
states
have
repealed
the
no
fault
law
or
schemes
that
they
have
in
their
states,
but
several
states
still
have
it
and
it's
woven
into
kind
of
the
culture
of
our
state
and
these
other
states
of
how
they
do
auto
accidents
and
as
far
as
its
usefulness
is
concerned,
it
kind
of
depends
on
where
you're
sitting.
If,
if
you're
the
injured
person
in
an
auto
accident,
wondering
you
know
how
do
I
get
treatment?
E
What
do
I
do
chances?
Are
you
have
health
insurance,
but
if
you
don't
you're
awfully
glad
that
you
have
this
pip
coverage,
you
know
or
if
you're
the
injured
party,
the
injured
person
and
you
have
all
these
bills
and
you
need
to
keep
a
little
income
coming
in
the
law,
allows
you
to
keep
an
income
stream
coming
in.
You
can
reserve
your
benefits
for
things
that
you
need
it
for
so,
in
that
aspect,
pip
can
be
a
very
useful
coverage.
E
If
you're
a
provider,
some
providers
don't
get
paid
very
much
from
health
insurance
if
you're
a
chiropractor,
for
example,
or
a
physical
therapist,
you
may
be
very
limited
in
what
you
can
collect
from
a
person's
health
insurance
company
pip.
On
the
other
hand,
as
you've
heard,
it
will
pay,
it
will
pay
promptly
and
it
will
pay
basically
whatever
it's
billed.
That's
part
of
the
problem,
because
that
can
be
easily
taken
advantage
of,
as
you
can
probably
imagine,
that's
not
what
I
think
the
legislature
intended
it
to
turn
into.
E
E
The
burden
of
proof
is
basically
on
the
pip
provider
to
show
that
what
it's
paying
is
is
reasonable,
that
we
can
deal
with
that
as
well.
It's
turned
into
something
quite
different.
Now,
though,
where,
basically
anything
that's
built
as
ron
was
talking
about,
you
have
to
pay
it.
Your
only
recourse
if
that
bill
is
outrageous,
is
to
try
to
negotiate
with
the
provider.
Well,
they
don't
have
any
real
incentive
in
many
cases
to
want
to
negotiate.
E
E
E
So
again,
it
kind
of
depends
on
on
what
side
of
the
of
the
situation
you're
in
it
can
be
useful.
At
times
it
can
be
problematic
on
a
grander
scheme.
You
know
people
move
to
kentucky
and
they're
like.
Why
are
my
insurance
rates
so
high?
They
don't?
They
were
surrounded,
as
you
saw
on
the
map
a
little
while
ago
by
states
that
don't
have
this
coverage,
so
insurance
tends
to
be
a
little
more
expensive
here.
Is
that
a
good
or
a
bad
thing?
E
Well,
the
citizens
of
kentucky
have
to
decide
that
the
legislature
has
to
decide
that
again.
This
is
part
of
the
culture
of
how
we
do
insurance
and
how
we
do
auto
accidents
in
kentucky,
but
the
coverage
is
difficult
to
sort
of
manage,
there's
really
no
tools
to
manage
it,
and
now,
with
some
of
the
recent
case
law,
you
know
you
get
a
bill
you're
charged
with
paying
it,
you
better,
pay
it
properly
or
you're,
going
to
be
paying
12
or
18
interest
who
wouldn't
like
those
rates
today,
and
so
on
one
hand,
that's
good.
E
E
We
want
to
take
care
of
our
customers,
but
at
some
point
you
know
the
line
of
fairness
has
kind
of
gotten
very
far
afield
and-
and
it's
very
challenging
now
to
handle
these
claims
within
a
person's
limited
coverage
benefit
they
go
to
the
hospital
and
they
come
out
with
a
bill.
They
had
an
x-ray.
They
have
no
idea,
they
walked
out
with
a
fifteen
thousand
dollar
hospital.
E
That's
a
problem!
The
coverage
doesn't
even
come
close
to
taking
care
of
that.
So
you
know
in
from
that
aspect.
Pip
is,
is
not
as
efficient
as
it
could
be.
So
you
know
for
people
that
have
auto
accidents,
they
they
don't
even
know
they
have
this
coverage
a
lot
of
times.
