RULE NO.: RULE TITLE:
69L-3.012: Notice of Denial
PURPOSE AND EFFECT: The proposed rule is amended to add new subsection 69L-3.012(9), F.A.C., to inform claims-handling entities of notice requirements to employees when the payment of a compensable medical benefit will be apportioned, pursuant to Section 440.15(5), F.S. The proposed rule clarifies that claims-handling entities must provide employees with notification of decisions to apply apportionment prior to the rendering of medical service(s). The proposed rule provides that compliance with the notice requirements is achieved by mailing Form DFS-F2-DWC-12 (Notice of Denial) to the employee as specified. The proposed rule also references the notice required under subsection 69L-7.602(5), F.A.C., that claims handling entities must provide to health care providers. The proposed rule applies for dates of injury occurring on or after October 1, 2003.
SUBJECT AREA TO BE ADDRESSED: Notice requirements to employees by claims-handling entities where apportionment is applied in the payment of a medical benefit.
RULEMAKING AUTHORITY: 440.185(5), 440.20(3), 440.591 FS.
LAW IMPLEMENTED: 440.12(2), 440.14, 440.15(5), 440.192(8), 440.20(2), (4), (9), (15)(f), 440.207(2) FS.
IF REQUESTED IN WRITING AND NOT DEEMED UNNECESSARY BY THE AGENCY HEAD, A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:
DATE AND TIME: Thursday, February 23, 2012, 9:00 a.m. – 10:00 a.m.
PLACE: Room 102, Hartman Building, 2012 Capital Circle Southeast, Tallahassee, Florida
Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 5 days before the workshop/meeting by contacting: Eric Lloyd, (850)413-1689 or Eric.Lloyd@myfloridacfo.com. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Eric Lloyd, Program Administrator, Office of Medical Services, Division of Workers’ Compensation, Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-4232, (850)413-1689 or Eric.Lloyd@myfloridacfo.com

THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS AVAILABLE AT NO CHARGE FROM THE CONTACT PERSON LISTED ABOVE.