The Workers' Compensation Regulatory News blog page has all been duplicated and reposted. This address will no longer be updated or supplemented after December 31, 2021.
Visit the new location: https://regulatoryworkcomp.blogspot.com/
Tuesday, December 21, 2021
Tuesday, July 13, 2021
69L-6.007 Compensation Notice; Anti-Fraud Reward Program Notice.
July 13, 2021
To: All Self-Insurers, Insurers, Claim Administrators, Employers, Injured Workers, Attorneys, and Interested Consumers
From: Florida Division of Workers' Compensation
Subject: Notice of Proposed Rule for 69L-6.007 F.A.C. – Compensation Notice
If requested in writing, a workshop regarding Proposed Rule 69L-6.007, F.A.C. – Compensation Notice will be held August 3, 2021 at 9:30 a.m. ET., at 1579 Summit Lake Drive, Tallahassee, FL 32317
SUBJECT AREA TO BE ADDRESSED: Compensation notice and anti-fraud reward program notice.
A copy of the Notice of Workshop Hearing may be found here.
A copy of the agenda and draft Rule may be found here.
"Anti fraud reward program"
The official Notice of Development of Rulemaking appeared in the Volume 47, Number 133 of the Florida Administrative Weekly, published on July 12, 2021. If you have questions about the contents of this notice, please contact Pamela Macon, Chief, Bureau of Compliance, Division of Workers' Compensation at pamela.macon@myfloridacfo.com
To: All Self-Insurers, Insurers, Claim Administrators, Employers, Injured Workers, Attorneys, and Interested Consumers
From: Florida Division of Workers' Compensation
Subject: Notice of Proposed Rule for 69L-6.007 F.A.C. – Compensation Notice
If requested in writing, a workshop regarding Proposed Rule 69L-6.007, F.A.C. – Compensation Notice will be held August 3, 2021 at 9:30 a.m. ET., at 1579 Summit Lake Drive, Tallahassee, FL 32317
SUBJECT AREA TO BE ADDRESSED: Compensation notice and anti-fraud reward program notice.
A copy of the Notice of Workshop Hearing may be found here.
A copy of the agenda and draft Rule may be found here.
"Anti fraud reward program"
The official Notice of Development of Rulemaking appeared in the Volume 47, Number 133 of the Florida Administrative Weekly, published on July 12, 2021. If you have questions about the contents of this notice, please contact Pamela Macon, Chief, Bureau of Compliance, Division of Workers' Compensation at pamela.macon@myfloridacfo.com
Wednesday, December 2, 2020
Max Comp Rate 2021
The Florida Department of Economic Opportunity has determined the statewide average weekly wage paid by employers subject to the Florida Reemployment Assistance Program Law to be $1,011.07 for the four calendar quarters ending June 30, 2020.
Section 440.12(2), Florida Statutes (2020), expressly provides that, for injuries occurring on or after August 1, 1979, the weekly compensation rate shall be equal to 100 percent of the statewide average weekly wage, adjusted to the nearest dollar, and that the average weekly wage determined by the Department of Economic Opportunity for the four calendar quarters ending each June 30 shall be used in determining the maximum weekly compensation rate with respect to injuries occurring in the calendar year immediately following.
Accordingly, the maximum weekly compensation rate for work-related injuries and illnesses occurring on or after January 1, 2021, shall be $1,011.
Wednesday, July 1, 2020
69L-31, F.A.C. - Utilization and Reimbursement Dispute Rules
The Florida Division of Workers' Compensation submitted a Notice of Meeting/Workshop Hearing for 69L-31, F.A.C. - Utilization and Reimbursement Dispute Rules. The hearing will be held on Wednesday, July 15, 2020, 9:00 a.m. Eastern Time, via webinar. The webinar details are below.
You may join the meeting from your computer, tablet or smartphone at the time of the meeting.
The link to the GoToMeeting is as follows: https://global.gotomeeting.com/join/573862389
You may also Join via phone at:
You may join the meeting from your computer, tablet or smartphone at the time of the meeting.
