Regulatory News

Revised Rule 69L-7.100, Florida Administrative Code, (Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs)), became effective as of September 28, 2015; however, the reimbursement manual does not go into effect until January 1, 2016 (as provided in the rule text). https://www.flrules.org/gateway/RuleNo.asp?title=WORKERS''%20COMPENSATION%20MEDICAL%20REIMBURSEMENT%20AND%20UTILIZATION%20REVIEW&ID=69L-7.100 If you have any questions regarding this message, please contact Pam Macon, Chief, Bureau of Monitoring and Audit, Division of Workers' Compensation at (850) 413-1708 or Pamela.Macon@myfloridacfo.com . 

The following is directly from a Division of Workers' Compensation notification and is all quoted verbatim.  On October 1, 2015 the Centers for Medicare & Medicaid Services (CMS) will be transitioning to ICD-10 (diagnosis coding).  In line with the CMS policy, the Division of Workers' Compensation will require ICD-10 codes for medical bills and medical EDI transactions containing dates of service on or after 10/1/15.  The Division will require ICD-9 codes on medical bills and medical EDI transactions with dates of service prior to 10/1/15. In an effort to promote the self-executing nature of the workers' compensation system, the Division urges all interested parties to consider Rule 69L-7.710(5)(j)1.a., F.A.C. in securing correct diagnosis codes.  The rule states, in part, the insurer, service company/TPA, or entity acting on behalf of the insurer can: "Secure and/or correct the information on the medical bill and proceed to make a reimbursement decision to pay, ad

https://www.flrules.org/gateway/ruleNo.asp?id=69L-30.002 Notice of Change/Withdrawal DEPARTMENT OF FINANCIAL SERVICES Division of Worker's Compensation RULE NOS.:        RULE TITLES: 69L-30.002           Definitions 69L-30.003           Qualifications for Expert Medical Advisor Certification 69L-30.004           Application for Expert Medical Advisor Certification 69L-30.005           Selection of Expert Medical Advisors 69L-30.006           Temporary Expert Medical Advisors 69L-30.007           Expert Medical Advisor Responsibilities 69L-30.008           Billing and Reimbursement for Expert Medical Advisor 69L-30.010           Expert Medical Advisor Decertification NOTICE OF CHANGE Notice is hereby given that the following changes have been made to the proposed rule in accordance with subparagraph 120.54(3)(d)1., F.S., published in Vol. 41 No. 57, March 24, 2015 issue of the Florida Administrative Register. The changes to the proposed rules are made in response to comments submitt