RULE NO: RULE TITLE
69L-7.501: Florida Workers' Compensation Reimbursement Manual for Hospitals
PURPOSE AND EFFECT: The purpose and effect of the proposed rule development is to amend the rule to adopt by reference the 2009 Edition of the Florida Workers’ Compensation Reimbursement Manual for Hospitals, replacing the 2006 Edition of the Florida Workers’ Compensation Reimbursement Manual for Hospitals in the existing rule. The 2009 Edition of the Florida Workers’ Compensation Reimbursement Manual for Hospitals will incorporate Medicare’s Outpatient Hospital Prospective Payment System payment methodology for reimbursing hospitals for outpatient bills, with payment adjustment factors of 1.74 times the Medicare allowed amount for scheduled surgeries and 3.95 times the Medicare allowed amount for other specified compensable charges, as approved by the Three Member Panel at its November 20, 2008 meeting. The 2009 Edition of the Florida Workers’ Compensation Reimbursement Manual for Hospitals also incorporates a definition for the Medicare Hospital Outpatient Prospective Payment System, recognizes the Integrated Outpatient Code Editor and the National Correct Coding Initiative (NCCI) edits and their updates from the Centers for Medicare and Medicaid Services (CMS) in the Medicare Hospital Outpatient Prospective Payment System, and makes technical changes to include a new manual format, an expanded table of contents and chapters by topic.
SUBJECT AREA TO BE ADDRESSED: Reimbursements to hospitals for outpatient care provided to workers’ compensation patients pursuant to the Florida Workers’ Compensation Reimbursement Manual for Hospitals.
SPECIFIC AUTHORITY: 440.13(12),(14), 440.591 FS.
LAW IMPLEMENTED: 440.13(7), (12), (14) FS.
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 SHOWN BELOW:
TIME AND DATE: Tuesday, July 7, 2009, 1:00 p.m. – 4:00 p.m.
PLACE: 104J Hartman Bldg., 2012 Capital Circle Southeast, Tallahassee, Florida
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: Samuel Willis @ (850)413-1898. 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).
THE PERSON TO BE CONTACTED REGARDING THE PROPOSED RULE DEVELOPMENT AND A COPY OF THE PRELIMINARY DRAFT, IF AVAILABLE, IS: Samuel Willis, III, Operations Management Consultant II, Office of Medical Services, Department of Financial Services, Division of Workers’ Compensation, 200 East Gaines Street, Tallahassee, Florida 32399-4232, (850)413-1898
THE PRELIMINARY TEXT OF THE PROPOSED RULE DEVELOPMENT IS AVAILABLE AT NO CHARGE FROM THE CONTACT PERSON LISTED ABOVE.