Division of Workers' Compensation
News and Updates (2007-2009)
December 2009
- The newly updated Employee Notification Letter is available. See
Publications and Reimbursement Manuals for more information.
- The Division is offering free classes to educate employers,
business owners, licensed contractors and other interested
stakeholders to help them understand their statutory obligations
under the Workers' Compensation Law. The Division is partnering with
the U.S. Department of Labor, Office of Safety and Health
Administration (OSHA) to provide employers with information relating
to both workers’ compensation and workplace safety. Continuing
Education Units are available to individuals licensed by the
Department of Business and Professional Regulation, the Department
of Financial Services, Bureau of Fire Prevention and the Florida
Water Well Administration. The attached flyer lists class dates and
locations around the State. Advanced registration is required to
assure availability.
- Schedule of Classes:
English [18K PDF]
-
Registration Form:
English [57K Word]
For additional information,
bocseminars@myfloridacfo.com or call (850) 221-6518.
- The Division of Insurance Fraud, Bureau of Workers' Compensation
Fraud and the Division of Workers' Compensation, Bureau of
Compliance issued a Joint Report summarizing their respective
efforts and activities in combating workers' compensation fraud and
employer non-compliance for the period of July 1, 2008 through June
30, 2009.
- New Informational Memorandum:
DFS-05-2009 [28K PDF] - Maximum
Workers' Compensation Rate, Effective January 1, 2010
-
EDI statistics (paper vs. electronic submissions)
updated
November 2009
- The Division will hold a rule hearing on
Rule 69L-7.501, FAC
on Wednesday, December 2, 2009 @ 1:30 PM in 104J Hartman Building,
2012 Capital Circle SE, Tallahassee, FL, if a hearing is requested
in writing within 21 days of the
Notice of Proposed Rule. The title of the rule is the
Florida Workers' Compensation Reimbursement Manual for Hospitals.
» More info
- Draft informational documents
for Revision E are available under Medical
EDI
- A Notice of Change for Rule 69L-7.602, Florida Administrative
Code, was published in the Friday, November 13, 2009, Florida
Administrative Weekly. The rule, titled the Florida Workers'
Compensation Medical Services, Billing, Filing and Reporting Rule,
includes changes that have been made to address concerns expressed
at the public hearing and in response to written comments received
from the Joint Administrative Procedures Committee.
» More info
- The Division of Workers' Compensation will hold a rule development
workshop on Wednesday, December 2, 2009 @ 9:00 AM in 104J Hartman
Building, 2012 Capital Circle Southeast, Tallahassee, Florida. The
title of the rule is Carrier Report of Health Care Provider
Violations. » More info
October 2009
- The Injured Worker FAQs
have been updated
- Compliance statistics
updated
- A
Spanish version [560K PowerPoint]
of the Injured Worker Workshop slideshow is now available on the
Employee Education and Information page
-
EDI statistics (paper vs. electronic submissions)
updated
- Bureau of Compliance
district offices information has been updated
- The Division is pleased to announce the continuation of
Employer Seminars regarding Workers' Compensation and Workplace
Safety (presented by OSHA). These seminars are designed to
assist Florida employers in understanding their rights and
responsibilities under the Florida Workers' Compensation law and
in providing a Safe Workplace for their employees. The seminars
are free and are offered in several locations throughout
Florida. In addition, 4 seminars (in various locations) will be
presented in the Spanish language. More details can be found on
the Employer Education
page. You are welcome to disseminate the flyer and registration
forms to anyone you believe may be interested in attending.
September 2009
- DWC
FWCI Conference PowerPoint Slides (August 2009)
[5.8MB PowerPoint]
- A Hearing on the Notice of Proposed Rulemaking for the
Division of Workers' Compensation Rule 69L-6.012, Notice of
Election to be Exempt, Florida Administrative Code, will be
held, if requested within 21 days of the date the notice is
published. The Notice was published in the September 18, 2009,
Florida Administrative Weekly. If requested, the hearing will be
held on Wednesday, October 14, 2009; 10:00 am – 12:00 pm in Room
104J Hartman Building., 2012 Capital Circle SE, Tallahassee,
Florida. If a hearing is not requested, it will not be held. For
additional information, please contact Tasha Carter at (850)
413-1878 or
Tasha.Carter@myfloridacfo.com.
-
EDI Training PowerPoint Slides [1.9MB
PowerPoint] from the
DWC FWCI Conference are available on the
Claims EDI
page
- The Division of Workers' Compensation has published its
2009 Annual Report [2.5MB PDF] and
it is now available under
Publications and Manuals. The Annual Report contains a
summary of the Division’s activities and accomplishments for
fiscal year 2008/2009.
- Compliance statistics
have been updated
- The 2009 4th quarter schedule for the Division's free
classes regarding Florida’s Workers' Compensation law and
Workplace Safety is available. For more information see the
Employer Education section.
- Claims
EDI section updated
- The Injured Worker Frequently
Asked Questions page has been updated
- The Florida Division of Workers’ Compensation and Division of Risk
Management announce a free two day EDI training class October 6, 7,
and 8, 2009 in Tallahassee on the Claims EDI Release 3 mandate, and
EDI Rule (69L-56, F.A.C.). Seating is limited to 75, and prior
registration is required. Registration preference will be given to
those who have previously submitted a request for future training
and those who have not previously attended an EDI training class.
Please complete and return the EDI Training Registration form to the
Division. » Get form
August 2009
- An updated
Health Care Provider Tutorial [1.5MB
PowerPoint] is available
- The Division of Workers' Compensation announces the
publication of Informational
Bulletin DFS-02-2009 issued on August 12, 2009. This
bulletin deals with employer/carrier reimbursement decisions
regarding pharmaceuticals dispensed by Florida licensed
physicians. All Division bulletins are available under
Informational Memoranda.
