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Division of Workers' Compensation

Notices

  • The Florida Department of Financial Services, Division of Workers' Compensation submitted a Notice of Development of Rulemaking for Rule 69L-7.501, F.A.C., (Florida Workers' Compensation Reimbursement Manual for Hospitals) which published in the Friday, January 20, 2012, Florida Administrative Weekly. The Notice provides that a rule development workshop has been scheduled for Thursday, February 16, 2012, from 9:00 a.m.-11:00 a.m., in room 102 of the Hartman Building located at 2012 Capital Circle Southeast, Tallahassee, Florida.
    The purpose and effect of the proposed rule development is to amend the rule to adopt by reference the 2012 Edition of the Florida Workers' Compensation Reimbursement Manual for Hospitals, replacing the 2006 Edition of the Florida Workers' Compensation Reimbursement Manual for Hospitals in the existing rule. The 2012 Edition of the Florida Workers' Compensation Reimbursement Manual for Hospitals will incorporate a fee schedule for certain hospital outpatient services within defined geographic areas in Florida utilizing Current Procedural Terminology® (CPT) line level charge data. The methodology for the incorporated fee schedule establishes criteria to evaluate 18 months of hospital outpatient bill data. The 2012 Edition of the Florida Workers' Compensation Reimbursement Manual for Hospitals also makes technical changes to include a new manual format, an expanded table of contents and chapters by topic.
    If you have questions about this communication please contact Eric Lloyd, Program Administrator, Office of Medical Services, Division of Workers' Compensation, Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-4232, (850)413-1689 or Eric.Lloyd@myfloridacfo.com.
  • The Florida Department of Financial Services, Division of Workers' Compensation submitted a Notice of Development of Rulemaking for Rule 69L-7.602, F.A.C., (Florida Workers' Compensation Medical Services Billing, Filing and Reporting Rule) which published in the Friday, January 20, 2012, Florida Administrative Weekly. The Notice provides that a rule development workshop has been scheduled for Thursday, February 23, 2012, from 10:00 a.m.-11:00 a.m., in room 102 of the Hartman Building located at 2012 Capital Circle Southeast, Tallahassee, Florida.
    The proposed rule (which applies to dates of injury occurring on or after October 1, 2003) clarifies that an insurer must provide health care providers with prior notification of a decision to apply apportionment in the payment of reimbursement for medical services. The amendment also provides that an insurer shall, at the time of authorization or following authorization but prior to the rendering of medical service(s), provide each health care provider with written or electronic notification of its decision to apply apportionment in the payment of reimbursement for medical service(s).
    If you have questions about this communication please contact Eric Lloyd, Program Administrator, Office of Medical Services, Division of Workers' Compensation, Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-4232, (850)413-1689 or Eric.Lloyd@myfloridacfo.com.
  • The Florida Department of Financial Services, Division of Workers' Compensation submitted a Notice of Development of Rulemaking for Rule 69L-3.012, F.A.C., (Notice of Denial) which published in the Friday, January 20, 2012, Florida Administrative Weekly. The Notice provides that a rule development workshop has been scheduled for Thursday, February 23, 2012, from 9:00 a.m.-10:00 a.m., in room 102 of the Hartman Building located at 2012 Capital Circle Southeast, Tallahassee, Florida.
    The proposed rule revision would add a new subsection, 69L-3.012(9), F.A.C., to inform claims-handling entities of notice requirements when the payment of a compensable medical benefit will be apportioned, pursuant to Section 440.15(5), F.S. The proposed rule also clarifies that claims-handling entities must provide employees with notification of decisions to apply apportionment prior to the rendering of medical service(s). Finally, the proposed rule provides that compliance with the notice requirements is achieved by mailing Form DFS-F2-DWC-12 (Notice of Denial) to the employee as specified. The proposed rule also references the notice required under subsection 69L-7.602(5), F.A.C., which claims handling entities must provide to health care providers. The proposed rule applies to dates of injury occurring on or after October 1, 2003.
    If you have questions about this communication please contact Eric Lloyd, Program Administrator, Office of Medical Services, Division of Workers' Compensation, Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-4232, (850)413-1689 or Eric.Lloyd@myfloridacfo.com.
