REGULATORY ACTIVITY:

• Pursuant to a petition to initiate rulemaking, the proposed rules are written to comply with the requirement in section 440.45(4), F.S. that the Office of Judges of Compensation Claims adopt rules setting forth uniform criteria for measuring the performance of the office, including, but not limited to, the number of cases assigned and resolved, the age of pending and resolved cases, timeliness of decisions, extraordinary fee awards, and other data necessary for the judicial nominating commission to review the performance of judges as required in paragraph (2)(c).  The proposed rule provides notice to applicants for the position of judge of compensation claims and for current judges seeking reappointment of the information that will be provided to the statewide nominating commission for consideration of applications for appointment and reappointment. Some of the provisions of the rule apply only to current JCCs seeking reappointment, while other provisions may apply to both current JCCs seeking reappointment and applicants to fill vacancies. To view a copy of the notice and proposed rule, go to https://www.flrules.org/gateway/ruleNo.asp?id=60Q-6.129.
• The DEPARTMENT OF FINANCIAL SERVICES, Division of Worker's Compensation, and the Three-member Panel announces a public meeting to which all persons are invited.
  • DATE AND TIME: Tuesday, April 10, 2018, 1:00 p.m.
  • PLACE: Room 116, Larson Bldg., 200 E. Gaines St., Tallahassee, Florida

GENERAL SUBJECT MATTER TO BE CONSIDERED: Pursuant to s. 440.13(12), Florida Statutes, the Three-Member Panel will hold a meeting to adopt the 2018 schedules for maximum reimbursement allowances for physicians, hospital inpatient care, hospital outpatient care, and ambulatory surgical centers. Public comment will also be received. A copy of the agenda may be obtained by contacting: The Division of Workers' Compensation will publish the agenda and meeting packet for the Panel's April 10, 2018, meeting on the Division's website under "Notices" (http://www.myfloridacfo.com/Division/WC/noticesRules.htm). Pursuant to the provisions of the Americans with Disabilities Act, any person requiring special accommodations to participate in this workshop/meeting is asked to advise the agency at least 5 days before the workshop/meeting by contacting: Vicky Fletcher at (850)413-4185. If you are hearing or speech impaired, please contact the agency using the Florida Relay Service, 1(800)955-8771 (TDD) or 1(800)955-8770 (Voice). For more information, you may contact: Theresa Pugh at (850)413-1721.

LEGISLATIVE ACTIONS:

House Bill 1073

The bill modifies several areas regulated by the Department of Financial Services (DFS), including deeming electronic images of all records as original documents as used by the Division of Treasury. The legislation requires that financial literacy be addressed in a foster youth’s transition plan.  It changes the managing general agent license to an appointment and allows a general lines agent to obtain a managing general agent appointment.  It authorizes the Chief Financial Officer to develop the Florida Open Financial Statement System. It clarifies and expanding the circumstances under which a life agent may serve as a trustee or guardian or to act under a power of attorney for the insured. The legislation deems fingerprint submissions to be valid for 48 months for currently licensed individuals seeking additional licensure under Ch. 626, F.S., and for bail bond agents under Ch. 648, F.S.; It reduces the number of insurance policies that can be written each year, with an insurer by an un-appointed agent from 24 to 4.  The legislation eliminates an affidavit requirement for nonresident public and all-lines insurance adjusters.  It clarifies the terms of members of the Florida Fire and Safety Board.  The legislation allows franchisees to operate under the fire equipment dealer license of their parent company.  It modifies the requirements for the firefighter Special Certificate of Compliance.   It makes it mandatory that agency safety coordinators complete the safety coordinator training offered by DFS within one year of being appointed to his or her position.  It requires agencies to report to DFS on their return-to-work and risk management programs.  It requires each agency to communicate with DRM about discrepancies in claims and loss records, and about any inquiries identifying conditions or trends that may lead to claims involving the state; and Allowing DRM to share personal identifying information of individual workers’ compensation claims with its contracted vendors, for the purpose of ascertaining claimant history to investigate the compensability of a claim or to identify and prevent fraud.  Effective Date July 1, 2018.