-
EDI statistics (paper vs. electronic submissions)
updated
- Rule 69L-6.025 - Conditional Release of Stop-Work Order and
Periodic Payment Agreement was amended effective July 20, 2009.
The amendment provides new language that outlines the terms and
conditions under which an employer qualifies to enter into a new
Payment Agreement Schedule For Periodic Payment of Penalty.
- The recently available
Non-Compliance Referral Database allows individuals to
submit referrals of alleged violations of the workers’
compensation laws. Since June the Division has received 328
referrals. As a result of those referrals, 36 Stop-Work Orders
were issued, resulting in $526,000 in assessed penalties. See
the Databases section for all
Division applications.
- Audio files from the July workshops (69L-7.501 - Florida
Workers' Compensation Reimbursement Manual for Hospitals and
69L-7.602 - Florida Workers' Compensation Medical Services
Billing, Filing and Reporting Rule) are available under
Draft Rules
July 2009
- New Bureau of Monitoring and
Audit statistics are available in the
Statistics section
- A new
Publications
Order Form [16K PDF] (Effective
July 1, 2009)
has been posted under
Publications
- 69L-5 Hearing Transcript
[text file] - from the June 24th
Hearing on the Notice of Proposed Rulemaking for the Division of
Workers' Compensation's Rules for Self Insurers Under the
Workers Compensation Act, 69L-5
- The
Claims Statistics Database has been restored and is
available under Databases
- Claims
EDI section updated
- Compliance statistics have
been updated
- A Hearing on the Notice of
Proposed Rulemaking of 69L-24,
F.A.C. [124K PDF],
Workers' Compensation Insurers' Standards and Practices,
WILL be held on Wednesday, August 5, 2009;
10:00am-12:00pm in Room 104 J Hartman Bldg., 2012 Capital Circle
SE, Tallahassee, Florida.
- The Division has published the assessment rates for the
Workers' Compensation Administration Trust Fund (WCATF) and
Special Disability Trust Fund (SDTF), in Informational Bulletin
DFS-03-2009 [3.5MB PDF] and
Assessment Rate Orders number 105011-09-WC and 105012-09-WC. The
assessment rate for the WCATF will be 0.80% for calendar year
2010. For the 2009-2010 fiscal year, the SDTF assessment rate
remains at 4.52%. All division bulletins are available under
Informational Memoranda.
June 2009
- A Hearing on the Notice of Proposed Rulemaking for the
Division’s Draft rule 69L-24
[124K PDF], Insurers' Standards and Practices, will be
held if requested within 21 days of the date the Notice was
published. If requested, the hearing will be
held on Wednesday, August 5, 2009 at 10:00 a.m. in Room 104 J
Hartman Bldg., 2012 Capital Circle SE, Tallahassee, Florida. If
a hearing is not requested, it will not be held.
- Division Rule Workshop Notice:
69L-6.012, F.A.C.
[15K PDF] - Notice of Election to be Exempt
- The Division of Workers' Compensation will hold a rule
workshop the purpose and effect of which is to amend Rule
69L-7.501, Florida Administrative Code, to adopt by reference
the Florida Workers' Compensation Reimbursement Manual for
Hospitals, 2009 Edition.
The Florida Workers' Compensation Reimbursement Manual for
Hospitals, 2009 Edition [1MB PDF]
will incorporate Medicare’s Outpatient Hospital Prospective
Payment System payment methodology for reimbursing hospitals for
outpatient bills, with payment adjustment factors of 1.74 times
the Medicare allowed amount for scheduled surgeries and 3.95
times the Medicare allowed amount for other specified
compensable charges, as approved by the Three Member Panel at
its November 20, 2008 public meeting. The proposed Manual also
incorporates a definition for the Medicare Hospital Outpatient
Prospective Payment System, recognizes the Integrated Outpatient
Code Editor and the National Correct Coding Initiative (NCCI)
edits and their updates from the Centers for Medicare and
Medicaid Services (CMS) in the Medicare Hospital Outpatient
Prospective Payment System, and makes technical changes to
include a new manual format, an expanded table of contents and
chapters by topic.
This rule workshop was noticed in the Friday, June 12, 2009
Florida Administrative Weekly and will be held on Tuesday, July
7, 1:00-4:00 pm., in Room 104J, 2012 Capital Circle SE,
Tallahassee, FL. View the proposed manual:
Florida Workers' Compensation Reimbursement Manual for
Hospitals, 2009 Edition [1MB PDF]
- Attention Business Owners and Employers:
The Division is offering free classes regarding Florida’s
Workers' Compensation law and Workplace Safety presented by the
U.S. Dept. of Labor OSHA to business owners, licensed
contractors and others who are interested. There are several
dates and locations available around the State as indicated in
the attached flyer:
English |
Spanish. While there is no fee, advanced registration is
required to assure that you have a seat. Registration Form:
English |
Spanish. Continuing Education Units (CEUs) are available to
those licensed by the
DBPR - CILB,
DBPR - ECLB,
State Fire Marshall - Bureau of Fire Prevention, and the
Florida Water Well Administration. For additional information
you may email
bocseminars@MyFloridaCFO.com or call (813) 221-6518.
- A Hearing on the Notice of Proposed Rulemaking for the
Division of Workers' Compensation's Florida Workers'
Compensation Medical Services Billing, Filing and Reporting Rule,
69L-7.602, Florida Administrative Code will be held if requested
within 21 days of the date the Notice is published. The Notice
is scheduled for publication in the June 12, 2009, Florida
Administrative Weekly. If requested, the hearing will be held on
Tuesday, July 7, 2009 from 10:00 a.m. until noon in room 104 J
of the Hartman Bldg., 2012 Capital Circle SE, Tallahassee,
Florida. If a hearing is not requested, it will not be held. For
additional information please contact Samuel Willis at (850)
413-1898 or
Samuel.Willis@myfloridacfo.com
- The Division has submitted to the Three-Member Panel its
Annual Report on Reimbursement Disputes and Overutilization
[95K PDF].