E
They're
they're,
sometimes
very
pleasantly
surprised
to
find
that
they
have
a
coverage
that
will
help
pay
their
their
medical
bills,
and
so
you
know
we
helped
walk
them
through
the
process,
but
they're
also
disturbed
to
find
that
when
their
bills
start
coming
in
the
coverage
didn't
go
very
far.
E
E
E
Other
coverages
are
offered
by
insurance
carriers
medpay,
for
example,
you
can
buy
a
coverage
that
would
help
supplement
your
your
coverage,
your
health
insurance,
if,
if
you
want
it
to
help
pay
the
deductible
or
co-pays
and
that
sort
of
thing,
so
that's
that's
available
in
kentucky
as
well.
Most
insurance
carriers
sell
that
coverage
as
well
as
pip,
which
is
a
mandatory
coverage
and
our
culture
in
kentucky
is
we
want
you
to
have
this
coverage
consumer?
E
E
So
we
we're
here
just
want
to
have
the
conversation,
maybe
get
some
thoughts
and
ideas
on
either.
Is
this
coverage
worth
keeping
and
if
it
is,
what
can
we
do
to
make
it
reasonable
for
everyone?
You
know
the
consumer,
the
provider
and
the
insurance
carrier
alike.
A
C
You,
mr
chairman,
and
thank
you
all
for
this
topic,
so
I'm
pretty
familiar
with
this.
Obviously
a
lot
of
the
issues.
I
think
I
know
the
group
that
you're
probably
going
to
be
you
didn't
mention
by
name,
but
I
think
I
know
who
you're
talking
about
it's
kind
of
a
well-known
group
that
having
done
primary
care
work,
I
know
it
was
easy
for
a
lot
of
primary
care
doctors.
They
tend
to
go
to.
C
Pcp's
person
comes
in
with
an
accident,
they
have
complaints,
there's
all
kinds
of
paperwork
which
we're
already
up
to
here
as
primary
care.
Doctors,
these
guys
say:
hey,
we'll
manage
it
all
for
you.
You
refer
the
patients
there
and
they
manage
it.
All
patients
are
happy,
it's
managed.
Well,
they
get
better.
Everything
gets
improved,
but
when
I
find
out
later
there's
a
lot
of
other
issues
that
come
on
the
back
side
of
this.
This
to
me
sounds
like
surprise
billing.
C
Just
on
the
other
side,
now
it's
for
insurance
companies
instead
of
the
providers
or
patients
that
complain
about
it
and
it's
the
same
thing.
It's
an
out-of-network
provider.
That's
going
to
basically
say
is
what
we
get
the
way
the
law
defines
it.
They
can
do
that.
So
a
couple
of
questions
that
I've
got
one
is
we've
just
had
a
federal
law
passed.
We
know
on
surprise
billing
when
it
comes
to
medical
mal.
C
You
know
medical
insurance
and
that
sort
of
thing
and
kind
of
holding
the
patient
harmless
and
there's
a
negotiated
agreement
between
both
parties,
and
they
can
use
some
databases
to
determine
what
a
fair
cost
would
be.
Have
we
thought
about
using
that
same
kind
of
a
model
to
solve
this
problem
in
kentucky
and
the
second
one
would
be
we
thought
about
using?
I
can
all
players,
I
mean,
I
don't
think,
we've
developed
one
there's
been
some
discussion
about
getting
an
all-payers
database
set
up,
so
we
can
find
out
exactly
you
know.
C
It
helps
us
track
a
lot
of
disease
states,
but
also
helps
you
track
costs
as
far
as
what
an
average
cost
would
be.
That
might
help
bring
this
into
range.
If
we
thought
about
using
those
two
types
of
things
to
bring
these
costs
down,
to
make
it
where
it's
a
fair
reimbursement,
but
also
no
one's
getting
gouged.
C
Well,
can
you
clarify
yeah
so
and
out
of
network
billing?
What
we
had
proposed
in
this
state
before
for
several
years
we
couldn't
get
through,
but
eventually
almost
the
same
models
would
pass
on.
The
federal
side
is
that
if
you
have
a
you,
have
a
a
patient
goes
to
an
out-of-network
provider,
there's
no
contract
between
the
insurance
company
and
that
provider.
So
how
do
you
determine
what
they
pay?
They
say:
hey,
we
we
charge
thousand
bucks.
We
want
a
thousand
dollars.
We
want
retail
right.
C
We
don't
want
to
have
a
discounted
price,
which
is
what,
which
still
is
a
provider
bothers
me
that
we
can
charge
it
and
the
norm
is
to
get
paid
less
than
what
you
think
your
services
are
worth.