House Bill 21

The bill addresses opioid abuse by expanding the use of the Prescription Drug Monitoring Program (PDMP), increasing regulation of prescribers and dispensers, amending criminal laws, and making appropriations. The bill limits the prescription for a Schedule II opioid for acute pain to a 3-day supply, or a 7-day supply if deemed medically necessary by the prescriber. The bill excludes pain related to cancer, terminal illness, palliative care, and serious traumatic injury from these prescribing limits. The bill requires regulatory boards within the Department of Health (DOH) to adopt rules establishing guidelines for prescribing controlled substances for acute pain. The bill also requires a health care practitioner to review a patient’s PDMP history before prescribing or dispensing a controlled substance, with exemptions. The bill authorizes a dispensing practitioner who is approved to provide medication-assisted treatment for substance abuse disorders to dispense Schedule II and III substances for such purpose.

The bill requires all pain management clinics that claim an exemption from statutory registration requirements to obtain a certificate of exemption by January 1, 2019. Currently, pharmacies only report dispensing controlled substances listed in Schedule II, III, and IV to the PDMP. The bill expands the reporting requirement to include certain Schedule V substances. The bill authorizes direct access to the PDMP for employees of certain federal agencies who prescribe or dispense controlled substances, and indirect access for district medical examiners under certain conditions. The bill authorizes DOH to share and exchange PDMP data with other states if certain conditions are met and authorizes the PDMP to interface with practitioner electronic health record systems. Chapter 893, F.S., the “Florida Comprehensive Drug Abuse Prevention and Control Act,” classifies controlled substances into five schedules, based on the substance’s “potential for abuse” and whether the substance has a currently accepted medical use. The bill aligns the state schedule of drugs with the federal schedule of drugs. The bill also makes it a crime to possess, purchase, deliver, or sell a tableting machine, encapsulating machine, or controlled substance counterfeiting material for the purpose of illegally manufacturing controlled substances. The bill increases the level of offense from a third-degree felony to a second-degree felony for intentionally prescribing medically unnecessary controlled substances, or medically unnecessary amounts of controlled substances. The bill has an insignificant, positive fiscal impact on DOH from savings from pain management clinic investigations; a positive indeterminate impact on prison beds; and a possible positive, indeterminate fiscal impact on local governments.  For Fiscal Year 201819, the bill appropriates $27,035,532 in nonrecurring funds from the Federal Grants Trust Fund for substance abuse treatment and other services; $26,500,000 in recurring funds from the General Revenue Fund for substance abuse treatment and upgrades to the PDMP, and $117,700 in nonrecurring funds from the General Revenue Fund for upgrades to the PDMP.  Effective Date July 1, 2018.

Senate Bill 376

The enacted legislation revises the standards for determining compensability of employment-related posttraumatic stress disorder (PTSD) under workers’ compensation for first responders, which includes volunteers or employees engaged as law enforcement officers, firefighters, emergency medical technicians, and paramedics. The bill allows first responders that meet certain conditions to access indemnity and medical benefits for PTSD without an accompanying physical injury. Current law provides only medical benefits for a mental or nervous injury without an accompanying physical injury and requires the first responder to incur a compensable physical injury to receive indemnity benefits for a mental or nervous injury. The legislation specifies that benefits do not require a physical injury and are not subject to certain apportionment or limitations. Effective Date October 1, 2018.