-
EDI statistics (paper vs. electronic submissions)
updated
May 2009
- The Proof of Coverage
EDI and Claims
EDI sections have been updated
- New Informational Memoranda:
DFS-01-2009 [245K PDF] - Wage Loss
Discount Factor Tables, May 20, 2009
- The Bureau of Data Quality
and Collection page has been updated. All bureau information
can be found under About the
Division.
- A Hearing on the Notice of Proposed Rulemaking for the
Division of Workers' Compensation’s Rules for Self Insurers
Under the Workers Compensation Act, 69L-5, Florida
Administrative Code, will be held if requested within 21 days of
the date the Notice was published. Rule Chapter 69L-5,
F.A.C. is being amended to concurrently repeal and
replace all existing rules with new rules which have been
restructured and renumbered to promote clarity and efficiencies
to the process by which self-insured employers comply with the
duties and obligations associated with the privilege of
self-insuring pursuant to
Chapter 440, Florida Statutes. If requested,
the hearing will be held on Wednesday, June 24, 2009; 10:00am –
12:00pm in Room 104 J Hartman Bldg., 2012 Capital Circle SE,
Tallahassee, Florida. If a hearing is not requested, it will not
be held.
- The following forms have been updated:
SI-5 Self-Insurers Payroll Report,
SI-6 Sample Self-Insurers Irrevocable Letter of Credit,
SI-20 Report of Outstanding Workers' Compensation
Liabilities, SI-23 Service
Company Annual Report Form. All Division forms can be found
under Rules and Forms.
- Updated files and information have been added to the
Claims EDI
section
- The DWC-250 form
[36K PDF] (Notice of Election to be Exempt) has been
updated again
- The Division is pleased to announce the publication of its
first research brief, which focuses on the effects of the
changes to the compensability requirements in SB 50A, which was
the 2003 workers’ compensation legislative reform bill.
- Compliance statistics have
been updated
- Employee Assistance Office
information updated
-
EDI statistics (paper vs. electronic submissions)
updated
April 2009
- The following forms from
Chapter 69L-6 (Workers' Compensation Compliance) have been
updated 4/30/09: DWC-250,
DWC-250i, DWC-250-R,
Request for Duplicate Exemption. These and all other
Division forms can be found under Rules and
Forms.
- The Three-Member Panel has issued its
2009 biennial report [360K PDF] on
methods for improving the workers' compensation medical delivery
system.
- Draft Rule 69L-6.025
[28K PDF] - Conditional Release of Stop-Work Order and
Periodic Payment Agreement
- The Bureau of Employee
Assistance page has changed
- The following Medical EDI forms
have been updated:
Submitter SSL/FTP Instructions for WSFTP Pro 9.0,
SSL/FTP Transfer Instructions,
SSL/FTP Troubleshooting Guide
-
2009 Medical EDI Implementation Guide (MEIG)
[387K PDF] (draft version revised 4/9/09)
- Attention Business Owners and Employers: The Division
is offering free classes regarding Florida’s Workers’
Compensation law and Workplace Safety presented by the
U.S. Dept. of Labor
OSHA to business owners, licensed contractors and
others who are interested. There are several dates and locations
available around the State as indicated in the attached flyer:
English |
Spanish. While there is no fee, advanced registration is
required to assure that you have a seat. Registration Form:
English |
Spanish. Continuing Education Units (CEUs) are available to
those licensed by the
DBPR - CILB,
DBPR - ECLB,
State Fire Marshall - Bureau of Fire Prevention, Florida
Water Well Administration and DFS - Agents. For additional
information you may email
bocseminars@MyFloridaCFO.com or call (813) 221-6518.
-
EDI statistics (paper vs. electronic submissions)
updated
- The Bureau of Compliance
page has been updated. All bureau information can be found
under About the Division.
- Compliance statistics have
been updated
March 2009
- The Florida Workers' Compensation Claims forms have been
updated and are available under the 69L-3 tab of
Rules and Forms. Forms were revised to comply with the
revision of
Section 119.071(5), F.S.
(2007) that precludes an agency from collecting an individual’s
social security number unless such collection conforms to the
specific provisions of that statute. If you have any questions,
please submit your inquiries to
Stephen.Yon@myfloridacfo.com.
-
2009 Medical EDI Implementation Guide (MEIG)
[387K PDF] (draft version revised 3/30/09) - See Draft
Rules on the homepage for more
information.
- Proposed Rule 69L-24,
F.A.C., Insurers' Standards and Practices, has been
revised since the initial notice of rule development was posted.
A second workshop will be held on Wednesday, April 15th, 2009,
at 10:00 a.m. in Room 104 J, Hartman Building, 2012 Capital
Circle, S.E., Tallahassee, Florida.
- The Publications Order Form
[29K PDF] has been updated and is available under
Publications and Manuals
- Correction: The effective date for the Florida Workers'
Compensation Health Care Provider Reimbursement Manual, 2008
Edition was 2/4/09. The manual is available under
Publications and Manuals.
- Claims
EDI section updated
- Audio file of the
February 16, 2009 workshop of proposed rule 69L-5,
F.A.C. [14MB mp3] - See
Draft Rules on the homepage for more
information on this workshop.
