The purpose and effect of this proposed rule is to: 1. Clarify that the mandatory reporting of all instances of overutilization to the Division of Workers’ Compensation (Division) shall be accomplished by means of the Carrier’s compliance with the ...

DEPARTMENT OF FINANCIAL SERVICES
Division of Worker's Compensation

RULE NO: RULE TITLE
69L-34.001: Definitions
69L-34.002: Mandatory Carrier Reporting
69L-34.003: Referral of Alleged Health Care Provider Violation
69L-34.004: Timeliness of Referral
69L-34.005: Referral Investigation
69L-34.006: Invalid Referrals
PURPOSE AND EFFECT: The purpose and effect of this proposed rule is to:
1. Clarify that the mandatory reporting of all instances of overutilization to the Division of Workers’ Compensation (Division) shall be accomplished by means of the Carrier’s compliance with the Division’s medical claims information filing requirements in subsections 69L-7.602(5) and (6), Florida Administrative Code (F.A.C.), Florida Workers’ Compensation Medical Services Billing, Reporting and Filing Rule; and
2. Introduce a discretionary reporting process by which Carriers may report to the Division, a Health Care Provider’s violation of Chapter 440, Florida Statutes (F.S.), and applicable administrative rules.
SUBJECT AREA TO BE ADDRESSED: The process by which a Carrier shall comply with mandatory reporting requirements set forth in Section 440.13(8)(a), F.S., and the procedure by which a carrier may also report to the Division other Health Care Provider violations as specifically defined in this rule.
SPECIFIC AUTHORITY: 440.13(13)(g), 440.591 FS.
LAW IMPLEMENTED: 440.13(4), (7), (8), (11), (13), (14), (16), 440.192 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:
TIME AND DATE: Wednesday, December 2, 2009, 9:00 a.m.
PLACE: 104J 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, [phone] or [e-mail]. 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, Office of Medical Services, Division of Workers’ Compensation, Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-4232, [phone], [e-mail]

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