REGULATORY ACTIVITY:

• Notice of Development of Rulemaking
  Department: Department of Financial Services
  Division: Division of Worker's Compensation
  Rule No.: 69L-31.003, 69L-31.004, 69L-31.005, 69L-31.006, 69L-31.007, 69L-31.008, 69L-31.009, 69L-31.010, 69L-31.011, 69L-31.012, 69L-31.013, 69L-31.014, 69L-31.016
  Purpose: The proposed rulemaking amends existing rules governing the process for the resolution of reimbursement disputes between workers’ compensation carriers and health care providers, creates a new rule, and repeals an existing rule. Changes proposed include:
  • amending Rule 69L-31.005, F.A.C., to provide greater detail regarding the materials that must accompany a petition for dispute resolution (Petition Form);
  • amending Rule 69L-31.008, F.A.C., to clarify the computation of the time period within which a Petition Form must be submitted to the Division, to increase the time period for the submission of a Petition Form from 30 days to 45 days, to add the website address for the Division’s Web Portal, and to provide additional guidance regarding the electronic submission of a Petition Form;
  • amending Rule 69L-31.009, F.A.C., to increase the time period for a carrier to respond to a petition from 10 days to 30 days;
  • repealing Rule 69L-31.012, F.A.C.;
  • creating Rule 69L-31.016, F.A.C., to address penalties for improper reimbursement and billing practices.

Revisions to certain rule titles are proposed to more accurately reflect the subject matter or issues addressed by the rule. Other changes proposed include minor edits and the adoption of revised forms.
https://www.flrules.org/gateway/View_Notice.asp?id=20029062

• Notice of Development of Rulemaking
  Department: Department of Financial Services
  Division: Division of Worker's Compensation
  Rule No.: 69L-6.025
  Purpose: The proposed amendment to paragraph 69L-6.025(4)(b), F.A.C., will allow employers an additional opportunity to remain compliant with their payment agreement schedules by increasing the number of times the Department will rescind an Order Reinstating Stop-Work Order from two to three in any one case. The proposed amendment to paragraph 69L-6.025(7)(c), F.A.C., will allow employers whose Reinstatement of Stop-Work Orders have been rescinded, the opportunity to enter into new payment agreements after making three monthly payments of the original agreed amount. Currently, the employer is required to make six monthly payments of the original agreed amount after the rescission of the Reinstatement of the Stop-Work Order prior to entering into a new payment agreement. Reducing the number of payments required from six to three will shorten the timeframe for entering into a new payment agreement.
  https://www.flrules.org/gateway/View_Notice.asp?id=20029159
• Posted notice of a petition received.  NOTICE IS HEREBY GIVEN that the Department of Financial Services, Division of Workers’ Compensation, has received the petition for declaratory statement from Jessup, Inc. The petition seeks the agency’s opinion as to the applicability of Section 440.02(15) (d)1., Florida Statutes (2017), as it applies to the petitioner. The petition seeks the Department’s opinion that if a provider complies with petitioner’s requirements that the provider will meet the criteria enumerated in subsections 440.02(15)(d)1.(I)-(IV), Florida Statutes. The petition seeks the Department’s opinion whether petitioner may appropriately deem the provider to be an independent contractor and not an employee. A copy of the Petition for Declaratory Statement may be obtained by contacting: Thomas Nemecek, Supervising Attorney, Office of the General Counsel, 200 E. Gaines Street, Tallahassee, Florida 32399-0333, (850)413-1606, Nemecek@myfloridacfo.com. Please refer all comments to Thomas Nemecek.

REGULATORY ACTIVITY:

• Has published adopted rules that become effective January 18, 2018.  The two rules are:
  • 69L-8.071 Materials for use with the Florida Workers' Compensation Health Care Provider Reimbursement Manual and
  • 69L-8.074 Materials for use throughout rule chapter 69L-7 F.A.C.  To view the two rules, go to https://www.myfloridacfo.com/Division/WC/noticesRules.htm
• Posted notice of proposed rule regarding anti-fraud prevention standards.  The proposed changes are to 69D-2.002, 2.003 and 2.005. The proposed amendments will implement the changes to Section 626.9891, F.S., enacted by Chapter 2017-178, Laws of Florida, establishing uniform anti-fraud prevention standards applicable to all insurers. Section 626.9891, F.S., requires all insurers to establish and maintain an anti-fraud investigation unit, or to contract for such services, and to submit an anti-fraud plan to the Department.  Rule 69D-2.002, F.A.C., adds definitions of the terms “anti-fraud investigative unit,” “Commission,” and “designated anti-fraud unit or division.” Rule 69D-2.003, F.A.C., adopts a form that an insurer can use to comply with the anti-fraud plan filing requirements of Section 626.9891, F.S. Rule 69D-2.005, F.A.C., is amended to reflect statutory changes.   The notice and full text of the proposed rule can be viewed at https://www.flrules.org/gateway/ruleNo.asp?id=69D-2.002.