- The Medical, Medical Provider,
Managed Care Arrangement
FAQ has been updated and is available on the
Information and FAQs
page
-
EDI statistics (paper vs. electronic submissions)
updated
February 2009
- The following forms from
Chapter 69L-6 (Workers' Compensation Compliance) have been
updated: DWC-250,
DWC-250i,
DWC-250-R,
DWC-251,
DWC-251-R. All Division forms can be found under
Rules and Forms.
- The database listing has been updated--see
Databases for all our online Workers' Compensation
applications.
- Statistics for both the Bureau
of Compliance and EDI have
been updated
- 69L-7.020 Florida Workers' Compensation Reimbursement Manual
for Health Care Providers Rule - The Florida Workers'
Compensation Health Care Provider Reimbursement Manual, 2008
Edition, has been adopted and will become effective 2/4/2009. A
copy can be found below or under the
Publications & Manuals section.
- This News and Updates page has been upgraded for easier
navigation.
- Bureau of Compliance
statistics have been updated
January 2009
- The Workers' Compensation Administration Trust Fund and
Special Disability Trust Fund assessment
rates have been updated for 2009
- Audio file of the
January 14, 2009 workshop of proposed rule 69L-7.602, F.A.C.
[26MB mp3] - The public comment period for this proposed
rule runs through January 29, 2009. Comments may be emailed to
Samuel Willis at
Sam.Willis@myfloridacfo.com
- Audio file of the
January 6, 2009 workshop of proposed rule 69L-24, F.A.C.
[17MB mp3] - The public comment period for this proposed
rule runs through January 29, 2009. Comments may be emailed to
Samuel Willis at
Sam.Willis@myfloridacfo.com
- Several items in the Claims EDI
area have been updated
- The Division of Workers' Compensation,
Bureau of Monitoring and Audit will hold a rulemaking
workshop on proposed rule 69L-5, F.A.C., Rules for Self-Insurers
Under the Workers' Compensation Act. The purpose of this rule is
to interpret and implement provisions of
Chapter 440 regarding regulation by the Department and the
Florida Self-Insurers Guaranty Association, Inc. of entities
self-insuring the payment of compensation for Florida employees.
This rulemaking workshop will be held in room 104J of the
Hartman Building which is located at 2012 Capital Circle S.E.,
Tallahassee, Florida. The workshop is scheduled for Monday,
February 16, 2008 at 10:00 a.m. The workshop is open to the
public.
- The Division of Workers' Compensation, Office of Medical
Services will hold a rulemaking workshop on proposed rule
69L-7.602, F.A.C., Florida Workers' Compensation Medical
Services Billing, Filing and Reporting Rule. This rule
incorporates the 2009 Medical EDI Implementation Guide (MEIG).
This rulemaking workshop will be held in room 104J of the
Hartman Building which is located at 2012 Capital Circle S.E.,
Tallahassee, Florida. The workshop is scheduled for January 14,
2008 at 10:00 a.m. The workshop is open to the public.
- Bureau of Compliance
statistics have been updated
- Special Disability Trust
Fund, Estimation of Liabilities as of June 30, 2008
[237K PDF]
- New information and statistics for the
Bureau of Monitoring and Audit have been added to
Statistics, which can be found under
Information and FAQs.
- EDI statistics (paper vs.
electronic submissions) updated
December 2008
- The Division of Insurance Fraud, Bureau of Workers’
Compensation Fraud and the Division of Workers’ Compensation,
Bureau of Compliance issued a
Joint Report [3.7M PDF]
summarizing their respective efforts and activities in combating
workers’ compensation fraud and employer non-compliance for the
period of July 1, 2007 through June 30, 2008.
- The National Council on
Compensation Insurance (NCCI) has proposed a rate increase
in response to a recent
Florida Supreme Court Decision involving attorney fees. The
NCCI estimates that the full impact of this decision will be an
increase in overall Florida workers’ compensation system costs
of 18.6%. The NCCI anticipates that it will take two years for
the full impact to be realized, and therefore proposes a first
year increase of half of the full impact. On November 14, 2008,
NCCI submitted its filing for a proposed first year rate level
increase of 8.9% to Florida’s
Office of Insurance Regulation (OIR). The NCCI rate filing
is proposed to be effective on March 1, 2009, and is currently
under review at OIR.
More » [62K PDF]
This rate filing comes on the heels of NCCI’s recently approved
annual rate filing wherein the NCCI reduced Florida workers’
compensation rates by 18.6% effective January 1, 2009. The new
overall workers' compensation rate level will result in a
cumulative 60.5% average decrease since reforms to the workers’
compensation system were implemented in 2003.
More » [103K PDF]
- The Office of Medical
Services page has been updated
- New Informational Memorandum:
DFS-02-2008 [22K PDF] - Maximum
Workers' Compensation Rate, Effective January 1, 2009
- A Hearing on the Notice of Proposed Rulemaking for the
Division of Workers' Compensation’s EDI Rule, 69L-56, Florida
Administrative Code, will be held if requested within 21 days of
the date the Notice was published. The proposed rule amendment
addresses Electronic Proof of Coverage filing requirements for
Employee leasing companies, as well as revisions made to EDI
forms and EDI Implementation Manuals. If requested,
the hearing will be held on Wednesday, January 21, 2009; 10:00am
– 12:00pm in room 104 J Hartman Bldg., 2012 Capital Circle SE,
Tallahassee, Florida. If a hearing is not requested, it will not
be held.
- The Division of Workers' Compensation will hold a rule
workshop to amend rule 69L-24 F.A.C. Insurers' Standards and
Practices. The workshop will be held on Tuesday, January 6,
2009; 10:00am - 12:00pm in room 104 J Hartman Bldg., 2012
Capital Circle SE, Tallahassee, Florida. The proposed rule
amendment establishes guidelines to monitor, audit and
investigate regulated entities for compliance with requirements
of Chapter 440, Florida Statutes, regarding timely payment of
benefits to injured workers, timely payment of medical bills,
and timely reporting of data to the Department, and establish
penalty guidelines for assessment of penalties for failure to
comply with the statutory requirements.
