REGULATORY ACTIVITY:

• Florida held a public hearing for 69L-6.015 Record Maintenance and Production Requirements for Employers 69L-6.027 Penalty Calculation Worksheet.  The hearing was scheduled for Thursday, February 16, 2017 at Room 102, Hartman Building, 2012 Capital Circle SE, Tallahassee, FL.  Proposed Rule 69L-6.015, F.A.C., deletes the requirement for corporations with exempt officers who are engaged in the construction industry to maintain written statements of those exempted persons acknowledging each such individual’s exempt status. Proposed Rule 69L-6.027, F.A.C., incorporates to the Penalty Worksheet the 25% penalty reduction for eligible employers and the reduced imputed payroll multiplier changes.
• Florida posted notice that a public hearing was not requested for either Rule 69L-6.015, 69L-6.027 regarding exemption from coverage or rule 69L-30 expert medical advisors and therefore not hearing was held.  The proposed rules remain as published when the notice was published.

REGULATORY ACTIVITY:

• DWC posted notice of a public hearing regarding rule 69L-30, Expert Medical Advisors to be held on Tuesday, February 7, 2017 at 10:00 a.m. in Room 102 of the Hartman Building at 2012 Capital Circle SE, Tallahassee.  The proposed changes reflect statutory changes allowing Judges of Compensation Claims to appoint Expert Medical Advisors, update a website address, and update the list of final orders that disqualify a physician from Expert Medical Advisor certification.
• The Division held a hearing on January 5th regarding Rule 69L-31 Utilization and Reimbursement Dispute.
• The state has finalized the effective date for Revision F Medical Bill Reporting. Revision F must be fully implemented by March 15, 2017.  On and after that date Revision E will no longer be accepted for reporting medical bills.  On January 11, 2017, Michelle Carter at the FL DWC formally announced the transition to Revision F filing format of Medical EDI Data must be completed by March 15, 2017.

FEE SCHEDULE NEWS:

• The state has adopted a new manual for Ambulatory Surgical Centers with an effective date of January 1, 2016. On February 10^th, 2016 the state published a notification for a technical correction in the manual for CPT code 64492 which had an incorrect MRA value.  The new value is $1,059.90 and it is retroactive to January 1, 2016.
• The state has adopted the new Florida Workers’ Compensation Health Care Provider Reimbursement Manual 2015 Edition with an effective date of July 1, 2016.

REGULATORY ACTIVITY:

