14131365, 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: 14131365

Notice of Proposed Rule

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 and effect of the proposed rule development is to amend the rule to adopt by reference the 2014 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 2014 Edition of the Florida Workers’ Compensation Reimbursement Manual will incorporate a fee schedule for certain hospital outpatient services utilizing current procedural terminology (CPT) line level charge data. The proposed outpatient fee schedule includes adjustment of the reimbursement amount depending upon the geographic location of the service provider.  In addition, the manual increases the current inpatient surgical and non-surgical per diem amounts by 16.5% and raises the current stop-loss threshold by 16.5%. Technical changes incorporated into the 2014 Edition of the Florida Workers’ Compensation Reimbursement Manual for Hospitals include a new manual format and an expanded table of contents, with chapters organized by topic.

SUMMARY:

Rule amendment to adopt the 2014 Edition of the Florida Workers’ Compensation Reimbursement Manual for Hospitals. The Manual incorporates a fee schedule reimbursement methodology for certain hospital outpatient services based on CPT line level charge data including an adjustment based upon defined geographic areas in Florida.

RULEMAKING AUTHORITY:

440.13(12), (14), 440.591, F.S.

LAW:

440.13(7), (12), (14), F.S.

PRINT PUBLISH DATE:

2/4/2014 Vol. 40/23

COMMENTS:

From 2/4/2014 To 2/25/2014 (21 Days)
The public comment period for this notice has already expired.

REFERENCE MATERIALS:

No reference(s).

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