- EDI statistics (paper vs.
electronic submissions) updated
November 2008
- The new Online Workers'
Compensation Insurance Registration site is now available on
the homepage under Popular Items
- The Bureau of Compliance
is offering free workers’ compensation and workplace
safety classes, and more than 100 Florida employers and
licensed contractors have attended since the classes began on
October 1, 2008, some earning continuing education credits. The
Bureau will offer 11 classes quarterly throughout Florida, and
the first quarter 2009 schedule will be available in December.
- Bureau of Compliance
statistics have been updated for November
- 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.
- The Division of Workers’ Compensation will hold a rule
workshop to amend the rule 69L-56 F.A.C. Electronic Data
Interchange (EDI) Requirements for Proof Coverage and Claims
(Non-Medical). The workshop will be held on Monday, Nov. 17,
2008; 10:00am - 12:00pm in room 104 J Hartman Bldg., 2012
Capital Circle SE, Tallahassee, Florida. The proposed rule
amendment addresses Electronic Proof of Coverage filing
requirements for Employee leasing companies, as well as
revisions made to forms and EDI Implementation Manuals.
October 2008
- The Workers' Compensation System Guide (WC System Guide) has
been written and published in accordance with section
440.207, Florida Statutes. Its purpose is to provide a
summary and overview of the Workers Compensation Law. It is
intended to educate and assist all stakeholders in the workers'
compensation system as to their rights and responsibilities and
to provide resources to persons needing direction and support
with the workers' compensation process and system. The Workers'
Compensation Guide is not intended to replace or supersede the
workers' compensation law (Chapter
440, Florida Statutes) or Florida workers' compensation case
law.
- Bureau of Compliance
statistics have been updated
- The Medical EDI section has been
updated
- Several additions have been made to the
Claims EDI area
- EDI statistics (paper vs.
electronic submissions) updated
September 2008
August 2008
July 2008
- EDI statistics (paper vs.
electronic submissions) updated
- A slideshow entitled
FL Claims EDI Release 3 EDI History & Overview
[5.4MB PowerPoint] has been added to the
Claims EDI page.
- Most of the older information from the
homepage has been removed, but is still available on this
page and/or elsewhere around the site.
- The Division has published the assessment rates for the
Workers' Compensation Administration Trust Fund (WCATF) and
Special Disability Trust Fund (SDTF), in Informational Bulletin
DFS-01-2008 [252K PDF] and
Assessment Rate Orders number 95975-08-WC and 95978-08-WC. The
assessment rate for the WCATF will remain at 0.25% for calendar
year 2009. For the 2008-2009 fiscal year, the SDTF assessment
rate remains at 4.52%.
June 2008
- New Informational Memorandum:
DFS-01-2008 [252K PDF] - Orders
Setting Assessment Rates for the Workers’ Compensation
Administration Trust Fund and Special Disability Trust Fund
- The footers on all the Division pages have been updated with the
correct contact information
- Bureau of Compliance statistics
have been updated once again
- Updated Mileage Reimbursement forms (MR-2) are available under the
69L-26 tab (Employee Assistance and Ombudsman Office) in the
Rules and Forms section
- Contact information for the various
Bureau of Compliance district offices has been updated
- The Three-Member Panel Meeting scheduled for Thursday, June 19,
2008, in Tallahassee, Florida has been CANCELLED.
The purpose of the meeting was for the Panel to consider testimony
and comments regarding its proposed adoption of Medicare’s
Outpatient Prospective Payment System and appropriate 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. If adopted, the new
reimbursement methodology would be an amendment to
Rule 69L-7.501, F.A.C.
May 2008
- Updated Bureau of Compliance
statistics are available. These graphs and all other Division
statistics can be found in the Statistics
section under Information and Faqs.
- Much of the Claims EDI area has been
updated
- New Rule: 69L-24.0231
Benefits and Administration Trust Fund Penalties Improper Filing
Practices
- The Division of Workers’ Compensation announces a public meeting
to which all persons are invited. The Three-Member Panel will
consider testimony and comments regarding the proposed adoption of
Medicare’s Outpatient Prospective Payment System in concert with
appropriate 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. The
proposed reimbursement methodology being considered is for purposes
of amending
Rule 69L-7.501, F.A.C. The meeting will take place on Thursday,
June 19, 2008, at 2:00 p.m. in Room 116, Larson Bldg., 200 E. Gaines
St., Tallahassee, Florida.
- The UCC-1 [103K
PDF] Uniform Commercial Code Financing Statement, available
under Rules and Forms Chapter 69L-5, has
been updated
- The Medical EDI section has been
updated
April 2008
- The Bureau of Employee Assistance
information has been updated, as well as the bureau's
district offices
- The following forms have been updated:
DFS-F2-DWC-1a [51K PDF] (Wage
Statement) and DFS-F2-DWC-30
[23K PDF] (Authorization and Request for Unemployment
Compensation Information)
- Florida Stay-at-Work Consortium - Florida’s CFO Alex Sink
and the Division of Workers’ Compensation are participating in a
national initiative and summit seeking better ways to help sick or
injured workers stay at work or return to work sooner--and stay
employed. The Florida Summit on Preventing Needless Work Disability,
to be held at the Rosen Centre in Orlando on June 1 & 2, 2008, is
expected to draw up to 200 healthcare providers, employers, insurers
and others seeking to improve the service now delivered by
disability benefits and workers’ compensation systems. If you wish
to learn more, request an invitation, and or be involved as a
sponsor of this unique and extremely important event visit
www.60summits.org or call 1-800-319-7425.