The link to the GoToMeeting is as follows: https://global.gotomeeting.com/join/573862389
You may also Join via phone at:
United States (Toll Free): (877) 309-2073
United States: (646) 749-3129
Access Code: 573-862-389
Access Code: 573-862-389
69L-7, F.A.C. - Utilization and Reimbursement Dispute
Virtual Workshop
The Florida Division of Workers' Compensation submitted a Notice of Meeting/Workshop Hearing for 69L-7, F.A.C. - Workers' Compensation Medical Reimbursement and Utilization Review. The hearing will be held on Wednesday, July 22, 2020, 9:30 a.m. Eastern Time, via webinar. The webinar details are below.
You may join the meeting from your computer, tablet or smartphone at the time of the meeting.
The link to the GoToMeeting is as follows: https://global.gotomeeting.com/join/962878717
You may also Join via phone at:
United States (Toll Free): (877) 309-2073
United States: (571) 317-3129
Access Code: 962-878-717
Thursday, May 21, 2020
Workshop Hearing for 69L-31, F.A.C
To: All Self-Insurers, Insurers, Claim Administrators, and Medical Service Providers
From: Florida Division of Workers' Compensation
Subject: Notice of Meeting/Workshop Hearing for 69L-31, F.A.C. - Utilization and Reimbursement Dispute Rules
The Florida Division of Workers' Compensation submitted a Notice of Meeting/Workshop Hearing for 69L-31, F.A.C. - Utilization and Reimbursement Dispute Rules. The hearing scheduled for Wednesday, June 10, 2020 will not take place and will be held on Wednesday, July 15, 2020, 9:00 a.m. Eastern Time, at 1579 Summit Lake Drive, Room 155, Tallahassee, FL 32317.
SUBJECT AREA TO BE ADDRESSED: The hearing is being conducted to receive public input and consider proposed changes to the above-referenced rule chapter.
The official Notice of Meeting/Workshop Hearing appeared in the Volume 46, Number 100 of the Florida Administrative Weekly, published on May 21, 2020. If you have questions about the contents of this notice, please contact Theresa Pugh, Program Administrator, Medical Services Section, Division of Workers' Compensation at Theresa.Pugh@myfloridacfo.com.
A copy of the notice may be found here.
Monday, April 6, 2020
Medical Billing and Bill Review Rule Making
April 3, 2020
To: All Self-Insurers, Insurers, Claim Administrators, and Medical Service Providers
From: Florida Division of Workers' Compensation
Subject: Notice of Development of Rulemaking for the following:
69L-7.710 Definitions
69L-7.720 Forms Incorporated by Reference for Medical Billing, Filing and Reporting
69L-7.730 Health Care Provider Medical Billing and Reporting Responsibilities
69L-7.740 Insurer Authorization and Medical Bill Review Responsibilities
The Florida Division of Workers' Compensation submitted a Notice of Development of Rulemaking for 69L-7.710, 69L-7.720, 69L-7.730, and 69L-7.740, F.A.C. A workshop will be held Wednesday, May 27, 2020, 9:30 a.m. Eastern Time, at 1579 Summit Lake Drive, Room 155, Tallahassee, FL 32317.
SUBJECT AREA TO BE ADDRESSED: The medical reimbursement and utilization review requirements.
The official Notice of Development of Rulemaking appeared in Volume 46, Number 66 of the Florida Administrative Weekly, published on April 3, 2020. If you have questions about the contents of this notice, please contact Theresa Pugh, Program Administrator, Medical Services Section, Division of Workers' Compensation at Theresa.Pugh@myfloridacfo.com.
A copy of the notice may be found here.
To: All Self-Insurers, Insurers, Claim Administrators, and Medical Service Providers
From: Florida Division of Workers' Compensation
Subject: Notice of Development of Rulemaking for the following:
69L-7.710 Definitions
69L-7.720 Forms Incorporated by Reference for Medical Billing, Filing and Reporting
69L-7.730 Health Care Provider Medical Billing and Reporting Responsibilities
69L-7.740 Insurer Authorization and Medical Bill Review Responsibilities
The Florida Division of Workers' Compensation submitted a Notice of Development of Rulemaking for 69L-7.710, 69L-7.720, 69L-7.730, and 69L-7.740, F.A.C. A workshop will be held Wednesday, May 27, 2020, 9:30 a.m. Eastern Time, at 1579 Summit Lake Drive, Room 155, Tallahassee, FL 32317.
