Note: The Division has scheduled (2) Rule Workshops or Rule Hearings.
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
|Wednesday, May 27, 2020, 9:30 a.m. Eastern Time||1579 Summit Lake Drive, Room 155, Tallahassee, FL 32317|
|Subject Area to be Addressed: The medical reimbursement and utilization review requirements.
A copy of the notice may be found here.
|Hearing||69L-31, F.A.C. - Utilization and Reimbursement Dispute Rules||Wednesday, June 10, 2020, 9:00 a.m. Eastern Time||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.
A copy of the notice may be found here.
Past Workshops and Hearings
|Workshop||69L-3.003, F.A.C. Procedures for Filing Documents.
69L-3.0035, F.A.C. Injured Worker Informational Brochure.
69L-3.0036, F.A.C. Employer Informational Brochure.
69L-3.01915, F.A.C. Temporary Partial Disability Benefits (Dates of Accident on or After October 1, 2003).
69L-3.025, F.A.C. Forms.
|Tuesday, February 4, 2020, 9:00 a.m. Eastern Time||1579 Summit Lake Drive, Room 155, Tallahassee, FL 32317|
|Summary: The proposed rulemaking clarifies procedures regarding assigning and updating employee numerical identifiers used to track injured employee’s claims filed under the Florida’s workers’ compensation system. The proposed rulemaking also clarifies the process by which an employer and an injured employee are notified of changes to the injured employee’s numerical identifier, updates the forms, and deletes a form.|
|Rule Hearing||69L-31, F.A.C. - Utilization and Reimbursement Dispute Rules||Wednesday, January 8, 2020, 9:30 a.m. Eastern Time||1579 Summit Lake Drive, Room 155, Tallahassee, FL 32317|
|Summary: Modification of the processes related to resolution of reimbursement disputes by the Florida Department of Financial Services pursuant to section 440.13(7)(e), F.S.
A copy of the notice with full text of the proposed Rule may be found here.
A copy of the Petition Form and Carrier Response Form may be found here.
69L-31 Hearing Agenda
Note: This tab reflects Rules adopted within the past 6 months.
|March 30, 2020||Telehealth and Telemedicine Services|
|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
|November 27, 2019||Maximum Workers' Compensation Rate, Effective Jan. 1, 2020|
|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.
2020 Max Comp Rate Bulletin