That's
a
discussion
for
another
day.
Basically,
we
want
to
charge
this
amount.
We
don't
have
a
negotiated
contract.
C
The
insurance
company
says
hey,
that's
too
high
of
a
cost.
You
know,
and
if
you're
not
we're
not
contracted
with
you
pass
it
on
to
the
patient.
The
patient
gets
stuck
with
a
thousand
dollar
bill.
That
says:
hey,
I,
you
know,
I
don't
know
what
I'm
doing
here.
I
have
to
pay
this
amount
and
they
get
stuff.
C
Well,
it
depends
on
who's
paying
if
you
get
in
a
car
wreck
and
it's
through
state
farm
it'll
be
three
thousand
bucks
because
that's
what
they
can
charge
for
the
retail
amount,
if
it's
through
aetna,
because
you
have
arthritis
or
a
meniscal,
tear
it's
twelve
hundred
dollars
if
yourself
pay
and
you're
paying
out
of
pocket.
Well,
we'll
do
it
for
five
500..
So
what's
the
cost
of
the
test,
it
just
depends
on
who's
paying
the
bill.
That's
part
of
the
problem
we
have.
This
is
the
high-end
one.
So
what
I'm
thinking
is?
C
Can
we
not
use
model
language?
We
have
for
surprise
billing.
We
use
for
medical
kind
of
insurance
and
negotiate
those
issues
to
protect
patients.
To
do
the
same
thing
here
so
make
sure
that
a
payer
isn't
getting
gouged
and
that
you
can
find
some
kind
of
a
middle
ground
there
to
provide
what
it's
really
worth.
G
Yeah-
and
we
have
I'll-
probably
defer
to
owen
on
this
since
he
does
this
every
day
all
day,
but
we
have
offered
legislation
in
the
past
that
would
have
used
the
workers
comp
fee
schedule
that
was
deemed
not
to
be
the
best
approach
by
a
number
of
providers.
I
think
especially
hospitals
had
issues
with
that.
Oh
essentially,
all
of
pip
is
pretty
much
non-networked,
but
owen,
do
you
want
to
address
some
of
that.
E
Thanks
and
senator
alvarez,
those
are
excellent
points
and
the
database
that
idea.
Actually
there
are
more
than
one
that
exist.
One
is
a
not-for-profit
database.
It's
called
fair
health,
it's
nationwide,
it's
very
robust
as
far
as
the
information
in
it
and
insurance
cares
were
actually
it's
available
to
anybody,
consumers,
insurers
and
they're,
pretty
granular,
and
that
you
can
get
down
into
geographic
areas
and
kind
of
see
the
differences
in
what
the
health
care
costs
are.
E
E
Make
some
sense.
You
know.
Certainly
we
understand.
Providers
need
to
be
able
to
to
charge
a
fair
amount.
They
get
squeezed
every
which
way.
So
you
know
it's
tough
on
them.
We
realize
that
it's
tough
on
the
industry
too,
to
get
bills
that
are
just
crazy
and
you
know,
what's
your
recourse.
The
problem
that's
happened
in
kentucky.
E
We
feel
like
we
have
good
data
to
show
that
vast
majority
of
providers
charge
that,
but
a
court
case
from
three
years
ago
basically
said
can't
do
that.
If
you
get
the
bill,
then
you
have
to
pay
it,
and
if
you
don't
like
what
was
charged,
then
your
recourse
is
to
either
call
them
up,
try
to
negotiate
with
them
or
you
can
sue
them.
Well,
we
don't
want
to
get
into
that.
We
can
avoid
that.
C
For
the
cost
of
cases,
it's
often
not
worth,
if
I
may,
mr
chairman,
not
worth
not
worth
the
cost
of
going
to
court.
But
again
this
is
the
same
discussion
we've
had
on
in
and
again
this
is
a
bill
I've
proposed.
I
would
encourage
you
all,
maybe
to
talk
to
some
of
your
other
partners
in
the
insurance
world
in
the
medical
side,
because
this
I
got
a
lot
of
resistance
on
this
concept
that
you're
saying
might
be
reasonable,
got
a
lot
of
resistance
from
the
health
care
insurers
saying
we
don't
want
that,
and
it
would.
C
I
think
it
would
have
been
a
good
middle
ground
so
and
I'm
probably
looking
at
filing
a
bill
to
create
an
all
payers
database.