SUBJECT AREA TO BE ADDRESSED: The medical reimbursement and utilization review requirements.
The official Notice of Development of Rulemaking appeared in Volume 46, Number 66 of the Florida Administrative Weekly, published on April 3, 2020. If you have questions about the contents of this notice, please contact Theresa Pugh, Program Administrator, Medical Services Section, Division of Workers' Compensation at Theresa.Pugh@myfloridacfo.com.
A copy of the notice may be found here.
Monday, March 30, 2020
Telehealth Announcement
The Following was sent by the Division of Workers' Compensation.
|
March 30, 2020
To: All Self-Insurers, Insurers, Claim Administrators, and
Medical Service Providers
From: Florida Division of Workers' Compensation Subject: Telehealth and Telemedicine Services Provided Under Chapter 440, Florida Statutes
In response to the recent
outbreak of COVID-19, the Division of Workers’ Compensation is providing the
following information related to telehealth and telemedicine services
provided by licensed practitioners to workers’ compensation patients under
chapter 440, Florida Statutes.
All telehealth and telemedicine
services are governed under the Florida Department of Health, section 456.47,
Florida Statutes. Authorized services must be in compliance with section
456.47,
Florida Statutes and Florida Department
of Health Emergency Order 20-002.
The provision of telehealth and
telemedicine services provided by licensed practitioners must be mutually
agreed upon by the carrier and health care provider prior to
treatment. Emergency services and care, defined in section 395.002,
Florida Statutes, do not require prior authorization.
Carriers and health care providers should utilize national
coding standards as adopted by the Centers for Medicaid and Medicare Services
to accommodate the provision of telehealth and telemedicine services.
All telemedicine and telehealth services provided by health care
practitioners should be billed with Place of Service Code (POS) 02 on the
DFS-F5-DWC-09/CMS-1500 claim form.
Reimbursement is according to a mutually agreed upon contract amount or the listed Maximum Reimbursement Allowance (MRA) in the Florida Workers’ Compensation Health Care Provider Reimbursement Manual, 2016 Edition. A copy of this reimbursement manual may be found here.
Please email any questions regarding this e-alert notification
to Workers.CompMedService@myfloridacfo.com
To learn more about these issues and other Workers' Compensation
information click here: https://www.myfloridacfo.com/division/wc/
|
Tuesday, November 26, 2019
2020 Maximum Compensation Rate Announced
The Florida Department of Economic Opportunity has determined the statewide average weekly wage paid by employers subject to the Florida Reemployment Assistance Program Law to be $970.58 for the four calendar quarters ending June 30, 2019.
Section 440.12(2), Florida Statutes (2019), expressly provides that, for injuries occurring on or after August 1, 1979, the weekly compensation rate shall be equal to 100 percent of the statewide average weekly wage, adjusted to the nearest dollar, and that the average weekly wage determined by the Department of Economic Opportunity for the four calendar quarters ending each June 30 shall be used in determining the maximum weekly compensation rate with respect to injuries occurring in the calendar year immediately following.
Accordingly, the maximum weekly compensation rate for work-related injuries and illnesses occurring on or after January 1, 2020, shall be $971.00.
