5128698, 69L-7.501 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 5128698

Notice of Development of Rulemaking

Department:

DEPARTMENT OF FINANCIAL SERVICES

Division:

Division of Workers' Compensation

Chapter:

WORKERS' COMPENSATION MEDICAL REIMBURSEMENT AND UTILIZATION REVIEW

Overview

RULE:

69L-7.501

Florida Workers' Compensation Reimbursement Manual for Hospitals

PURPOSE:

The purpose of the workshop is to assist the Department of Financial Services (Department) and the Three-Member Panel in determining appropriate usual and customary charges for hospital outpatient care provided by Florida hospitals for inclusion in the Florida Workers’ Compensation Reimbursement Manual for Hospitals, adopted through Rule 69L-7.501, Florida Administrative Code. The Department will take testimony at the workshop regarding the “Recommendations for Determining Customary Charges for Florida Outpatient Hospital Services to Workers’ Compensation Patients”, a report prepared for the Department that can be accessed at www.myfloridacfo.com/wc/. The report will be listed under the “News” section of the Division of Workers’ Compensation’s homepage. The Department solicits comments to be made at the workshop by interested parties regarding any additional methodologies for determining appropriate usual and customary charges for hospital outpatient care provided by Florida hospitals. In addition, the purpose of the workshop is to assist the Department and the Three-Member Panel in determining maximum reimbursement allowances for inpatient hospital care based on a schedule of per diem rates, excluding a stop-loss provision, for inclusion in the Florida Workers’ Compensation Reimbursement Manual for Hospitals, adopted through Rule 69L-7.501, F.A.C. Florida Administrative Code. The Department will take testimony regarding the following per diem reimbursement methodologies: a straight per diem rate, in that the hospital is reimbursed a set amount for each day the patient remains in the hospital; per diem by service type, where the per diem rate varies based upon the type of clinical service provided; and a per diem rate indexed to length of stay, where the per diem rate is based on the patient’s length of stay. The Department solicits comments to be made at the workshop by interested parties regarding any additional methodologies for determining appropriate maximum reimbursement allowances for inpatient hospital care based on a schedule of per diem rates, excluding a stop-loss provision. The effect of the workshop is to lead to development of revised reimbursements for hospital inpatient and outpatient care for inclusion in the Florida Workers’ Compensation Reimbursement Manual for Hospitals.

SUBJECT:

Reimbursements to hospitals for care provided to workers’ compensation patients pursuant to the Florida Workers’ Compensation Reimbursement Manual for Hospitals.

RULEMAKING AUTHORITY:

440.13(14), 440.591 FS.

LAW:

440.13(7), (12), (14) FS.

PRINT PUBLISH DATE:

1/18/2008 Vol. 34/03

RELATED STATUTES
AND LAWS:

440.13(14), 440.591 FS., 440.13(7), (12), (14) FS.

OVERSIGHT COMMITTEE:

Joint Administrative Procedures Committee
Florida Administrative Law Central Online Network (F.A.L.C.O.N.)

RELATED COURT CASES:

Division of Administrative Hearings

FEDERAL eRULEMAKING
WEB PORTAL:

Regulations.gov

HOW TO LINK TO
THIS NOTICE:

http://www.flrules.org/gateway/ruleno.asp?id=69L-7.501&PDate=1/18/2008&Section=1

REFERENCE MATERIALS:

No reference(s).

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