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, ...

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     ...

The Florida Division of Workers' Compensation recently participated in the 70th Annual Workers' Compensation Educational Conference with the Workers' Compensation Institute, in Orlando, Florida.  The Division's breakout session included the following topics: Legislative Updates, What Injured Workers Are Telling Us, Audits and Carrier Compliance, Medical Services and EDI Updates.  If you were unable to attend or would like to view the presentations, the Division power point has been published as a .PDF at http://www.myfloridacfo.com/Division/WC/news.htm .  Please contact Brittany O'Neil at 850-413-1927 with any questions. To learn more about these issues and other Workers' Compensation information click here: http://www.myfloridacfo.com/Division/WC/ To remove yourself from the DWC Notification list and STOP e-mail Alerts sent to your e-mail address at david.langham@doah.state.fl.us , click the following link and unsubscribe your e-mail address: http://www.myflori...

The Florida Department of Financial Services, Division of Workers' Compensation has adopted the following rules with an effective date of September 6, 2015: 69L-6.015 - Record Maintenance and Production Requirements for Employers 69L-6.025 - Conditional Release of Stop-Work Order and Periodic Payment Agreement These rules are amended to conform to applicable provisions of Section 440.107, F.S., as revised under Chapter No. 2014-109, Laws of Florida.  Rule 69L-6.015, F.A.C., reduces the business record retention period requirements for employers under Florida's Workers' Compensation law to a period consisting of an employer's two, rather than three, years of employment activity.  Rule 69L-6.025, F.A.C., modifies the terms and conditions under which the Department's Division of Workers' Compensation is authorized to issue an Agreed Order of Conditional Release from Stop-Work Order to employers who violate Chapter 440, F.S., as well as the circumstances under which...

Director of Workers’ Compensation Unit  The Director of the Workers’ Compensation Unit provides supervisory administrative and legal work coordinating and overseeing the assignments and work product of staff attorneys assigned to the unit. Consistent with court policy, the Director develops procedures for efficient processing of all workers’ compensation cases filed with the court, assists in adopting means to implement those policies.  The Court’s goal is to have workers’ compensation cases resolved expeditiously, and to achieve decision uniformity.  To achieve these goals, the Directors reviews and has responsibility for all documents produced by the workers’ compensation unit.  The Director reports to the Chief Judge and participates in senior staff meetings and court conferences as required.  The Director, as a member of the unit, will analyze cases, prepare summaries with recommendations, and draft opinions based on the analyses.  The number of cases p...

Ninety-six members of The Florida Bar are presenting at the WCI in Orlando next week. NINETY-SIX! There could be a few more. I reviewed the program, page by page, and did my best to identify them all. If I missed someone, let me know. The annual WCI gathering is the largest workers’ compensation conference in the country. I am told that this year could see the largest turnout yet, as the conference celebrates its 70th anniversary. There are a multitude of programs, National Trends, National Review, Safety, Multistate Workers’ Compensation Laws, and breakouts for medical providers, therapists, attorneys, adjusters, and risk managers. It is the only workers’ compensation conference of which I know that hosts a national judicial college focused on the workers’ compensation adjudicator. This year the NAWCJ College will have over 100 adjudicators from across the country. This conference also hosts the SAWCA Regulator College, an unparalleled gathering of regulators to discuss ...