11695016, 69L-7.602 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 11695016

Notice of Proposed Rule

Department:

DEPARTMENT OF FINANCIAL SERVICES

Division:

Division of Workers' Compensation

Chapter:

WORKERS' COMPENSATION MEDICAL REIMBURSEMENT AND UTILIZATION REVIEW

Overview

RULE:

69L-7.602

Florida Workers' Compensation Medical Services Billing, Filing and Reporting Rule

PURPOSE:

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 provides that an insurer shall, at the time of authorization or, if the decision to apportion the reimbursement is made after authorization, but prior to the rendering of services, 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). The proposed rule also deletes subsection (7) of the rule which addresses administrative penalties and fines for untimely payments to health care providers or the disposition of other medical bills. These penalty provisions are transferred to Rule Chapter 69L-24, F.A.C.

SUMMARY:

The proposed rule clarifies that insurers are required to provide notification to health care providers in cases where payment of reimbursement for medical services will be subject to apportionment. This proposed change also deletes a penalties provision that has previously been moved to Rule Chapter 24, F.A.C.

RULEMAKING AUTHORITY:

440.13(4), 440.15(3)(b), (d), 440.185(5), 440.525(2), 440.591, 440.593(5) FS.

LAW:

440.09, 440.13(2)(a), (3), (4), (6), (11), (12), (14), (16), 440.15(3)(b), (d), (5), 440.185(5), (9), 440.20(6), 440.525(2), 440.593 FS.

PRINT PUBLISH DATE:

7/6/2012 Vol. 38/27

COMMENTS:

From 7/6/2012 To 7/27/2012 (21 Days)
The public comment period for this notice has already expired.

REFERENCE MATERIALS:

No reference(s).

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