Regulatory News

The Florida Division of Workers' Compensation submitted a Notice of Change for Chapters 69L-7 and 69L-8 of the Florida Administrative Code.  The changes to the proposed rules are being made to address public comments and comments submitted by the Joint Administrative Procedures Committee.  Completion instructions for incorporated forms DFS-F5-DWC-9-A, DFS-F5-DWC-9-B, and DFS-F5-DWC-9-C are changed to clarify the dates of use for the ICD-9 and the required use of the ICD-10 upon federal implementation.  The proposed rules also include certain technical changes. The official Notices of Change appeared in the Volume 41, Number 216 of the Florida Administrative Weekly, published on November 5, 2015.  If you have questions about the Notices, please contact Pam Macon, Chief, Bureau of Monitoring and Audit, Division of Workers' Compensation at (850) 413-1708 or Pamela.Macon@myfloridacfo.com . A copy of each Notice may be found via the following links: http://www.FLRules.org...

The following is quoted from an NCCI release: OIR Issues Order on NCCI's Florida Workers Compensation Rate Filing On August 19, 2015, the National Council on Compensation Insurance (NCCI) proposed an overall workers compensation rate level decrease of 1.9% in Florida effective January 1, 2016. On November 3, 2015, the Office of Insurance Regulation (OIR) issued an order denying the 1.9% decrease and requesting NCCI make an amended filing for an overall workers compensation rate level decrease of 5.1% effective January 1, 2016. The 3.2% difference between NCCI's filing of 1.9% and the OIR's request for an amended filing of 5.1% is due to the inclusion of a 0.1% decrease associated with the Reimbursement Manual for Ambulatory Surgical Centers, and the disapproval of profit and contingency provision, expense constant component; and, indemnity trend. The OIR's order requested that NCCI amend its filing by November 9, 2015. NCCI is currently in the process of reviewing the ...

The Florida Division of Workers' Compensation has submitted its Special Disability Trust Fund, Estimation of Liabilities as of June 30, 2015.  The report was published according to 440.49(9)(e), Florida Statutes, on September 10, 2015, and is available on the Division's website on the Division of Workers' Compensation Report screen ( www.myfloridacfo.com/Division/WC/PublicationsFormsManualsReports/Reports/ ).

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...