11694337, 69L-3.017 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 11694337

Notice of Proposed Rule

Department:

DEPARTMENT OF FINANCIAL SERVICES

Division:

Division of Workers' Compensation

Chapter:

WORKERS' COMPENSATION CLAIMS

Overview

RULE:

69L-3.017

Notice of Apportionment of Medical Reimbursement Due to a Pre-Existing Condition(s)

PURPOSE:

The purpose of this proposed new rule is to inform claims administrators of notice requirements to employees when the payment of a compensable medical benefit will be apportioned, pursuant to Section 440.15(5), F.S. The proposed rule clarifies that claims administrators must provide employees with notification of decisions to apply apportionment. The proposed rule provides that compliance with the notice requirements is achieved by mailing Form DFS-F2-DWC-12 (Notice of Denial), or a letter to the employee explaining its apportionment decision to the employee, as specified. The proposed rule also clarifies that compliance with the notice requirements under proposed Rule 69L-3.017, F.A.C., does not satisfy the notification requirement under subsection 69L-7.602(5), F.A.C.

SUMMARY:

The proposed new rule addresses the apportionment of benefits by claims administrators under Section 440.15(5), F.S. The proposed rule clarifies that claims administrators are required to provide employees seeking medical services (for dates of injury on or after 10/1/2003) with notification, in cases where the payment of a medical benefit will be subject to apportionment.

RULEMAKING AUTHORITY:

440.185(5), 440.20(3), 440.591 FS.

LAW:

440.12(2), 440.14, 440.15(5), 440.192(8), 440.20(2), (4), (9), (15)(f), 440.207(2) FS.

PRINT PUBLISH DATE:

7/6/2012 Vol. 38/27

COMMENTS:

From 7/6/2012 To 7/27/2012 (21 Days)
The public comment period for this notice has already expired.

REFERENCE MATERIALS:

No reference(s).

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