To adopt the new version of the Florida Workers’ Compensation Reimbursement Manual for Hospitals, 2006 Edition, to implement the reimbursement rates authorized by the Three-Member Panel pursuant to Section 440.13(12), F.S., at its meeting on ...

 

DEPARTMENT OF FINANCIAL SERVICES
Divsion of Worker's Compensation

RULE NO: RULE TITLE
69L-7.501: Florida Workers' Compensation Reimbursement Manual for Hospitals
PURPOSE AND EFFECT: To adopt the new version of the Florida Workers’ Compensation Reimbursement Manual for Hospitals, 2006 Edition, to implement the reimbursement rates authorized by the Three-Member Panel pursuant to Section 440.13(12), F.S., at its meeting on December 14, 2006. In addition, the proposed Rule 69L-7.501 will incorporate by reference versions of the Florida Workers’ Compensation Medical Services Billing, Filing and Reporting Rule, (Rule 69L-7.602, F.A.C.) and the Florida Workers’ Compensation Health Care Provider Reimbursement Manual.

SUMMARY: Rule amendment reflecting changes to certain reimbursement levels, policy instructions, and, reference materials as authorized by Florida’s Three-Member Panel.

SUMMARY OF STATEMENT OF ESTIMATED REGULATORY COST: No Statement of Estimated Regulatory Cost was prepared.

Any person who wishes to provide information regarding a statement of estimated regulatory costs, or provide a proposal for a lower cost regulatory alternative must do so in writing within 21 days of this notice.

SPECIFIC AUTHORITY: 440.13(12), (14), 440.591 FS.
LAW IMPLEMENTED: 440.13(7), (12), (14) FS.
IF REQUESTED WITHIN 21 DAYS OF THE DATE OF THIS NOTICE, A HEARING WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW (IF NOT REQUESTED, THIS HEARING WILL NOT BE HELD):

DATE AND TIME: Tuesday, February 13, 2007, 1:00 p.m.

PLACE: 104J Hartman Building, 2012 Capital Circle, S.E., Tallahassee, Florida

THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE IS: Don Davis, Division of Workers’ Compensation, Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-4226, phone [phone]

 

THE FULL TEXT OF THE PROPOSED RULE IS:

69L-7.501 Florida Workers’ Compensation Reimbursement Manual for Hospitals.

(1) The Florida Workers’ Compensation Reimbursement Manual for Hospitals, 2006 2004 Second Edition, is adopted by reference as part of this rule. The Hospital Mmanual contains the Maximum Reimbursement Allowances (MRAs) determined by the Three Member Panel, pursuant to Section 440.13(12), Florida Statutes, and establishes reimbursement policyies, procedures, principles and standards for implementing statutory provisions regarding reimbursement for medically necessary services and supplies provided to injured workers in a hospital setting and per diem rates for hospital services and supplies. The policy, procedures, principles and standards in the Manual are in addition to the requirements established by the Florida Workers’ Compensation Medical Services Billing, Filing and Reporting Rule, Rule 69L-7.602, F.A.C. The Reimbursement Manual for Hospitals is available for inspection during normal business hours at the Florida Department of Financial Services, Document Processing Section, 200 East Gaines Street, Tallahassee, Florida 32399-0311, or may be obtained free of charge by print or download from the Department’s website at http://www.fldfs.com/wc.

(2) The Florida Workers’ Compensation Health Care Provider Reimbursement Manual [HCP RM], 2006, incorporated by reference into Rule 69L-7.020, F.A.C.; and the Workers’ Compensation Medical Services Billing, Filing and Reporting Rule, Rule 69L-7.602, F.A.C., are also incorporated by reference into this rule. Both rules and the HCP RM are available for inspection during normal business hours at the Florida Department of Financial Services, Document Processing Section, 200 East Gaines Street, Tallahassee, Florida 32399-0311, or via the Department’s web site at http://www.fldfs.com/wc. Form DWC-90, Uniform Bill (rev. 1992), also known as the UB-92, or HCFA-1450, is hereby incorporated by reference as part of this rule. The Florida Workers’ Compensation Health Care Provider Reimbursement Manual 2004, Second Edition, is incorporated by reference as part of this rule also. The reimbursement policies, billing codes and maximum reimbursement allowances for physical therapy, occupational therapy, speech therapy, radiology and clinical laboratory services contained in the manual shall be applied to hospital services provided on an outpatient basis only.

(3) The Florida Workers’ Compensation Reimbursement Manual for Hospitals, incorporated in subsection (1) above, and Form DWC-90 are available for inspection during normal business hours at the State of Florida Department of Financial Services, Document Processing Section, 200 East Gaines Street, Tallahassee, Florida 32399-0311, or via the Department’s website at http://www.fldfs.com.

Specific Authority 440.13(12), (14), 440.591 FS. Law Implemented 440.13(7), (12), (14), FS. History–New 6-9-87, Amended 6-1-92, 10-27-99, 7-3-01, Formerly 38F-7.501, 4L-7.501, Amended 12-4-03, 1-1-04, 7-4-04,________.

 

NAME OF PERSON ORIGINATING PROPOSED RULE: Don Davis, Office of Data Quality and Collection, Division of Workers’ Compensation

NAME OF SUPERVISOR OR PERSON WHO APPROVED THE PROPOSED RULE: Dan Sumner, Assistant Director, Division of Workers’ Compensation

DATE PROPOSED RULE APPROVED BY AGENCY HEAD: October 6, 2006

DATE NOTICE OF PROPOSED RULE DEVELOPMENT PUBLISHED IN FAW: October 20, 2006