20029062, 69L-31.003 - Florida Administrative Rules, Law, Code, Register

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Florida Department of State and Division of Library and Information Services

Notice: 20029062

Notice of Development of Rulemaking

Department:

DEPARTMENT OF FINANCIAL SERVICES

Division:

Division of Workers' Compensation

Chapter:

UTILIZATION AND REIMBURSEMENT DISPUTE RULES

Overview

RULE:

69L-31.003	Petition for Resolution of Reimbursement Dispute Form and Requirements
69L-31.004	Carrier Response to Petition for Resolution of Reimbursement Dispute Form and Requirements
69L-31.005	Written Determinations
69L-31.006	Consolidation of Petitions (Repealed)
69L-31.007	Service of Petition on Carrier and All Affected Parties
69L-31.008	Computation of Time
69L-31.009	Carrier Response Requirements (Repealed)
69L-31.010	Effect of Non-Response by Carrier (Repealed)
69L-31.011	Complete Record (Repealed)
69L-31.012	Joint Stipulation of the Parties (Repealed)
69L-31.013	Petition Withdrawal
69L-31.014	Overutilization Issues Raised in Reimbursement Dispute Resolution (Repealed)
69L-31.016	Reimbursement Disputes Involving a Contract or Workers' Compensation Managed Care Arrangement

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.; and 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.

SUBJECT:

Procedures for the resolution of reimbursement disputes between workers’ compensation carriers and health care providers.

RULEMAKING AUTHORITY:

440.13(7)(e), 440.591, FS

LAW:

440.13(7), 440.13(7)(a), (b), (c), (e), 440.13(8)(b), 440.13(11)(a), 440.13(12), 440.525, FS

PRINT PUBLISH DATE:

2/5/2018 Vol. 44/24

RELATED STATUTES
AND LAWS:

440.13(7)(e), 440.591, FS, 440.13(7), 440.13(7)(a), (b), (c), (e), 440.13(8)(b), 440.13(11)(a), 440.13(12), 440.525, 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-31.003&PDate=2/5/2018&Section=1

REFERENCE MATERIALS:

No reference(s).

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