So
we
can
have
something
to
base
this
off
of
to
help.
Do
some
of
these
things.
So
that's
why
I
was
wondering
fair
health
is
another
group
that
you're
right?
We
were
referencing
that
organization
in
one
of
our
bills,
to
try
to
say:
hey
we're
going
to
be
able
to
use.
C
Let
them
collect
the
data
they're
nonpartisan
they're,
not
political
they're,
just
there
to
present
information,
and
then
we
could
use
them
for
that
and
the
last
thing
I'll
mention.
Mr
chairman,
also,
I
know
you
you
mentioned
the
words
defensive
medicine,
which
obviously
for
me,
I
think,
whether
for
better
or
worse,
I'm
well
known
as
a
guy
who's
for
tort
reform
in
this
state
that
we
desperately
desperately
need.
I
think,
we're
number
two
in
lawsuits
per
capita
in
the
country
and
people
don't
realize
how
bad
of
a
situation
there
is
talk
to
our
bar
association.
C
It
doesn't
perceive
a
problem,
but
there's
significantly
one
there,
and
when
you
talk
about
providers
having
to
use
imaging
as
defensive
medicine,
I
can
tell
you:
that's
become
the
norm,
it's
not
where
you
use
your
judgment,
no
one
trusts
provider
judgment
to
say
I
don't
think
you
need
this
well,
you
might
be
wrong.
I
want
an
x-ray.
I
want
to
test.
That
is
never
wrong.
They
think,
although
it
can
be,
but
they
want
that
because
that's
we're
going
to
use
and
our
attorneys
push
that
as
well.
C
That
is
the
crux
of
a
lot
of
these
things.
Also
is
people
saying
I'm
going
to
do
this?
Just
it's
a
cheaper
insurance
for
me
than
having
to
pay
higher
malpractice
insurance
premiums
for
a
lot
of
our
providers,
and
so
that's
a
problem
that
needs
to
be
fixed
in
our
state
as
well
and
I'll
be
filing
that
also
every
year.
So
again,
it's
something
that's
continually
needed,
but
I
was
just
curious
about
the
database
and
maybe
looking
what
the
feds
have
done
when
it
comes
to
surprise.
F
May
I
address
this
as
well.
In
just
a
moment,
there
is
nothing
in
our
pip
act
right
now
or
no
fault
act
that
mandates
negotiation,
there's
a
provision
in
there
that
allows
a
carrier
to
ask
a
provider
to
negotiate,
but
there's
nothing
on
the
other
side
that
requires
that
the
the
provider
negotiate
and,
as
owen
said,
there's
no
incentive
at
this
point
for
the
provider
to
negotiate,
especially
with
some
of
the
case
law.
That's
come
down
recently
and
so
that
there's
just
nothing
there
to
to
force
that
type
of
discussion.
F
Negotiation
type
of
discussion
that
you're
talking
about,
I
personally,
just
speaking
for
john
bush
as
an
attorney
of
a
few
years
experience
in
this
in
this
commonwealth
and
and
engaging
in
these
areas
of
law
practice.
I
would
welcome
that
type
of
thing
as
if
you
know
to
to
be
implemented.
I
think
the
question,
though,
is
everybody.
F
I
suspect
the
the
question
is
or
part
of
the
the
problem
is
everybody's,
going
to
have
a
different
price
point,
in
other
words,
a
different
schedule
of
those
that
are
already
out
there
that
they
would
want
to
use.
You
know,
obviously,
those
who
are
doing
the
paying
would
probably
prefer
something
on
the
lower
end
straight.
That
also
stretches
out
the
benefits
for
the
consumer,
okay
for
the
citizens,
but
those
on
the
other
end,
the
provider
end
and
and
those
who
have
an
interest
in
running
up
the
costs
that
I've
mentioned.
F
You
know
they
want
things
to
be
that
money
to
be
consumed
as
quickly
as
possible
and
for
them
to
be
paid
100
cents
on
the
dollar
as
quickly
as
possible.
So
you
know:
we've
got
this
whole
spectrum
of
different
types
of
of
schedules
or
other
databases
you
know
to
to
use.
I
think
we
just
need
to
pick
one
that
will
be
probably
equally
unfair
to
everyone.
I've
always
said
as
an
attorney
who
did
a
lot
of
trial
work,
especially
earlier
on
in
my
practice.