  • The Florida Department of Financial Services, Division of Workers' Compensation announces that Rule 69L-5.205 (Loss Data Reporting), F.A.C., and Rule 69L-5.217, (Civil Penalties and Fines), F.A.C., have been adopted with an effective date of December 29, 2011. Rule 69L-5.205, F.A.C., clarifies that former self-insurers must report loss data for the final period of authorization only once. Rule 69L-5.217, F.A.C., reduces the penalties assessed against self-insurers for late filing of required forms, reports and documents.
    Both rules may also be found via http://www.myfloridacfo.com/wc/forms.html or https://www.flrules.org/gateway/ChapterHome.asp?Chapter=69L-5 .
    If you have questions please contact Dwayne Manning, Insurance Administrator, of the Self-Insurance Section within the Bureau of Monitoring and Audit, at (850) 413-1784 or Dwayne.Manning@myfloridacfo.com .
  • Revisions to Rule 69L-7.100 Florida Administrative Code (F.A.C.) has been adopted with an effective date of November 13, 2011. This rule incorporates by reference the Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASC Manual), 2011 Edition. The ASC Manual contains the Maximum Reimbursement Allowances determined by the Three-Member Panel, pursuant to Section 440.13(12), F.S. and establishes reimbursement policies, guidelines, codes and maximum reimbursement allowances (MRAs) for items and services provided to an injured worker in connection with a surgical procedure performed in an Ambulatory Surgical Center. The official rule and ASC Manual can be view at http://www.flrules.org/Gateway/reference.asp?No=Ref-00686. The ASC Manual can also be viewed using the link below. If you have questions about this e-Alert, please contact Eric Lloyd, Program Administrator, Office of Medical Services, at (850) 413-1689 or Eric.Lloyd@myfloridacfo.com.
  • The Division of Workers' Compensation recognizes the importance of providing stakeholders with more information to assist them in fulfilling their rights and responsibilities under the Workers' Compensation Law. As a result, the Division is pleased to announce three new enhancements that have been added to the Proof of Coverage Database. These enhancements will provide information relating to the number of employees reported for each employer; the governing classification code reported for each employer; and the scope of business or trade(s) listed on Certificates of Exemption. A detailed description of each enhancement is listed below:
    1. Total Number of Employees – Represents the total number of employees for each employer as reported by the insurance carrier. The total number of employees is displayed for each location reported on the policy. Insurance carriers are required to report the total number of employees for all policies that are issued with an effective date of October 1, 2009 or after.
    2. Governing Classification Code – Represents the workers' compensation classification code which best describes the business operation and which includes the most payroll generated by the business as reported by the insurance carrier.
    3. Scope of Business or Trade – Refers to the trade or business activity that best describes the business as reported by the corporate officer. The scope of business or trades are displayed for each Certificate of Exemption. The Certificate of Exemption only applies to the scope of business or trade listed on the certificate.
  • The Special Disability Trust Fund, Estimation of Liabilities as of June 30, 2011 [357K PDF] has been produced, as required by Florida Statutes 440.49(9)(e).
  • The Three-Member Panel has finalized its 2011 Biennial Report. The Report contains the Panel’s recommendations on methods to improve the workers’ compensation health care delivery system and has been submitted to the Speaker of the House of Representatives and to the President of the Senate as required by subsection 440.13(12)(e)(4), Florida Statutes. The 2011 Three-Member Panel Report is hosted on this site under Publications and Reimbursement Manuals.
    If you have questions about this communication, please contact: Eric Lloyd, Program Administrator, Office of Medical Services, Division of Workers' Compensation, Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-4228, Phone (850) 413-1944 or eric.lloyd@myfloridacfo.com.
  • The Division of Workers’ Compensation has implemented an online Penalty Payment Service for employers that have been issued a Stop-Work Order or Order of Penalty Assessment. This free service allows you to pay your entire penalty in full or to pay the monthly installments that are required in your periodic payment plan. The Penalty Payment Service is convenient, simple to set up, and easy to use. See the Instructional Manual [2.8MB PDF] for general information about the online service and step-by-step instructions for setting up an online payment account. To make an online penalty payment, access the following links:

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