![FAQs [PDF]](../images/icon-faqs.gif "FAQs [PDF]"){kind=icon}
The Office of Medical Services (OMS) has the lead responsibility for medical cost containment (utilization review, fee schedule development, dispute resolution, etc.) by ensuring that medically necessary treatment, services and supplies are available and accessible to injured employees at an affordable cost to Florida employers; that the services are cost effective and efficiently rendered; and that health care providers are appropriately reimbursed by insurers.
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Health Care Provider Updates
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The Division of Workers' Compensation has announced a rule development workshop for a rule titled Carrier Report of Health Care Provider ViolationsThe Division will hold a rule development workshop on 12/2/2009 @ 9 AM in 104J Hartman Bldg, 2012 Capital Circle SE Tallahassee, FL. The title of the rule is Carrier Report of Health Care Provider Violations. For more information regarding this proposed rule, please contact Eric Lloyd, Office of Medical Services, Division of Workers' Compensation, Dept of Financial Services, 200 E. Gaines St, Tallahassee, FL 32399-4232, (850)413-1689, Eric.Lloyd@myfloridacfo.com.
- Proposed rule text
- DFS-F6-DWC-2000 [Word] (Health Care Provider Violation Referral Form) - Informational Bulletin DFS-02-2009, relating to reimbursement of dispensing physicians
- Current Reimbursement Manuals
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Pending Rule Development Workshops /HearingsOMS has scheduled rule workshops and or hearings for the adoption of the following policies related to system stakeholders' participation in the FL WC health care delivery system:
- Proposed Carrier Report of Health Care Provider Violations Rule | DFS-F6-DWC-2000 form
- Proposed 2009 Hospital Manual
- Proposed FL WC Medical Services Billing Reporting and Filing Rule (Rule Chapter 69L-7.602, F.A.C.)
- 2009 Medical EDI Implementation Guide (MEIG) (revised 6/9/09)
- DFS-F5-DWC-90 (UB-04) – B, Completion Instructions for Hospitals (revised 3/19/09)
- DFS-F5-DWC-90 (UB-04) – C, Completion Instructions for Ambulatory Surgical Centers (revised 3/19/09)
- DFS-F5-DWC-90 (UB-04) – D, Completion Instructions for Home Health C Agencies (revised 3/19/09)
- DFS-F5-DWC-90 (UB-04) – E, Completion Instructions for Nursing Homes (revised 3/19/09)
- DFS-F5-DWC-10 Form and Completion Instructions for Pharmacists and Med Suppliers (revised 3/18/09)
- DFS-F5-DWC-9 Completion Instructions for Health Care Providers (revised 3/19/09) -
Related Publications and PolicyNCCI Analysis - The National Council on Compensation Insurance, Inc. (NCCI) has issued its analysis on the proposed medical fee reimbursement changes for hospital outpatient services. This analysis will be presented at the Three-Member Panel meeting on Thursday, November 20 at 1:00 pm in room 116 of the Larsen Building in Tallahassee, Florida. The Three-Member Panel will consider testimony and comments regarding the proposed adoption of Medicare’s Outpatient Prospective Payment System in concert with determined payment adjustment factors as the methodology for reimbursing hospitals 60% and 75% of usual and customary charges for outpatient services provided to Florida’s injured workers. View NCCI’s analysis
Reimbursement Dispute and Overutilization Report - The Division has submitted to the Three-Member Panel its Annual Report on Reimbursement Disputes and Overutilization