Workers’ Comp Insurers’ Standards and Practices Rule Chapter Amendments Hearing Report–August 5

Aug 6, 2009

 

The Florida Department of Financial Services, Division of Workers’ Compensation (“Division”) held a hearing on August 5, 2009 regarding proposed Rules that would amend Chapter 69L-24, F.A.C. entitled “Workers’ Compensation Insurers’ Standards and Practices.”  Existing Rules would be repealed and replaced in order to provide clarity regarding Chapter 440, F.S. compliance guidelines.

To view the meeting notice and access Rule hyperlinks, click here.

The proposed Rules are also intended to facilitate the timely payment of workers’ compensation benefits, provider payment, data reporting, and to establish penalty assessment guidelines for non-compliance. 

The hearing, which was heavily attended by industry stakeholders, was conducted by Division Assistant Director Andrew Sabolic.  Following is a brief review of the issues raised during the hearing:

Insurance industry representatives expressed specific concerns regarding the anticipated cost of compliance with Rule 69L-24.005 relating to Electronic Access to Personal Information. 

Allowing companies that are currently not using the necessary software to submit hard copies was suggested as an alternative to the Rule.  Division officials indicated that they would consider alternatives, but did not address whether the Rule would be amended accordingly.

A surgery center representative urged the Division officials to ensure that workers’ compensation carriers abide by the Rules.  Suggesting that publication of the names of non-compliant carriers would provide public notice of violations subject to penalties, he further added that subsequent violations should then be categorized as willful.  Other insurance industry representatives in attendance at the hearing expressed serious concerns with this practice for fear that it could unnecessarily trigger costly lawsuits.  The Division did not indicate whether it would consider the suggestion.

In regard to proposed Rule 69L-24.022 relating to Auditing, a case management representative spoke on behalf of small claims management companies.  She noted small companies have limited technology and therefore, relinquishing a computer in order to accommodate an audit would delay claims processing operations.  Division officials noted this concern and stressed that they will work with third-party administrators to ensure their businesses are not overly burdened.

Discussion took place regarding the use of health care provider forms, specifically Form DWC- 25 and its use in conjunction with other healthcare provider forms.  Mr. Sabolic noted that this required educating the Form users and that the Department would work to ensure compliance.  Some debate took place on whether the imposition of penalties for failing to use the Form would remain permissive or become mandatory. 

Following public testimony, the meeting concluded.

The record will remain open for seven days in order for interested parties to submit additional written comments.

 

Please note that the above information is a brief review of the items and issues discussed during the hearing.  It is not intended to be a comprehensive analysis of the issues that arose or other issues that may be involved in this matter.  Should you have specific questions or comments, please feel free to contact Colodny Fass.

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