F
If
you
got
a
if
a
settlement
happened,
and
both
sides
were
unhappy,
it
probably
was
overall
a
fair
settlement
of
both
sides
were
so
you
know.
Maybe
it's
not
a
matter
of
even
trying
to
find
the
one.
That's
quote
most
fair,
because
every
interested
party
is
going
to
have
a
different
definition
of
that,
but
if
you
can
find
the
one
that
is
least
unfair
to
everybody,
in
other
words,
it
provides
fairness
to
everybody,
but
maybe
not
the
full
measure
that
each
side
thinks
they're
entitled
to.
Maybe
that's
the
way
to
go.
F
There
are
these
databases
out
there
in
addition
to
the
one
that
you
mentioned
and
they've
been
available
since
2000,
and
we-
and
we
in
part
of
that
plan
that
I
was
telling
you
about
that.
I
tried
to
put
together
for
this.
This
carrier,
who
first
came
to
me
with
these
issues.
We
used
an
outside
medical
reviewing
company
to
help
get
these
these
medical
paper.
F
These
chart,
reviews
done
and
also,
but
it
also
had
a
component
to
it
that
that
said,
okay
based
on
these
chart
reviews
here
is
specifically
what
does
appear
to
be
owed
and
and
and
in
terms
of
dollars
and
cents
that
was
allocated
out
by
line
items
on
the
bills
and
here's
what's
not
and
here's.
Why
not
there's
a
coding
system.
That
said,
this
is
why
this
we
don't
believe
this
should
be
owed
or
shouldn't
it.
F
Schedule
on
these
things
so
that
it
we
get
away
from
this
totally
amorphous
phrase
in
the
act
that
says
you
know
you
can
charge
a
reasonable,
reasonable
charges
would
be
extremely
helpful
and
I
and
I
I'm
not
familiar
with
the
surprise
billing
act-
that
you
mentioned
the
federal
act,
but
I
will
go.
Take
a
look
at
that
now
that
I'm
aware
of
it,
because
a
lot
of
this
is-
but
I
think,
probably
fall
in
that
category.
A
D
A
A
H
Thank
you,
mr
chairman,
something
that
hasn't
even
been
mentioned
here
today
that
I
think
is
a
very
important
part
of
pip
is:
is
loss
of
wages
that
that
that's
actually
included
in
that
and
and
possibly
you
know,
someone's
in
an
auto
accident,
they
their
eye
classes
are
broken
or
something
I
think
that
is
covered
as
well.
F
G
And
I
will
add
that
claimants
also
have
the
right
to
direct
among
the
different
elements.
So
if
someone
says
I
want
to
save
all
my
ten
thousand
dollars
for
lost
wages,
a
claimant
has
the
ability
to
do
that
in
lieu
of
having
medical
bills
paid.
They
just
need
to
inform
their
insurance
carrier.
Okay,.
H
Mr
chairman,
when
I
came
here
in
95,
I
had
a
independent
property
casualty
insurance
agency
and-
and
I
and
I
very
much
liked
the
idea
of
pip,
where,
if
someone
had
an
accident
auto
accident,
you
know
before
they
might
have
to,
if
they
didn't
have
medical
payments,
they
might
have
to
wait
in.
H
You
know
a
long
time
to
get
their
loss
of
wages
covered
in
their
medical
bills
and
all
of
that
and
then
finally
sue
the
other
party,
and
this
was
a
way
that
people
could
get
you
know
their,
maybe
their
medical
bills
covered
and
and
their
loss
of
wages.
But
one
of
the
things
that's
happened
is,
as
you
said,
this
hasn't
really
worked
that
well,
because
most
people
only
carry
ten
thousand
dollars
and
that's
used
up
really
really
quick
and
that
really
hurts
the
the
consumer.
H
I
think
I
encourage
everyone
to
have
increased
pip.
I
do
because
you
get
no,
no,
not
only
more,
you
know
medical
coverage,
but
you
also
get
additional
lost
wages
and
and
those
sort
of
things,
but
I
probably
have
been
working
on
trying
to
change
this
mark.
You
agree,
then,
probably
had
more
bills
to
do
this
than
anyone
else.
I
very
first
started
to
try
to
change.
I
don't
see
how
anyone
could
have
and
I
should
have
been
malpracticed
to
write
into
legislation,
a
phrase
that
any
bill
presented
was
presumed
reasonable.