- EDI statistics (paper vs.
electronic submissions) updated
March 2008
February 2008
January 2008
- The following forms have been updated and are available under
Rules and Forms:
- DFS-F2-DWC-1, 3, 4, 10, 12, 13, 14, 19, 33, 35, 40, 49
- SI-17, SI-27
- DWC-250, 250-R, 251, 251-R, Request for Duplicate Exemption
- DFS-F5-DWC-25 (all formats)
- DFS-F1-SDF-1, 2, 6, PW-2
- Added to Medical EDI:
EOBR Line Item Paid Business Rules for 2008
[27K PDF] (DWC-9, DWC-10, and DWC-11),
EOBR Business Rules Based on Revenue Code for 2008
[24K PDF] (DWC-90)
- The Claims EDI area has been updated
with new information and files
- EDI statistics (paper vs.
electronic submissions) updated
-
Recommendations for Determining Customary Charges for Florida
Outpatient Hospital Services to Workers’ Compensation Patients
[2MB PDF]
- The Division of Insurance Fraud, Bureau of Workers’ Compensation
Fraud and the Division of Workers’ Compensation, Bureau of
Compliance issued a
Joint Report [4MB PDF]
summarizing their respective efforts and activities in combating
workers’ compensation fraud and employer non-compliance for the
period of 7/1/06-6/30/07.
- Special Disability Trust
Fund, Actuarial Analysis as of June 30, 2007
[1.5MB PDF] has been added to
Publications
December 2007
- The Division of Workers’ Compensation is
proposing to amend Rule
69L-24.0231, F.A.C. The purpose of the amendment is to provide a
thirty day time period within which a Claims Administrator will not
receive a late filing penalty for any First Reports of Injury or
Illness accepted by the Division of Workers’ Compensation after the
Claims Administrator is first approved by the Division to
electronically submit such reports to the Division. The rule
workshop is scheduled for Monday, January 7, 9:00am – 12:00 pm in
Room104 J of the Hartman Bldg., 2012 Capital Circle S. E.,
Tallahassee, Florida. View rule
[40K PDF]
- New Informational Memorandum:
DFS-14-2007 [22K PDF] - Maximum
Workers’ Compensation Rate, Effective January 1, 2008
- Organization information for the
Bureau of Data Quality and Collection and
Bureau of Operations Support has been updated
- EDI statistics (paper vs.
electronic submissions) updated
- The following Medical EDI documents
have been updated on 12/6/2007:
- The Claims EDI section's
FL R3 Scenarios [2.9MB PDF] was
revised on 12/1/07
- Updated
Instructional Manual [2.8MB PDF] for
the online Penalty Payment Service
November 2007
- Statistics for
Non-Fatal Work-Related Injuries and Illnesses in Florida, 2006
has been added to the Statistics
section
- The Medical Services Unit, under the direction of the Division of
Workers Compensation, will hold a rulemaking workshop on
proposed rule 59A-34, Carrier Report of Health Care Provider
Violations and Initiation of Investigation. This workshop will take
place at the DWC headquarters, 2012 Capital Circle S.E.,
Tallahassee, FL, 104-J Hartman Building, on December 4, 2007
beginning at 9:00 a.m. This workshop is open to the public and
telephonic participation is available by dialing (850) 413-1591 or
(SC) 293-1591. External callers can reach Conference Connection via
this number. You will need the conference ID number, 920006, to
enter the conference call.
- The Occupational Safety and
Health Unit (OSH)
information located on the Safety page has
been updated
- Contact information for the Bureau
of Monitoring & Audit, EDI Medical,
Bureau of Employee Assistance, and
Data Quality & Collection sections have all been updated
- 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. Click here
[2.8MB PDF] to obtain a copy of the Instructional Manual,
which contains 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:
- EDI statistics (paper vs.
electronic submissions) updated
- Test DWC
Claims EDI R3 Data Warehouse (Release 3) added to
Claims EDI databases
- New additions and updates to the Claims
EDI section
October 2007
- An interactive Word version of the Florida Workers’ Compensation
Uniform Medical Treatment/Status Report Form (DFS-F5-DWC-25) has
been added under 69L-7 on the Rules & Forms
page
- The Revocation of Election of Coverage form (DFS-251-R
[17K PDF]) has been updated and can be found under
Rules & Forms (69L-6)
- The MDMS Web Site FAQ
[28K PDF] on the Medical EDI page
has been updated
- New additions and updates to the Claims
EDI section
- 69L-7.020 Florida Workers' Compensation Reimbursement Manual
for Health Care Providers Rule Update - The Florida Workers'
Compensation Health Care Provider Reimbursement Manual, 2007
Edition, has been adopted and will become effective 10/18/2007. The
rule implements new reimbursement rates as authorized by Florida’s
Three-Member Panel. A copy can be found below and also under the
Publications & Manuals section of our website.
- Contact information has been updated on the
Medical EDI and ODQC
sections
September 2007
- 69L-7.501 Florida Workers’ Compensation Reimbursement
Manual for Hospitals Rule Update - The Florida Workers'
Compensation Reimbursement Manual for Hospitals, 2006 Edition, has
been adopted and will become effective 10/01/2007, and applies to
all hospital admissions on or after 10/01/07. This rule implements
reimbursement rates as well as other important amendments throughout
each section of the rule. A copy can be found below and also under
Publications & Manuals.
- Division Notice of Proposed Rulemaking for proposed Rule
69L-7.020, Florida Workers' Compensation Health Care Provider
Reimbursement Manual, 2007 Edition. UPDATE - 9/25/07:
Administrative rule making procedures are in the final adoption
stages with an anticipated effective date of 10/19/07. The
Division will issue a formal DWC E-Alert notification advising
parties of the official effective date of this reimbursement manual,
and will update the website accordingly.
