Florida Division to Host February Webinar on Notices of Action/Change

The Florida Division of Workers' Compensation is holding a webinar regarding Electronic Notices of Action or Change.

February 18, 2015, from 1:30 PM EST to 4:30 PM EST

Details are here

2015 Biennial Report Available

Fla. Stat. §440.13(12) creates a "three-member panel." The full section cited at the end of this post. Essentially, the law empowers the Florida Chief Financial Officer (CFO) or designee and appointed representatives from the perspective of employer and employee form a committee. The committee or panel is charged with setting the reimbursement allowance schedules for doctors, chiropractors, hospitals, surgical centers and more. 

The 2015 Biennial Report of the Three Member Panel is available on the Division's website. 

The Biennial Reports since 2005 are also available.

The following is quoted directly from Fla. Stat. §440.13(12)

(12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM REIMBURSEMENT ALLOWANCES.—

(a) A three-member panel is created, consisting of the Chief Financial Officer, or the Chief Financial Officer’s designee, and two members to be appointed by the Governor, subject to confirmation by the Senate, one member who, on account of present or previous vocation, employment, or affiliation, shall be classified as a representative of employers, the other member who, on account of previous vocation, employment, or affiliation, shall be classified as a representative of employees. The panel shall determine statewide schedules of maximum reimbursement allowances for medically necessary treatment, care, and attendance provided by physicians, hospitals, ambulatory surgical centers, work-hardening programs, pain programs, and durable medical equipment. The maximum reimbursement allowances for inpatient hospital care shall be based on a schedule of per diem rates, to be approved by the three-member panel no later than March 1, 1994, to be used in conjunction with a precertification manual as determined by the department, including maximum hours in which an outpatient may remain in observation status, which shall not exceed 23 hours. All compensable charges for hospital outpatient care shall be reimbursed at 75 percent of usual and customary charges, except as otherwise provided by this subsection. Annually, the three-member panel shall adopt schedules of maximum reimbursement allowances for physicians, hospital inpatient care, hospital outpatient care, ambulatory surgical centers, work-hardening programs, and pain programs. An individual physician, hospital, ambulatory surgical center, pain program, or work-hardening program shall be reimbursed either the agreed-upon contract price or the maximum reimbursement allowance in the appropriate schedule.

Three Member Panel Meeting Today in Tallahassee

The Three Member Panel meets today in Tallahassee. The meeting is at 9:00 a.m. in the LArson Building, room 116.  The agenda and other information for the meeting is here. 

The Florida First District Court of Appeal is in session this morning in sunny Miami. The proceedings are in the University of Miami Student Activities Center accross from the Law School at 9:00. Parking is available in the Pavia Garage at 5615 Pavia Street, Coral Gables.

Florida Division Hosting Seminars and Webinars

The Florida Division of Workers' Compensation will host seminars throughout the state. The following is quoted from their flyer. 

The Florida Department of Financial Services, Division of Workers’ Compensation offers Free Seminars and Webinars for Employers Regarding Florida’s Workers’ Compensation Laws and
Workplace Safety

Workers’ Compensation Topics
- Review of Key Statutory Definitions
- Insurance Coverage Requirements - Exemptions
- Contractor Responsibilities - Enforcement Provisions

Workplace Safety Topics - presented by OSHA
(U.S. Dept. of Labor, Occupational Safety and Health
Administration)
- Direct and Indirect Costs - Inspections
- Florida Fatalities

Classroom programs

Time: 9AM to Noon

Locations & Dates:

Jacksonville - January 27, 2015

Tampa - February 17, 2015

Miami - February 25, 2015

Orlando - March 18, 2015

Ft. Lauderdale - March 19, 2015

Pensacola - April 14, 2015

Jacksonville - April 21, 2015

Tampa - May 19, 2015

Miami - May 19, 2015

Lantana - June 2, 2015

Tallahassee - June 9, 2015

Orlando - June 15, 2015

Webinar programs

Workers’ Compensation:

2:00 pm – 3:00 pm (ET)

February 18, 2015

March 4, 2015

April 1, 2015

May 6, 2015

June 10, 2015

The Content is Identical in Each Workers’ Compensation Webinar

Workplace Safety:

2:00 pm – 3:00 pm (ET)

February 19, 2015

March 5, 2015

April 2, 2015

May 7, 2015

June 11, 2015

The Content is Identical in Each Workplace Safety Webinar

Division Announces Proposed Rule Development

• The following is all quoted from the Division website, http://www.myfloridacfo.com/Division/WC/noticesRules.htm#.VK5_bCvF8SM

