The proposed rule reduces regulatory burdens placed on insurers under existing provisions of the rule. In the case of medical bills for pharmaceuticals or pharmaceutical services provided by a pharmacist licensed under Chapter 465, F.S., insurers ...

 

DEPARTMENT OF FINANCIAL SERVICES

Division of Worker's Compensation

RULE NO.:RULE TITLE:

69L-7.602Florida Workers' Compensation Medical Services Billing, Filing and Reporting Rule

PURPOSE AND EFFECT: The proposed rule reduces regulatory burdens placed on insurers under existing provisions of the rule. In the case of medical bills for pharmaceuticals or pharmaceutical services provided by a pharmacist licensed under Chapter 465, F.S., insurers would be relieved of the obligation of issuing an Explanation of Bill Review to that pharmacy or pharmacist if there is a contract between the two that governs and specifies the amount of reimbursement due on the medical bill.

SUBJECT AREA TO BE ADDRESSED: The proposed rule relieves insurers of the obligation of issuing an Explanation of Bill Review when providing reimbursement of medical bills for contractual pharmaceutical services.

RULEMAKING AUTHORITY: 440.13(4), 440.15(3)(b), (d), (f), 440.185(5), 440.20(6)(b), 440.525(2), 440.591, 440.593(5) FS.

LAW IMPLEMENTED: 440.09, 440.13(2)(a), (3), (4), (6), (11), (12), (14), (16), 440.15(3)(b), (d), (f), 440.185(5), (9), 440.20(6), 440.525(2), 440.593 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, June 6, 2013, 10:00 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, Program Administrator, Medical Services Unit, Division of Workers’ Compensation, Department of Financial Services, 200 East Gaines Street, Tallahassee, Florida 32399-4228, [phone] or [e-mail]

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