Comments Open Until October 21 on Proposed 2016 Florida Workers’ Compensation Manual Rules
Oct 3, 2016
Comments are being accepted until October 21, 2016 by the Florida Division of Workers’ Compensation on the following proposed Rules (to view the corresponding Notice of Proposed Rule, click on the corresponding hyperlinks below):
69L-7.501: The proposed Rule is amended to adopt the 2016 Edition of the Florida Workers’ Compensation Reimbursement Manual for Hospitals as approved by the Three-Member Panel during a scheduled meeting held on April 20, 2016, pursuant to paragraph 440.13(12)(a), F.S. The 2016 Edition of the Manual increases the per diem reimbursement rates for surgical and non-surgical hospital inpatient services and the threshold dollar amount triggering Stop-Loss reimbursement above reimbursement allowances specified in the 2014 Edition of the Manual, as adopted by the existing rule. The Manual also provides an updated fee schedule for various categories of hospital outpatient services based on the Current Procedural Terminology line level charge data, with an adjustment of the Maximum Reimbursement Allowance based on the geographic location of the service provider.
69L-7.100: The proposed Rule incorporates and adopts for use the 2016 Edition of the Florida Workers’ Compensation Reimbursement Manual for Ambulatory Surgical Centers as approved by the Three-Member Panel on April 20, 2016, pursuant to paragraph 440.13(12)(a), F.S. The 2016 Edition of the Reimbursement Manual contains an updated list of the Maximum Reimbursement Allowances for various medical services provided to Florida’s injured workers.
69L-7.020: The proposed Rule amends the existing rule to adopt and incorporate by reference the 2016 Edition of the Florida Workers’ Compensation Health Care Provider Reimbursement Manual, as approved by the Three-Member panel on April 20, 2016, pursuant to paragraph 440.13(12)(a), F.S. The aforementioned manual is updated to incorporate the 2016 Medicare Conversion Factor and Resource Based Relative Value Scale geographic-specific reimbursement levels used to determine Maximum Reimbursement Allowances for physician’s services and non-surgical hospital outpatient services provided to Florida’s injured workers.
If requested within 21 days of the date of the Notice date (September 30), a hearing will be held on these proposed Rule on Monday, October 24, 2016 at 1 p.m. in Tallahassee.
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