• 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, 2016 - June 30, 2017 report can be viewed at:  https://www.myfloridacfo.com/Division/WC/PublicationsFormsManualsReports/Reports/Default.htm

REGULATORY ACTIVITY:

• Florida has posted notice of proposed rules for the Health Care Provider Reimbursement Manual; Reimbursement Manual for Ambulatory Surgery Centers; and Reimbursement Manual for Hospitals.
• 69L-7.020
  Florida Workers' Compensation Health Care Provider Reimbursement Manual. The purpose of the changes being made to Rule 69L-7.020, F.A.C., is to incorporate the 2017 version of the Florida Workers’ Compensation Health Care Provider Reimbursement Manual. The manual contains the updated lists of Maximum Reimbursement Allowances for various medical services, as approved by the Three-Member Panel on April 19, 2017, pursuant to section 440.13(12) (a), Florida Statutes. The proposed rule amends the existing rule to adopt and incorporate by reference the 2017 version of the Florida Workers’ Compensation Health Care Provider Reimbursement Manual.

• 69L-7.100
  Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs). The purpose of the changes being made to Rule 69L-7.100, F.A.C., is to incorporate the 2017 version of the Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs). The manual contains the updated lists of Maximum Reimbursement Allowances for various medical services, as approved by the Three-Member Panel on April 19, 2017, pursuant to section 440.13(12) (a), Florida Statutes. The proposed rule amends the existing rule to adopt and incorporate by reference the 2017 version of the Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs).

• 69L-7.501
  Florida Workers' Compensation Reimbursement Manual for Hospitals. The purpose of the changes being made to Rule 69L-7.501, F.A.C., is to incorporate the 2017 version of the Florida Workers’ Compensation Reimbursement Manual for Hospitals. The manual contains the updated lists of Maximum Reimbursement Allowances for various medical services, as approved by the Three-Member Panel on April 19, 2017, pursuant to section 440.13(12) (a), Florida Statutes.   The proposed rule amends the existing rule to adopt and incorporate by reference the 2017 version of the Florida Workers’ Compensation Reimbursement Manual for Hospitals.

• Summary: The purpose of the changes being made to Rules 69L-7.020, 69L-7.100, and 69L-7.501, F.A.C., is to incorporate the 2017 versions of the Florida Workers' Compensation Health Care Provider Reimbursement Manual, the Florida Workers' Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs), and the Florida Workers' Compensation Reimbursement Manual for Hospitals. The manuals contain the updated lists of Maximum Reimbursement Allowances for various medical services, as approved by the Three-Member Panel on April 19, 2017, pursuant to section 440.13(12) (a), Florida Statutes. Posted notice regarding changes to rules affecting health facility and agency licensing regarding drug free workplace standards
• Posted notice of change to rule 69L-8.071 Materials for use with the Florida Workers' Compensation Health Care Provider Reimbursement Manual and 69L-8.074 Materials for use throughout Rule Chapter 69L-7 F. A. C.

REGULATORY ACTIVITY:

• Florida has posted notice of a rule hearing on 69L-8.071 Materials for use with the Florida Workers’ Compensation Health Care Provider Reimbursement Manual; 69L-8.074 Materials for Use throughout Rule Chapter 69L-7, F.A.C. The hearing will be held on Wednesday, October 4, 2017, at 1:00 p.m. (eastern) Room 102, Hartman Building, 2012 Capital Circle SE, Tallahassee, FL.

