Division of Workers' Compensation
Draft Rules
- 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.
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