| 01/01/2020 | $971 | $20 |
| 01/01/2019 | $939 | $20 |
| 01/01/2018 | $917 | $20 |
| 01/01/2017 | $886 | $20 |
| 01/01/2016 | $863 | $20 |
| 01/01/2015 | $842 | $20 |
| 01/01/2014 | $827 | $20 |
| 01/01/2013 | $816 | $20 |
| 01/01/2012 | $803 | $20 |
| 01/01/2011 | $782 | $20 |
| 01/01/2010 | $772 | $20 |
| 01/01/2009 | $765 | $20 |
| 01/01/2008 | $746 | $20 |
| 01/01/2007 | $724 | $20 |
| 01/01/2006 | $683 | $20 |
| 01/01/2005 | $651 | $20 |
| 01/01/2004 | $626 | $20 |
| 01/01/2003 | $608 | $20 |
| 01/01/2002 | $594 | $20 |
| 01/01/2001 | $571 | $20 |
| 01/01/2000 | $541 | $20 |
| 01/01/1999 | $522 | $20 |
| 01/01/1998 | $494 | $20 |
| 01/01/1997 | $479 | $20 |
| 01/01/1996 | $465 | $20 |
| 01/01/1995 | $453 | $20 |
| 01/01/1994 | $444 | $20 |
| 01/01/1993 | $425 | $20 |
| 01/01/1992 | $409 | $20 |
| 01/01/1991 | $392 | $20 |
| 01/01/1990 | $382 | $20 |
| 01/01/1989 | $362 | $20 |
| 01/01/1988 | $344 | $20 |
| 01/01/1987 | $330 | $20 |
| 01/01/1986 | $315 | $20 |
| 01/01/1985 | $307 | $20 |
| 01/01/1984 | $288 | $20 |
| 01/01/1983 | $271 | $20 |
| 01/01/1982 | $253 | $20 |
| 01/01/1981 | $228 | $20 |
| 01/01/1980 | $211 | $20 |
| 08/01/1979 | $195 | $20 |
| 01/01/1979 | $130 | $20 |
| 01/01/1978 | $126 | $20 |
| 01/01/1977 | $119 | $20 |
| 01/01/1976 | $112 | $20 |
| 01/01/1975 | $105 | $20 |
| 07/01/1973 | $80 | $20 |
| 07/01/1972 | $66 | $20 |
| 07/01/1970 | $56 | $12 |
| 01/01/1968 | $49 | $8 |
| 07/01/1959 | $42 | $8 |
| 07/01/1951 | $35 | $8 |
| 1945 | $22 | $8 |
| 1937 | $18 | $6 |
Wednesday, February 20, 2019
Florida Joint Report on Fraud and Non-Compliance
The Division of Investigative and Forensic Services, Bureau of
Workers’ Compensation Fraud and the Division of Workers' Compensation, Bureau
of Compliance issued a joint report summarizing their respective efforts and
activities in combating workers' compensation fraud and employer
non-compliance. The July 1, 2017 - June 30, 2018 report can be viewed at: https://www.myfloridacfo.com/Division/WC/PublicationsFormsManualsReports/Reports/
Tuesday, February 12, 2019
Meeting of the Three-Member Panel
On February 12, 2019 The Florida Department of Financial Services, Division of
Workers' Compensation announces a public meeting of the Three-Member Panel that
will be held on Monday, February 18, 2019, beginning at 1:00 p.m. in room 116
of the J. Edwin Larson Building located at 200 East Gaines Street, Tallahassee,
Florida. This public meeting, to which all are invited, has been convened to
facilitate the Panel's consideration of the following items:
- The Three-Member Panel 2019 Biennial Report
- Rulemaking status update for the 2018 editions of the
Reimbursement Manuals
- The Division's Annual Report on the resolution of
health care provider medical reimbursement disputes and activities (2018)
conducted pursuant to s. 440.13(8), F.S.
The Three-Member Panel Meeting agenda and meeting documents are
available here, under
the Notices tab.
Notice of this public meeting appeared in Volume
45, Number 26 of the of the Florida Administrative Register,
published on February 7, 2019.
If you have questions about
this communication, please contact: Brittany O'Neil, Policy Coordinator,
Division of Workers' Compensation, Department of Financial Services, 200 East
Gaines Street, Tallahassee, Florida 32399-4220, Phone (850) 413-1927 or Brittany.ONeil@myfloridacfo.com.
Monday, December 3, 2018
2019 Maximum Comp Rate Florida
The Florida Department of Economic Opportunity has determined the statewide average weekly wage paid by employers subject to the Florida Reemployment Assistance Program Law to be $939.41 for the four calendar quarters ending June 30, 2018.
Section 440.12(2), Florida Statutes (2018), expressly provides that, for injuries occurring on or after August 1, 1979, the weekly compensation rate shall be equal to 100 percent of the statewide average weekly wage, adjusted to the nearest dollar, and that the average weekly wage determined by the Department of Economic Opportunity for the four calendar quarters ending each June 30 shall be used in determining the maximum weekly compensation rate with respect to injuries occurring in the calendar year immediately following.
Accordingly, the maximum weekly compensation rate for work-related injuries and illnesses occurring on or after January 1, 2019, shall be $939.00.