• A public meeting was held on December 6, 2016 in Room 102 Hartman Building at 2012 Capital Circle SE, Tallahassee, Florida to take comments on the rules regarding Expert Medical Advisors.
• The Workers’ Compensation Appeals Board (WCAB) has issued a notice of public hearing regarding a proposed addition and amendments to its Rules of Practice and Procedure. The primary purpose of this rulemaking is to implement legislative changes to the filing requirements for lien claims mandated by Senate Bill 1160.  SB 1160 amended Labor Code section 4903.05 to require that section 4903(b) lien claimants file a declaration that includes information regarding the type of services provided by the lien claimant. A lien claimant’s failure to timely file this declaration shall result in the dismissal of the lien with prejudice by operation of law per Labor Code section 4903.05(c) (3). This rulemaking will mandate use of an e-filed declaration form to ensure uniform procedures for lien claimants who first file their liens after January 1, 2017 and current lien claimants who are required to file a declaration by July 1, 2017.
• The Florida Department of Economic Opportunity has determined the statewide average weekly wage paid by employer’s subject to the Florida Reemployment Assistance Program Law to be $886.46 for the four calendar quarters ending June 30, 2016.  Section 440.12(2), Florida Statutes (2016), 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, 2017, shall be $886.00.  If you have any questions regarding this Informational Bulletin, please contact Mr. Ryan Gagne, Government Analyst II, Division of Workers’ Compensation, Bureau of Monitoring and Audit, at 850- 413-1771.
• Florida is proposing to amend Rule Numbers 69L-31.03-69L-31.017 regarding resolution of reimbursement disputes between workers' compensation carriers and health care providers.  The proposed amendments are scheduled for a hearing if requested on January 5, 2017 at 1:00 p.m. in room 102 of the Hartman Building 2012 Capital Circle SE, Tallahassee, Florida. The proposed rulemaking amends existing rules governing the process for the resolution of reimbursement disputes between workers’ compensation carriers and health care providers, creates two new rules, and repeals an existing rule. Noteworthy highlights of the proposed rulemaking are as follows: Rule 69L-31.005, F.A.C., is amended to provide greater detail regarding the materials that must accompany a petition for dispute resolution; Rule 69L-31.008, F.A.C., is amended to clarify the computation of the time period within which a petition for dispute resolution must be submitted to the Division, to increase the time period from 30 days to 45 days for the submission of a Petition Form, to add a link to the Division’s Web Portal, and to provide additional guidance regarding the electronic submission of a Petition Form; Rule 69L-31.009, F.A.C., is amended to increase the time period for a carrier to respond to a petition from 10 days to 30 days; Rule 69L-31.012, F.A.C., is repealed; proposed new Rule 69L-31.016, F.A.C., specifies that the scope of Department determinations involving reimbursement disputes is limited to findings relating to reimbursement schedules, practice parameters, and protocols of treatment, and clarifies that the Department will issue no findings regarding an improper disallowance or adjustment in reimbursement involving managed care contracts or when the carrier asserts that medical treatment was either not compensable or not medically necessary; and proposed new Rule 69L-31.017, F.A.C., stipulates the consequences for failure to comply with Department determinations. Certain rule section titles are revised to more accurately reflect the subject matter or issues addressed by the underlying rule. The proposed rules include additional minor edits and technical changes, and have been renumbered accordingly. Revised forms are also adopted.
• Florida has posted notice of a rules work shop for Rules 69L-6.015, FAC and 69L-6.027, FAC for Monday December 19, 2016 at 9:30 A.M. in room 102, Hartman Building, 2012 Capital Circle SE, Tallahassee, Florida.  Proposed Rule 69L-6.015, F.A.C., deletes the requirement for corporations with exempt officers who are engaged in the construction industry to maintain written statements of those exempted persons acknowledging each such individual’s exempt status. Proposed Rule 69L-6.027, F.A.C., incorporates to the Penalty Worksheet the 25% penalty reduction for eligible employers and the reduced imputed payroll multiplier changes.

LEGISLATIVE ACTIONS:

• House Bill 613
  The legislation regards Workers’ Compensation System Administration. The legislation requires members of limited liability companies to submit specified notices however it deletes a required item to be listed on notice of election to be exempt.  The legislation revises specified rules regarding maintenance of business records by an officer of corporation.  It provides and removes duties of the Department of Financial Services.   The legislation prohibits application of specified credit unless employer provides specified documentation & proof of payment to department within specified period.  The bill revises penalty calculation for imputed weekly payroll for an employee.  It eliminates certification requirements when expert medical advisor is selected by judge of compensation claims.  The enacted legislation deletes requirement that employers notify department within 24 hours of any injury resulting in death. The bill revises requirements for filing claim. The legislation eliminates the preferred worker program. The enacted legislation deletes notification fees on certain filed claims which supplement Special Disability Trust Fund.  The legislation deletes fee for certain registration of insurance carriers.  Effective Date October 1, 2016.
• Senate Bill 828
  The enacted legislation substantially revises the FWCIGA assessment process. The bill: Increases the assessment cap for self-insurance funds from 1.5 to 2 percent of net direct written premiums in Florida for workers’ compensation insurance, which is consistent with the assessment cap for insurers and revises the insurer’s premium subject to an assessment from being based on the prior year’s net direct written premium to the net direct written premium of the calendar year of the assessment.  It transfers the authority to order assessments and other FWCIGA reporting related to insurer financial condition from the DFS to the OIR.  The bill provides that only insurers are subject to assessments by the FWCIGA and the provisions do not give a policyholder a cause of action regarding the FWCIGA assessments.  It provides that the failure of an insured to pay the surcharge or the recoupment of an assessment is considered nonpayment of premium, which could result in the cancellation of a policy and provides that an insurer is not liable for any uncollectible assessments.  Effective Date July 1, 2016.