H
I
mean
whoever
the
bill
director
was
that
wrote
that
and
the
people
that
voted.
For
that
I
mean
that's.
That
was
so.
We
tried
to
change
that.
We
couldn't
do
that.
We
tried
to,
as
mark
said,
we
tried
to
pass
a
bill
that
would
include
the
workers
comp
fee
schedule.
H
We've
had
other
bills
that
tried
to
prevent
some
fraud
from
people
working
together
in
in
specifically
louisville
and
other
places,
but
I
think
that
you
know
there
really
is
a
problem
when,
when
a
plumber
on
his
way
to
a
job
and
a
mom
taking
her
kid
to
school,
they
collide
both
of
them
have
a
broken
leg.
H
The
same
ambulance
provider
comes
out
to
pick
them
up
and
they
can
charge
the
mom
a
lot
more,
like
we've
seen
as
much
as
three
to
five
times
as
much
to
go
to
the
same
hospital
as
they
charge
the
gas
plumber
who's
under
the
workers
comp
fee
schedule
as
as
well
as
once
they
get
to
hospital.
It's
the
same
thing,
and
that
is
just
not
a
just
system.
We've
been
trying
to
change
that
for
many
many
years.
H
I
do
think
that,
if
having
the
current
law
the
way
it
is,
we
we
might
even
need
to
look
at
possibly
changing
or
eliminating
the
pip
law.
But
I
think
if
we
do
that,
I
would
want
us
to
mandate
some
type
of
medical
payments
coverage
and
maybe
even
some
type
of
lost
wages
in
the
auto
insurance
policy,
because
I
don't
think
that
it's
good
enough
to
say
well,
you
could
buy
that
through
aflac
or
something
else,
and
you
know
the
system
has
worked.
H
But
you
know
the
numbers
don't
add
up
anymore,
but
but
I
still
like
that
that
that
the
consumer,
once
they
have
those
medical
bills
or
those
lost
wages
through
no
fault
of
their
own,
should
have
a
place
that
they
can
be
reimbursed
for
those.
Thank
you,
mr
chairman,.
A
Appreciate
it,
representative
smith,
I
think
you
had
a
question
or
comment.
B
This
is
probably
just
for
information,
because
I
sent
a
question
to
ask
you
from
our
school
district
is
on
the
pip.
Is
there
a
reason
why
students
on
buses
have
a
20
000
cap
where
individuals,
just
private
individuals,
has
a
10.
does
any
mark?
You
know
I
mean.
Is
there
any
reason
for
that
that
you
know
of
or
why
school
districts
have
a
20
000.
D
B
B
B
B
Never
changed
follow-up
question.
It
appears
in
the
70s
from
the
slide
show
that
there
was
kind
of
a
movement
for
pip
and
and
what
we
call
basic
reparation
benefits
in
the
70s.
Have
others
was
10
000
the
norm
for
most
of
those
states
or
what
was
kentucky
unique
in
that.
D
B
E
Kentucky's
been
relatively
static
in
the
the
fact
that
you
can
buy
a
bit
additional
pip
is
available.
I
think
they.
This
would
be
trying
to
get
into
the
minds
of
the
legislature
at
that
time.
In
1974
and
75
they
probably
wanted
to
keep
the
cost
reasonable.
10
000,
you
know
versus,
say,
50
000,
which
a
few
states
had
that
as
their
basic
limit.
That's
going
to
be
more
expensive.
D
And
keep
in
mind
that
in
1975,
ten
thousand
dollars
probably
fully
treated
some
high
percentage,
80
85
percent
of
the
injuries,
and
so
it
was
probably
a
very
generous
number
in
1975.
yeah.
F
And
representative,
if
I
might
add,
I
haven't
been
part
of
these
discussions,
but
I
understand
some
of
the
discussions
that
have
occurred
over
the
years
about
on
that
issue
have
been
that,
for
example,
some
of
the
providers
out
there
want
to
want
to
have
it
raised
and
there
may
have
been
some
resistance
from
some
of
the
the
property
casualty
carriers,
because
if,
if
we've
got
ten
thousand
dollars,
it's
that
issue
right
now
to
and
if
we
don't
have
any
checks
really
on
it.
We
got
all
the
problems.
F
We've
got
right
now,
what's
the
incentive
for
the
industry
to
agree
to
raise
it
to
20
or
30
or
40
or
50,
when
we're
all
we're
all
we're
doing
adding
where
we're.