REGULATORY ACTIVITY:

• Published bulletin DWC-02-2017 an order setting the Order Setting Assessment Rate for the Workers’ Compensation Administration Trust Fund for Calendar Year 2018.
• The division is holding a rule workshop to discuss changes to the reimbursement manuals.  The purpose of the changes being made to Rules 69L-7.020, 69L-7.100, and 69L-7.501, F.A.C., is to incorporate the 2017 versions of the Florida Workers’ Compensation Health Care Provider Reimbursement Manual, the Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers (ASCs), and the Florida Workers’ Compensation Reimbursement Manual for Hospitals. The manuals contain the updated lists of Maximum Reimbursement Allowances for various medical services, as approved by the Three-Member Panel on April 19, 2017, pursuant to section 440.13(12) (a), Florida Statutes.  9:00 AM - 10:30 AM, 69L-7.501, Florida Workers’ Compensation Reimbursement Manual for Hospitals, 2017 Edition; 10:30 AM - 12:00 PM, 69L-7.100, Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers, 2017 Edition; and 1:00 PM - 2:30 PM, 69L-7.020, Florida Workers’ Compensation Health Care Provider Reimbursement Manual, 2017 Edition.
• Posted notice to amend Rule 69A-64.005.  The purpose of the amendment is to adjust the firefighter death benefits provided in section 112.191, F.S., for the 2017-2018 year based on the Consumer Price Index (CPI) for All Urban Consumers published by the United States Department of Labor.  If requested in writing and not deemed unnecessary by the agency head, a rule development workshop will be held at the date, time and place: Date and time: September 15, 2017, 9:30 a.m.; Place: Division of State Fire Marshal, 3rd Floor Conference Room, The Atrium Building, 325 John Knox Road, Tallahassee, FL.
• Has proposed to amend rule 69L-8.071 regarding materials for use with the Florida Workers' Compensation Health Care Provider Reimbursement Manual.  The proposed rules incorporate updated versions of currently adopted resource materials utilized in the determination and reimbursement of the costs of medical care provided to Florida’s injured employees. Is holding a rule workshop regarding Rule 69L-8.071 Materials for with the Florida Workers' Compensation Health Care Provider Reimbursement Manual 69L-8.074 Materials for Use Throughout Rule Chapter 69L-7 F.A.C. on October 4, 2017 at 1:00 p.m. EST in Room 102 of the Hartman Building located at 2012 Capital Circle SE, Tallahassee, Florida.   The proposed rules update resource materials utilized in the determination and efficient delivery of appropriate medical care to injured employees and the provision of timely reimbursement to health care providers under Florida’s workers’ compensation system.

REGULATORY ACTIVITY:

• A news article was recently published on the authorization procedures for compounded drugs in the 2016 Edition of the Florida Workers' Compensation Health Care Provider Reimbursement Manual (HCPRM) that went into effect on July 1, 2017.   The information contained in the article may have led to a misunderstanding of the applicability of this new provision in the HCPRM.  The HCPRM defines the dispensing of compounded drugs, regardless of the cost of the compounded drugs, as a specialty service under paragraph 440.13(3)(i), F.S.  For any further questions related to this subject or other medical service topics, please email WorkersComp.MedService@myfloridacfo.com.

