Summary


Rule amendment to change the Florida Workers’ Compensation Manual for Hospitals to incorporate Medicare’s Hospital Outpatient Prospective Payment System for reimbursing hospitals for outpatient bills, with payment adjustment factors of 1.74 times the Medicare allowed amount for scheduled surgeries and 3.95 times the Medicare amount for other specified compensable charges. Additional changes to the manual include recognition of the Integrated Outpatient Code Editor and the National Correct Coding Initiative edits and their updates from the Centers for Medicare and Medicaid Services in the Medicare Hospital Outpatient Prospective Payment System, and technical formatting changes to the manual.