Thursday, November 8, 2018
Rules 69L-7.020 and 69L-7.100 - Health Care Provider Reimbursement Manual
The Florida Division of Workers' Compensation submitted a Notice
of Proposed Rule for Rules 69L-7.020 and 69L-7.100, F.A.C. Rule Hearings will
be held on Tuesday, November 27, 2018, at the times listed below, at 2012
Capital Circle, SE, Room 102, Hartman Building. All times are Eastern.
SUBJECT AREA TO BE ADDRESSED:
Florida Workers' Compensation Health Care Provider Reimbursement Manual, 2018 Edition; Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs), 2018 Edition.
Florida Workers' Compensation Health Care Provider Reimbursement Manual, 2018 Edition; Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs), 2018 Edition.
02:00 p.m., Eastern, 69L-7.100, Florida Workers'
Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs), 2018
Edition.
03:00 p.m., Eastern, 69L-7.020, Florida Workers'
Compensation Health Care Provider Reimbursement Manual, 2018 Edition.
The official Notice of Proposed Rule appeared Volume 44, Number
217, of the Florida Administrative Weekly, published on November 6, 2018. If
you have questions about the contents of this notice, please contact Theresa
Pugh, Program Administrator, Medical Services Section, Division of Workers'
Compensation at (850) 413-1721 or Theresa.Pugh@myfloridacfo.com.
- A copy of the notice and preliminary text of the Rules
may be found here.
- Draft versions of the reimbursement manuals may be
found at the following links.
Rule 69L-7.501 - Reimbursement Manual for Hospitals
The Florida Division of Workers' Compensation submitted a Notice
of Development of Rulemaking for Rule 69L-7.501, F.A.C. A rule
development workshop will be held on Tuesday, November 27, 2018, at 1:00 p.m.,
Eastern, at 2012 Capital Circle SE, Room 102, Hartman Building.
SUBJECT AREA TO BE ADDRESSED:
Florida Workers’ Compensation Reimbursement Manual for
Hospitals, 2018 Edition
The official Notice of Development of Rulemaking appeared in
Volume 44, Number 217, of the Florida Administrative Weekly, published on
November 6, 2018. If you have questions about the contents of this notice,
please contact Theresa Pugh, Program Administrator, Medical Services Section,
Division of Workers' Compensation at (850) 413-1721 or Theresa.Pugh@myfloridacfo.com.
Rule 69L-31 Hearing Notice
The Florida Division of Workers' Compensation submitted Notice
of Proposed Rule for 69L-31, F.A.C. A hearing will be held Tuesday,
November 27, 2018, 11:00 a.m., Eastern, at 2012 Capital Circle, SE, Room 102,
Hartman Building, in Tallahassee, Florida.
SUBJECT AREA TO BE ADDRESSED: Procedures for the resolution of
reimbursement disputes between workers’ compensation carriers and health care
providers.
Please note that the Division encourages all parties to provide
details regarding any potential economic or cost impact related to the proposed
rule.
The official Notice of Proposed Rule appeared in appeared Volume
44, Number 217, of the Florida Administrative Weekly, published on November 6,
2018. If you have questions about the contents of this notice, please contact
Theresa Pugh, Program Administrator, Medical Services Section, Division of
Workers' Compensation at (850) 413-1721 or Theresa.Pugh@myfloridacfo.com.
Wednesday, October 31, 2018
Florida Division Notices Proposed Rule - Grievous Harm
The Florida Division of Workers' Compensation submitted a Notice
of Proposed Rule for Rule 69L-3.009, F.A.C. If requested within 21 days
of the notice, a hearing will be held on Tuesday, November 27, 2018, 9:00 a.m.
ET, at the Hartman Building Room 102, 2012 Capital Circle SE, Tallahassee, FL
32301.
A new rule is being introduced due to the passage of CS/CS/SB
376, which added subsections (5) and (6) to section 112.1815, Florida Statutes
(F.S.). Section 112.1815(5)(f), F.S., requires the Department of
Financial Services to adopt rules specifying injuries qualifying as grievous
bodily harm of a nature that shocks the conscience.
Rule draft:
69L-3.009 Injuries that Qualify as Grievous Bodily Harm of a Nature that Shocks the Conscience. Pursuant to section 112.1815(5), F.S., for purposes of determining the compensability of employment-related posttraumtic stress disorder for first responders, the following injuries qualify as grievous bodily harm of a nature that shocks the conscience:
(1) Decapitation (full or partial),
(2) Degloving,
(3) Enucleation,
(4) Evisceration.