LEGISLATIVE ACTIONS:

• House Bill 1114
  The enacted legislation achieves compliance with the federal Occupational Safety and Health Administration (OSHA) requirement that state-level standards and enforcement be at least as effective as OSHA standards and enforcement. It increases the monetary penalties for violations of the Hawaii Occupational Safety and Health Law or any standard or rule adopted there under. It requires the Director of Labor and Industrial Relations to: adjust the penalties each year as required by federal law; and report to the Legislature annually on the penalty adjustments. Effective Date January 1, 2018.
• Senate Bill 859
  The legislation Grants an employee the right to have a chaperone present during an independent medical examination relating to a work injury for workers' compensation purposes and, with the approval of the examining physician or surgeon, to record the medical examination. Specifies that if an employee or employee's chaperone obstructs the medical exam, the employee's right to workers' compensation shall be suspended until the obstruction ceases. Repeals on 6/30/2019. Effective Date July 12, 2017.
• Senate Bill 984
  The enacted legislation amends the definition of "physician" in Workers' Compensation Law to include advanced practice registered nurses. Effective Date July 11, 2017.

REGULATORY ACTIVITY:

• On May 11, 2017, the Department of Financial Services, Division of Workers' Compensation (Department) entered a Consent Order approving the Settlement Agreement between the Department and Samuel J. Gerson, M.D., thereby concluding the administrative matter in Case No. 198047-16-WC.  The Settlement Agreement prospectively bars Samuel J. Gerson, M.D. from receiving payment under chapter 440, Florida Statutes.  Dr. Gerson has agreed that he shall not, except on an emergency basis, provide any medical consultations, examination, treatment or care, including prescribing medication, for any injured worker whose claim falls under the scope and jurisdiction of chapter 440, Florida Statutes.

FEE SCHEDULE NEWS:

• The state has adopted the new Florida Workers’ Compensation Health Care Provider Reimbursement Manual 2016 Edition with an effective date of July 1, 2017.

LEGISLATIVE ACTIONS:

• House Bill 146
  The enacted legislation amends Code Section 25-3-23 of the Official Code of Georgia Annotated, relating to general requirements for legally organized fire departments, so as to require such fire departments to purchase and maintain certain insurance coverage for firefighters; to provide methods for funding; to provide for rules and regulations; to amend Code Section 48-7-27 of the Official Code of Georgia Annotated, relating to computation of Georgia taxable net income, so as to provide an exemption for benefits received under said insurance coverage for firefighters; to repeal conflicting laws; and for other purposes.  Effective Date January 1, 2018.

• Senate Bill 173
  The enacted legislation  amends Chapter 41 of Title 33 of the O.C.G.A., relating to captive insurance companies, so as to extensively revise certain provisions; to provide for change and revision of certain definitions; to provide for scope of provisions and lines of businesses a captive insurance company may engage to add an agency captive insurance company with certain restrictions; to change certificate of authority requirements; to provide for board of managers; to provide for captive corporate organization requirements making certain captives subject to Title 14; to provide for certain exemptions; to provide for exceptions, fees, and articles of incorporation requirements; to provide for powers and requirements by the Commissioner; to provide for related matters; to repeal conflicting laws; and for other purposes. Effective Date July 1, 2017.

REGULATORY ACTIVITY:

• The Florida Department of Financial Services, Division of Workers' Compensation held a public meeting of the Three-Member Panel on Wednesday, April 19, 2017, beginning at 10:00 a.m., in room 116 of the J. Edwin Larson Building located at 200 East Gaines Street, Tallahassee, Florida. The purpose of the meeting was to review and adopt the 2017 editions of the Health Care Provider Reimbursement Manual, Hospital Reimbursement Manual, and the Ambulatory Surgical Center Reimbursement Manual. Public comment was also received. The meeting agenda and the drafts of the respective reimbursement manuals are available on the Florida Division of Workers’ Compensation website.
• Florida has proposed Rule Workshop 69L-8, Selected Materials Incorporated by Reference Wednesday, May 31, 2017, 1:00 p.m. (eastern) Room 102, Hartman Building, 2012 Capital Circle SE, Tallahassee, FL.  The proposed rules incorporate updated versions of currently adopted resource materials utilized in the determination and reimbursement of the costs of medical care provided to Florida’s injured employees. The proposed rules promote the efficient delivery of medical care to Florida’s injured employees by reducing the potential for errors and delays resulting from the use of dated materials.