The proposed rulemaking amends existing rules governing the process for the resolution of reimbursement disputes between workers’ compensation carriers and health care providers, creates a new rule, and repeals four existing rules. The major changes ...

 

DEPARTMENT OF FINANCIAL SERVICES

Division of Workers’ Compensation

RULE NOS.:RULE TITLES:

69L-31.002Definitions

69L-31.003Petition Form

69L-31.004Carrier Response Form

69L-31.005Petition Requirements

69L-31.006Consolidation of Petitions

69L-31.007Service of Petition on Carrier and Affected Parties

69L-31.008Computation of Time

69L-31.009Carrier Response Requirements

69L-31.010Effect of Non-Response by Carrier

69L-31.011Complete Record

69L-31.012Joint Stipulation of the Parties

69L-31.013Petition Withdrawal

69L-31.014Overutilization Issues Raised in Reimbursement Dispute Resolution

PURPOSE AND EFFECT: The proposed rulemaking amends existing rules governing the process for the resolution of reimbursement disputes between workers’ compensation carriers and health care providers, creates a new rule, and repeals four existing rules. The major changes proposed include: adding a rule for defined terms; simplifying requirements for submission of reimbursement disputes; repealing rules related to non-response by a carrier and joint stipulations; and adopting revised forms.

SUBJECT AREA TO BE ADDRESSED: Procedures for the resolution of reimbursement disputes between workers’ compensation carriers and health care providers.

RULEMAKING AUTHORITY: 440.13(7)(e), 440.591, FS.

LAW IMPLEMENTED: 440.13(7), 440.13(7)(a), (b), (c), (e), 440.13(8)(b), 440.13(11)(a) and (c), 440.13(12), 440.13(14), 440.13(15), 440.525, FS.

A RULE DEVELOPMENT WORKSHOP WILL BE HELD AT THE DATE, TIME AND PLACE SHOWN BELOW:

DATE AND TIME: Wednesday, May 30, 2018, 9:30 a.m. to 12:00 p.m.

PLACE: Hartman Building, Room 102, 2012 Capital Circle SE, Tallahassee, FL 32301

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: Theresa Pugh, telephone: [phone], email: [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: Theresa Pugh, Program Administrator – Medical Services Section, Bureau of Monitoring and Auditing, Division of Workers’ Compensation, address: 2012 Capital Circle SE, Tallahassee, FL 32399-4229, telephone: [phone], email: [e-mail].

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