(5) Exposure of one or more internal organs,
(a) Brain,
(b) Heart,
(c) Intestines
(d) Kidneys,
(e) Liver, or
(f) Lungs
(6) Impalement,
(7) Severance (full or partial), and
(8) Third degree burn on 9% or more of the body
Rulemaking Authority 112.1815(5)(f), 440.591, FS. Law Implemented 112.1815, FS. History-New.
Wednesday, October 17, 2018
*Emergency Order 234790-18-EO : MICHAEL10152018*
On October 14, 2018, Governor Rick Scott directed Florida
Insurance Commissioner David Altmaier to take every action authorized pursuant
to Executive
Order 18-276 to provide additional protections to support
recovery efforts as it relates to Hurricane Michael’s impact on Florida
families as well as Florida policyholders.
On October 15, 2018, Commissioner Atlmaier issued the following
Emergency Order enacting those protections for Florida policyholders:
In response to the Emergency Order, the Florida Division of
Workers’ Compensation will review policies reported since September 27, 2018
and automatically extend coverage for the policies in the affected counties in
accordance with the time frames set forth in the Order.
Monday, September 24, 2018
SDTF Annual Status Report Filed
The Special Disability Trust Fund, within the Department of
Financial Services – Division of Workers’ Compensation, is required by Section
440.49(8)(d), Florida Statutes, to report, annually, on the status of the Fund
to the Governor, the Speaker of the House of Representatives and to the
President of the Senate. This report is required to be
produced by an independent actuary and is now available on the reports page of the DWC website along with all
prior annual reports. The link below will take you to the current report.
If you have any questions
about this report or about the Fund in general, please contact Tom Krick, Fund
Manager, at (850) 413-1651 or by email at Tom.Krick@Myfloridacfo.com
Tuesday, September 18, 2018
Florida Notices Rulemaking for 69L-3.3009
The Florida Division of Workers' Compensation submitted a Notice of Development of Rulemaking for Rule 69L-3.009, F.A.C. A Rule development workshop will be held on Thursday, October 4, 2018, at 9:00 a.m., EDT, at 2012 Capital Circle, SE, Room 102, Hartman Building.
A new rule is being introduced due to the passage of CS/CS/SB 376, which added subsections (5) and (6) to section 112.1815, Florida Statutes (F.S.). Section 112.1815(5)(f), F.S., requires the Department of Financial Services to adopt rules specifying injuries qualifying as grievous bodily harm of a nature that shocks the conscience.
The official Notice of Rule Development appeared in Volume 44, Number 182, of the Florida Administrative Weekly, published on September 18, 2018. If you have questions about the contents of this notice, please contact Brittany O’Neil, Policy Coordinator, Division of Workers' Compensation at (850) 413-1927 or brittany.oneil@myfloridacfo.com.
A copy of the Notice and draft Rule language may be found here.
The draft rule is as follows (explanations are in red parentheticals)
69L-3.009 Injuries that Qualify as Grievous Bodily Harm of
a Nature that Shocks the Conscience.
Pursuant to section
112.1815(5), F.S., for purposes of determining the compensability of
employment-related posttraumtic stress disorder for first responders, the
following injuries qualify as grievous bodily harm of a nature that shocks the
conscience:
(1)
Decapitation (full or partial),
(2)
Degloving,
(3)
Enucleation,
(4)
Evisceration,
(5)
Exposure of one or more of the following internal organs:
(a)
Brain,
(b)
Heart,
(c)
Intestines,
(d)
Kidneys,
(e)
Liver, or
(f)
Lungs
(6)
Impalement,
(7)
Severance (full or partial), and
(8)
Third degree burn on 9% or more of the body.
Rulemaking Authority 112.1815(5)(f), 440.591, FS. Law
Implemented 112.1815, FS. History-New.
Monday, September 10, 2018
2018 Construction Industry Summary
The Florida Division of Workers' Compensation has published a
new data summary report, the first in a series of reports. The purpose of this
and future publications is to provide insight into the unique aspects of the Florida’s
workers’ compensation system.
The report may be found at
the following link. 2018 Construction Industry Summary
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