None of the following content is original

• The Florida Division of Workers' Compensation submitted a Notice of Proposed Rule Development for Rules 69L-7.020 and 69L-7.100 F.A.C. The notice provides that, if requested in writing and not deemed unnecessary by the agency head, a rule development workshop will be held on Tuesday, January 13, 2015 at 2:00 p.m., eastern daylight time (EDT) at 2012 Capital Circle, SE, Room 102, Hartman Building.
  The official Notice of Rule Development appeared in the Volume 40, Number 248 of the Florida Administrative Weekly, published on December 24, 2014. If you have questions about the contents of this notice, please contact Pam Macon, Chief, Bureau of Monitoring and Audit, Division of Workers' Compensation at (850) 413-1708 orPamela.Macon@myfloridacfo.com.
  A copy of the notice and links to the proposed Rules may be found through the following link.
  • https://www.flrules.org/gateway/View_Notice.asp?id=15470644
  Draft versions of the reimbursement manuals may be found at the following links.
  • Draft of The Florida Workers’ Compensation Health Care Provider Reimbursement Manual, 2015
  • Draft of The Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers, 2015
• The Florida Division of Workers' Compensation will be holding a rule development workshop on Thursday, October 16, 2014 at 9:00 am in Room 102 of the Hartman Building, which is located at 2012 Capital Circle Southeast, Tallahassee, Florida. The Division has issued a Notice of Proposed Rulemaking via the Florida Administrative Register (FAR) for Rule Chapter 69L-6.026 Periodic Reports, and a Notice of Proposed Rule Development for Rule Chapter 69L-6.029 Employer Worksites, Florida Administrative Code (F.A.C.).
  Rule Chapter 69L-6.026, Florida Administrative Code, requires employers who are issued stop-work orders, where the assessed penalty exceeds $50,000, to file quarterly compliance reports with the Division of Workers' Compensation. The statutory language in section 440.107(7)(a), Florida Statutes, requiring employers to file quarterly reports has been repealed. Given the elimination of the need to file such reports, the rule, likewise, is now unnecessary. The official Notice of Proposed Rulemaking appeared in Volume 40, Number 187 of the FAR.
  Rule Chapter 69L-6.029, Florida Administrative Code, is being amended to implement applicable sections of Chapter 2014-109, Laws of Florida. Chapter 2014-109, Laws of Florida, amends section 440.107, Florida Statutes. This provision of Chapter 2014-109, Laws of Florida, after receipt of a written request from the DFS, increases the time within which an employer must produce requested business records or be subject to a Stop-Work Order from five (5) business days to ten (10) business days. The bill became effective July 1, 2014. The official Notice of Proposed Rule Development appeared in Volume 40, Number 187 of the FAR.

Division Report Details the State of Workers Comp in Florida.

The Florida Division of Workers' Compensation has issued its 2014 Results and Accomplishments Report. The report "was developed in an effort to provide meaningful workers’ compensation data" regarding Florida. 

Among the highlights:

The Bureau of Compliance completed more investigations in 2013-14 than in any of the four prior years.

Stop-work orders were also higher in 2013-14. Almost $9 million in "new" premiums were generated due to these stop-work orders.

Significant penalties, almost $39 million, were assessed. 

Applications for exemption from workers' compensation were also at a five-year high in 2013-14.

The Division concluded that providers had been underpaid in 86% of fee disputes in 2013-14.

The Division collected $78 million in assessments for the Administrative Trust Fund (ATF) and $46 million for the Special Disability Trust Fund (SDTF - which was sunset over a decade ago).

Total ATF income was almost $100 million, and expenditures almost $77 million. 

The Electronic Data Interchange (EDI) process has continued to improve. Accepted paper claims forms have decreased from 6,316 in 2010-11 to zero in 2013-14.

Healthcare provider payments were down in 2013-14. Hospital payments were up, both inpatient and outpatient. 

Pharmacy payments were up, while ambulatory surgical center payments remained consistent with 2012-13.

Payments for physician repackaged medications decreased almost $20 million from 2012-13.

The total volume of lost-time claims and the lost time claims rate per 1,000 employees were both lower in 2013-14. Each metric was the lowest last year compared to any other year in the presented data (since 2005).

The 2014 Report also provides statistics regarding what issues are being presented to Division Ombudsmen for resolution and their success rates with those issues. 

Florida Division to Host January 2015 Webinar on Notices of Action/Change

The Florida Division of Workers' Compensation is holding a webinar regarding Electronic Notices of Action or Change.

January 15, 2015, from 1:30 PM EST to 4:30 PM EST,

Details are here