- The Division of Workers’ Compensation has published its 2007
Annual Report and it is now available under
Publications and Manuals. The Annual Report contains a summary
of the Division’s activities and accomplishments for fiscal year
2006-2007. View/download report
[2.3MB PDF]
- Instruction
Manual for the Online Medical Data Management System (MDMS), 2007,
Revised 09/14/2007 [1.76 MB PDF] (New
for Revision D). Also available in the
Medical EDI section.
- EOBR
Business Rules for 2007 [27K PDF]
(DWC-9, DWC-10, and DWC-11) (New for
Revision D) - updated 9/5/2007. Also available in the
Medical EDI section.
- New additions and updates were made to the
Claims EDI area
August 2007
- Division Notice of Proposed Rulemaking for proposed Rule
69L-7.020, Florida Workers' Compensation Health Care Provider
Reimbursement Manual, 2007 Edition. UPDATE - 08/20/2007:
The hearing scheduled on 08/22/2007 for the FL WC Health Care
Provider Reimbursement Manual was not requested, and therefore, will
not be held. After all required rule adoption administrative
procedures are taken, it is anticipated that this reimbursement
manual will go into effect in late September 2007. The Division will
issue a formal DWC E-Alert notification advising parties of the
official effective date of this reimbursement manual, and will
update the website accordingly.
- 69L-7.501 Reimbursement Rule Update 08/20/2007 –
On February 23, 2007, two rule challenge petitions were filed in
reference to the Florida Workers’ Compensation Reimbursement Manual
for Hospitals, 2006 Edition. The parties subsequently entered into a
Settlement Agreement which was approved by the Three-Member Panel in
its meeting of June 14, 2007. Following release by the Division of
Administrative Hearings, the Division will file the rule with the
Secretary of State for final adoption. The effective date of the
rule will be twenty days after it is filed with the Secretary of
State. The Division anticipates these steps will result in an
effective date of approximately October 1, 2007. Until the effective
date of the 2006 edition, the appropriate reimbursement manual to
use is the Hospital Reimbursement Manual, 2004 Second Edition.
- 69L-7.100 Florida Workers’ Compensation Ambulatory
Surgical Center Reimbursement Manual Rule Update -The
Florida Workers' Compensation Ambulatory Surgical Center
Reimbursement Manual has been adopted and will become effective
08/19/2007. This rule implements reimbursement rates as well as
other important amendments throughout each section of the rule. A
copy can be found below and also under the
Publications section of our website.
- The statistics area has been
updated, and
2006 Fatal Work-Related Injuries in Florida stats have been
added.
July 2007
June 2007
- The next FL Claims EDI Release 3 (non-medical) Training for Claim
Administrators will be held from 8:30-5 p.m. on August 22 & 23, 2007
on the campus of the University of South Florida in Tampa, FL. It is
recommended that both a business and technical representative from a
claim administrator attend. Seating is limited to 125, and priority
will be given to those who have not previously attended. There is no
charge to attend this training; however, a prior registration
confirmation is required. To reserve your place in the training,
please complete the
training registration form [12K PDF]
and fax it to 850-488-3453.
- The EDI Informational Brochure
[111K PDF] has been updated
May 2007
April 2007
- Rule Development Workshop Notice: 69L-7.020 - A public workshop
for the FL Workers’ Compensation Health Care Provider Reimbursement
Manual, 2007 Edition has been scheduled on 5/8/2007, 10:00 a.m.,
104J Hartman Bldg., 2012 Capital Circle SE, Tallahassee, Fl. 32399.
A formal notice of public workshop appears in the Florida
Administrative Weekly on 4/20/2007. (Click
here to view the notice)
- The Special Disability Trust Fund
(SDTF) section has been updated
- Division of Workers’ Compensation (DWC) and the Office of the
Judge of Compensation Claims (OJCC) will hold its next seminar at
Florida Community College at Jacksonville, Kent Campus on Friday,
May 4. More
details [25K PDF]
- Injured Worker
Workshop [307K PowerPoint] - This
presentation provides an overview of injured workers’ rights and
responsibilities under Florida’s workers’ compensation law,
information on medical and indemnity benefits, and answers many
questions injured workers have following their injury.
- The Claims EDI area has been updated
again
- New Informational Memoranda: DFS-07-07
[52K PDF] - Wage Loss Discount Factor Tables, April 10, 2007.
A complete list of Division bulletins can be found under
Informational Memoranda.
March 2007
- Instruction Manual
for the Online Medical Data Management System (MDMS), 2007, Revised
03/29/2007 [1.8MB PDF] (New
for Revision D)
- Future Claims EDI (non-medical) Release 3 Training
(click
here [12K PDF])
- The Claims EDI area has been updated
- 69L-7.100 Reimbursement Rule Update 03/09/2007 –
As requested, a public hearing was held on February 13, 2007 for the
Florida Workers' Compensation Reimbursement Manual for Ambulatory
Surgical Centers, 2006 Edition. Subsequent to the public hearing
date, a rule challenge has been received by the Division of Workers’
Compensation regarding this reimbursement manual. Pending the
outcome of the rule challenge, the appropriate reimbursement manual
to use is the Florida Workers’ Compensation Reimbursement Manual for
Ambulatory Surgical Centers, 2005 Edition.
- The Medical EDI section has been
updated
- 69L-7.602 - The Florida Workers' Compensation Medical
Billing, Filing, and Reporting Rule, 69L-7.602, F.A.C., has
been adopted and became effective 3/8/2007. A copy of this rule,
form completion instructions, and the required billing forms can be
found below and also under the Rules and
Forms section of our website.
