17736661, 69L-7.501 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 17736661

Notice of Development of Rulemaking

Department:

DEPARTMENT OF FINANCIAL SERVICES

Division:

Division of Workers' Compensation

Chapter:

WORKERS' COMPENSATION MEDICAL REIMBURSEMENT AND UTILIZATION REVIEW

Overview

RULE:

69L-7.501

Florida Workers' Compensation Reimbursement Manual for Hospitals

PURPOSE:

The proposed rule is amended to adopt the 2016 Edition of the Florida Workers’ 
Compensation Reimbursement Manual for Hospitals (“Manual”), as approved by the Three-Member Panel during
a scheduled meeting held on April 20, 2016, pursuant to paragraph 440.13(12)(a), F.S. The 2016 Edition of the 
Manual increases the per diem reimbursement rates for surgical and non-surgical hospital inpatient services and
the threshold dollar amount triggering Stop-Loss reimbursement above reimbursement allowances specified in
the 2014 Edition of the Manual, as adopted by the existing rule. The 2016 Edition of the Manual also provides an
updated fee schedule for various categories of hospital outpatient services based on the Current Procedural 
Terminology (“CPT”) line level charge data, with an adjustment of the Maximum Reimbursement Allowance
 (“MRA”) based on the geographic location of the service provider.

SUBJECT:

Florida Workers’ Compensation Reimbursement Manual for Hospitals, 2016 Edition.

RULEMAKING AUTHORITY:

440.13(12), (14), 440.591, FS.

LAW:

440.13(7), (12), (14), FS.

PRINT PUBLISH DATE:

7/7/2016 Vol. 42/131

RELATED STATUTES
AND LAWS:

440.13(12), (14), 440.591, FS., 440.13(7), (12), (14), FS.

OVERSIGHT COMMITTEE:

Joint Administrative Procedures Committee
Florida Administrative Law Central Online Network (F.A.L.C.O.N.)

RELATED COURT CASES:

Division of Administrative Hearings

FEDERAL eRULEMAKING
WEB PORTAL:

Regulations.gov

HOW TO LINK TO
THIS NOTICE:

http://flrules.org/gateway/ruleno.asp?id=69L-7.501&PDate=7/7/2016&Section=1

REFERENCE MATERIALS:

No reference(s).

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