You
know
doubling
tripling
quadrupling
quintupling,
a
financial
problem
for
us,
because
we
don't
have
the
tools
right
now
to
manage
this,
regardless
of
whether
it's
ten
dollars
or
ten
thousand
or
or
fifty
thousand.
F
So,
if
you
know,
if,
if,
if
a
an
increase
in
the
the
basic
you
know
amount
is
on
everybody's
minds
and
if
that
should
occur,
please
please
please.
If
we're
going
to
keep
it,
give
us
the
tools
to
to
manage
it
and
to
prevent
the
unscrupulous
from
being
unscrupulous,
and
you
know
for
us
all
to
act
fairly.
You
know
throughout
the
process.
G
In,
in
short,
if
we
don't
do
something
about
fraud,
all
we're
doing
to
do
by
raising
the
minimum
is
get
twice
the
amount
of
fraud,
and
I
will
add
that
you
know.
As
we
mentioned,
a
person
does
have
the
ability
to
optionally
purchase
higher
coverage.
What
we're
talking
about
is
potentially
raising
the
minimum,
of
course
that
has
fraud
implications,
but
also
anytime.
You
raise
the
minimum
coverage
for
any
issue,
there's
a
trade-off
in
that,
and
because
higher
coverage
higher
minimum
coverage
means
higher
premium
because
of
higher
costs.
Higher
premiums
means
some
people.
G
You
know
more
people
are
going
to
make
the
choice
between
being
uninsured
and
insured.
It
will
increase
the
number
of
uninsured
when
you
raise
the
minimum,
raise
the
minimum
premium
or
raise
the
minimum
coverage
and
therefore
the
premium.
A
Representative
flannery
did
you
have
another
question
or
okay
good?
Well,
you
know
you
know
the
thing
about
it
is
in
1975
when
this
was
created
it.
This
probably
sounded
like
a
really
good
idea
and
there
probably
wasn't
as
many
people
trying
to
abuse
the
system.
Yes,
sir,
and
you
know
you
had
folks
that
said
hey.
This
is
something
good
it
entices
people
to
want
to
live
in
kentucky
it's
great
for
the
for
the
for
the
customer,
it's
great
for
the
the
coverage.
A
I'm
I'm,
I
feel
like
I'm
an
old
man
at
44,
and
I
was
born
in
77,
so
this
has
been
around
for
a
day
or
so,
and
so
it's
starting
to
create
some
issues
that
we
need
to
be
addressed.
I've
been
here
almost
12
years
now
and
I
think
it's
one
of
the
things
we
discussed
12
years
ago.
So
there's
lots
of
issues
up
here.
It's
something
that
really
gets.
We
have
friends
on
both
sides
that
bring
valid
arguments
to
the
table
and
you're
trying
to
discuss.
A
What's
the
right
things
to
do-
and
you
know,
like
senator
alvarado
said
he's
had
these
discussions
and
you
start
getting
people
that
you
would
think
would
be
on
board
of
what
you're
wanting
to
do
have
made
your
pushback
against
the
same
bill
that
you're
trying
to
present,
and
so
there's
so
much
misinformation
hard
to
believe
up
here
in
frankfort
there's
misinformation.
But
there
is
lots
of
that.
A
So
we
have
lots
of
discussions
and
that's
why
we're
working
to
deal
with
this
issue
and
we've
got
good
folks
involved
on
both
sides
and
hopefully,
in
the
short
term,
we
can
get
something
done
to
make
sure
we
can
protect
our
consumers
and
still
not
drive
rates
up
to
where
they're
outrageous
and
still
provide
a
quality
thing
to
where
people
can't
abuse
the
system
and
we're
in
a
world.
A
A
We
ran
just
a
few
minutes
over,
but
when
you
get
four
attorneys
and
two
or
three
insurance
guys
involved,
you
can't
expect
them
to
stop
right
now.
We
appreciate
the
insight.
It's
a
major
issue,
it's
hard
to
have
the
discussion
in
one
hour.
That's
why
we're
doing
this
over
over
a
several
a
day.
Time
frame
here,
several
meetings,
representative
roland,
will
be
chairing
it
next
next
month
and
we'll
have
more
in-depth
discussion.
So
we
appreciate
that
guys
with
that
being
said,
do
I
have
a
motion
for
a
journey.