- 69L-7.501 Reimbursement Rule Update 03/05/2007 –
As requested, a public hearing was held on February 13, 2007 for the
Florida Workers’ Compensation Reimbursement Manual for Hospitals,
2006 Edition. Subsequent to the public hearing date, a rule
challenge has been received by the Division of Workers’ Compensation
regarding this reimbursement manual. Pending the outcome of the rule
challenge, the appropriate reimbursement manual to use is the
Hospital Reimbursement Manual, 2004 Second Edition.
February 2007
- Claims EDI (non-medical) Release 3 Training in May in
Tallahassee: The Florida Division of Workers’ Compensation
announces a free two day training class, May 16 & 17, 2007 in
Tallahassee on the upcoming Claims EDI Release 3 mandate, and the
new EDI Rule (69L-56 F.A.C.) Prior registration is required. Please
complete and return the EDI Training Registration form to the
Division. (click
here [12K PDF])
- Claims EDI Release 3 Training in April: The
Florida Division of Workers’ Compensation announces a free two day
training class, April 17 & 18, 2007 in Orlando on the upcoming
Claims EDI Release 3 mandate, and the new EDI Rule (69L-56 F.A.C.)
Seating is limited to 120, and prior registration is required.
Class in now full.
- The Publications Order Form
[28K PDF] available under
Publications has changed
- EDI statistics (paper vs.
electronic submissions) have been updated
- The Claims EDI section has been
updated
- 69L-7.100 Reimbursement Rule Update 02/05/2007 -
A written request to conduct a public hearing has been received for
the Florida Division of Workers' Compensation Reimbursement Manual
for Ambulatory Surgical Centers, 2006 Edition. Accordingly a public
hearing will be held on Tuesday, February 13, 2007 at 9:00 a.m. in
room 104J Hartman Bldg., 2012 Capital Circle SE, Tallahassee, Fl.
32399.(Please see proposed rule
69L-7.100 [20K PDF] for contact
information.)
- 69L-7.501 Reimbursement Rule Update 02/05/2007 -
A written request to conduct a public hearing has been received for
the Florida Division of Workers' Compensation Reimbursement Manual
for Hospitals, 2006 Edition. Accordingly a public hearing will be
held on Tuesday, February 13, 2007 at 1:00 p.m. in room 104J Hartman
Bldg., 2012 Capital Circle SE, Tallahassee, Fl. 32399. (Please see
proposed rule 69L-7.501
[18K PDF] for contact information.)
January 2007
- 69L-7.602 - A written request to conduct a public hearing for the
Florida Workers' Compensation Medical Billing, Filing, and Reporting
Rule, 69L-7.602, F.A.C., was not received by the Division of
Workers' Compensation. Accordingly, the public hearing scheduled for
1/23/2007, 104J Hartman Building, 9:00 a.m., Tallahassee, Florida,
was not held. Formal adoption of this rule is forthcoming, and
notification of the effective adoption date will be issued via the
DWC-eAlert system, publication on the Division's
web page, and through the Secretary of State's Florida
Administrative Weekly publication.
- The Three-Member Panel has issued its
biennial report [170K PDF] on methods
for improving the workers’ compensation medical delivery system.
- 69L-7.100 Rule Development Hearing Announcement - If requested, a
hearing will be scheduled for the Florida Division of Workers’
Compensation Reimbursement Manual for Ambulatory Surgical Centers,
2006 Edition on 2/13/2007, 9:00 a.m., 104J Hartman Bldg., 2012
Capital Circle SE, Tallahassee, Fl. 32399. (Please see proposed rule
69L-7.100 [20K PDF] for contact
information.)
- 69L-7.501 Rule Development Hearing Announcement - If requested, a
hearing will be scheduled for the Florida Division of Workers’
Compensation Reimbursement Manual for Hospitals, 2006 Edition on
2/13/2007, 1:00 p.m., 104J Hartman Bldg., 2012 Capital Circle SE,
Tallahassee, Fl. 32399. (Please see proposed rule
69L-7.501 [18K PDF] for contact
information.)
- The information in the EDI Proof of
Coverage section has been updated
- ATTENTION: ALL INSURERS AND TPA'S: The Division
of Workers’ Compensation announces the adoption of Rule 69L-56,
F.A.C., Electronic Data Interchange (EDI) Requirements for Proof of
Coverage and Claims (non-medical), effective January 7, 2007. The
rule now requires all insurers to report certain
claims information to the Division electronically, rather than on
DWC Forms adopted in Rule 69L-3, F.A.C. A copy of the rule text has
been posted to the Division’s web site
here. The rule also incorporates amendments to the POC
EDI filing requirements which will become effective April 2, 2007,
including the reporting of a new data element, “Transaction Issue
Date”, and a revised Florida POC EDI R2.1 Implementation Manual. A
copy of the revised POC EDI R1.2 Implementation Manual can be found
here.
- FAQs about Rule 59A-31, Resolution of
Workers’ Compensation Reimbursement Disputes
[21K PDF]
- The Bureau of Compliance section
has been updated
- The Division of Insurance Fraud, Bureau of Workers’ Compensation
Fraud and the Division of Workers’ Compensation, Bureau of
Compliance issued a joint
report [1.83M PDF] summarizing their
respective efforts and activities in combating workers’ compensation
fraud and employer non-compliance for the period of July 1, 2005 -
June 30, 2006.
- 69L-7.602 Rule Development Hearing Announcement - If requested, a
hearing will be scheduled for the Medical Billing, Filing and
Reporting Rule on 1/23/2007, 9:00 a.m., 104J Hartman Bldg., 2012
Capital Circle SE, Tallahassee, Fl. 32399. (Please see rule for
contact information.)
- The Bureau of Monitoring and Audit's
Statistics have been updated