Florida Division of Workers’ Compensation Considers Mandatory Reporting Requirements in Proposed Rule Chapter 69L-34: Carrier Report of Health Care Provider Violation
Jun 23, 2011
On Thursday, June 23, 2011 the Florida Department of Financial Services, Division of Workers’ Compensation (“Division”) held a public hearing on proposed Rule Chapter 69L-34 entitled “Carrier Report of Health Care Provider Violation.”
The proposed Rule chapter provides that workers’ compensation carriers can satisfy their mandatory reporting requirements under 440.13(8), F.S., entitled “Pattern or Practice of Overutilization,” by filing the required medical claims data elements and any other medical billing and payment information required by the Division in Rule Chapter 69L-7.602.
The proposed Rule Chapter also incorporates a new form, DFS-F6-DWC-2000, entitled “Health Care Provider Violation Referral Form,” which is discretionary and intended to augment the mandatory reporting process.
Division Program Administrator Eric Lloyd explained the proposed Rule Chapter noting the Rule is intended to clarify the overutilization reporting process and is not intended to be overly burdensome on carriers.
During public testimony, concerns were raised over the necessity of the optional form, which some felt could create abuses that would be problematic for carriers. Mr. Lloyd responded that Form DFS-F6-DWC-2000 is intended to give the Division a better initial “snapshot” of a potential overutilization violation. He added that the Division intends to use the new form to determine what, if any, further steps are necessary in regard to an alleged violation.
Mr. Lloyd stated that the record will remain open for 10 business days. The meeting then concluded.
For complete information and text of proposed Rule Chapter 69L-34, click here.
A copy of Form DFS-F6-DWC-2000 is attached for review.
Should you have any questions, please do not hesitate to contact Colodny Fass.
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