Rule 69L-30 changes effective March 1, 2016

Summary: The rule dictates how to qualify, apply to become, be selected, and be recertified as an Expert Medical Advisor (EMA). This Rule also dictates how to bill for and receive reimbursement for EMA services. Finally, this Rule states circumstances under which previously certified EMAs can become decertified.

https://www.flrules.org/gateway/ChapterHome.asp?Chapter=69L-30

DWC Rule Changes February 18, 2016

Summary for 69L-8 series Rules: The rules within this new chapter reorganize incorporated materials that are utilized in conjunction with DWC medical reimbursement manuals and throughout Rule Chapter 69L-7, F.A.C.

https://www.flrules.org/gateway/ChapterHome.asp?Chapter=69L-8

Summary for 69L-7 series Rules: The rules within this chapter represent a substantial rewrite and reorganization of the previous Rule 69L-7.710, F.A.C. It is now divided into five rule sections. The rulemaking also incorporates and adopts the ICD-10 medical code sets for use in conjunction with the Florida Medical EDI Implementation Guide ("MEIG"). The proposed rules also include revised billing forms and accompanying instructions.

https://www.flrules.org/gateway/ChapterHome.asp?Chapter=69L-7

Division Proposes Amendment of 69L-22 - Reemployment Services

The Florida Division of Workers' Compensation submitted a Notice of Development for Chapters 69L-22 of the Florida Administrative Code. The proposed rules are amended to clarify the process injured employees must follow when seeking to obtain Department-sponsored reemployment services. The proposed rules provide injured employees with information and guidance regarding available reemployment services and the terms, conditions, and responsibilities associated with receiving such services. Additionally, the proposed rulemaking incorporates two new forms and revises two existing forms.

The official Notices of Change appeared in the Volume 42, Number 04 of the Florida Administrative Weekly, published on January 7, 2016. If you have questions about the Notice, please contact Stephen Yon, Chief, Bureau of Employee Assistance and Ombudsman Office, Division of Workers' Compensation at (850) 413-1786 or Stephen.Yon@myfloridacfo.com.

If requested in writing and not deemed unnecessary by the agency head, a rule development workshop will be held Thursday, February 4, 2016, 9:00 a.m. in Room 102, Hartman Building, 2012 Capital Circle Southeast, Tallahassee, Florida.

New Fraud Report Published

The Division of Insurance Fraud, Bureau of Worker's Compensation Fraud and the Division of Workers' Compensation, Bureau of Compliance issue a joint report summarizing their respective efforts and activities in combating workers' compensation fraud and employer non-compliance.  The July 1, 2014 - June 30, 2015 report can be viewed at:

http://www.myfloridacfo.com/Division/WC/PublicationsFormsManualsReports/Reports/DIF-DWC-Joint-Annual-Report-2014-2015.pdf

Please contact Robin Delaney at Robin.Delaney@myfloridacfo.com or (850) 413-1775 if additional information is needed. 

DWC has Released 2015 Report

The Division of Workers' Compensation has issued its 2015 Results and Accomplishments Report.  The Report contains important system information related to lost-time claims and medical costs as well as outcome and performance measures for each of the Division's major program areas.  To view the Report, click here:

http://www.myfloridacfo.com/Division/WC/PublicationsFormsManualsReports/Reports/AnnualReportWC2015.pdf

Rules Workshop Announced for January 12, 2015 in Tallahassee

Summary: Rules are being amended which govern the process for resolution of disputes between workers’ compensation carriers and health care providers. Revised forms are adopted. Rule 69L-31.005, F.A.C., is amended to provide greater detail regarding materials required to be included in a petition for dispute resolution. Rule 69L-31.008, F.A.C., is revised to provide clarity regarding computation of the time period to submit a petition for dispute resolution. The time period in Rule 69L-31.009, F.A.C., for a carrier to respond to a petition is expanded from 10 to 30 days. New Rule 69L-31.016, F.A.C., is proposed to limit the scope of the dispute resolutions to compliance with standards under Chapter 440, F.S., and exclude issues of contract interpretation. Changes are also made to provide several minor edits, primarily for the purpose of clarity.

A copy of the notice and link to the proposed Rules may be found through the following link. https://www.flrules.org/Gateway/View_notice.asp?id=16896544

2016 Maximum Compensation Rate Announced

December 8, 2105

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 $862.51 for the four calendar quarters ending June 30, 2015.

Section 440.12(2), Florida Statutes (2015), 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, 2016 shall be $863.00.