Florida Division of Workers’ Compensation Rule Hearing Reports: Medical Billing, Filing and Reporting; Hospital Reimbursement
Jul 7, 2009
Workers’ Compensation Medical Services Billing, Filing and Reporting Rule
Today, July 7, 2009, the Florida Department of Financial Services (“DFS”), Division of Workers’ Compensation (“Division”) held a hearing on Proposed Rule 69L-7.602 entitled Florida Workers’ Compensation Medical Services Billing, Filing and Reporting Rule (“Rule”). The Rule would adopt revised reference manuals for medical billing, filing, and reporting, as well as add and clarify several statutory definitions.
To view a list of related forms, along with the meeting Notice and complete text of the proposed Rule, click here.
DFS Officials explained the proposed Rule and considered public testimony. Insurance industry representatives expressed concerns with the some of the claim forms and certain billing practices. For example, the Rule requires multiple forms to be completed by different physicians treating the same patient on the same day. Healthcare providers also expressed concerns with the use of the terms “highest level of specificity” as well as “medical services approved.”
The DFS Officials and affected parties engaged in an open dialogue intended to clarify the intent of the changes in the Rule. It was stated that the Division would consider the concerns and recommendations presented by these affected parties.
The record will remain open for additional written comments through close of business on July 17, 2009. Comments should be addressed to Sam Willis, DFS Division of Workers’ Compensation, Office of Medical Services.
Workers’ Compensation Reimbursement Manual for Hospitals
The DFS Division of Workers Compensation (“Division”) held a Rule Development Workshop today, July 7, 2009, on proposed Rule 69L-7.501 entitled Florida Workers’ Compensation Reimbursement Manual for Hospitals (“Rule”). The proposed Rule would adopt the 2009 edition of the Florida Worker’s Compensation Reimbursement Manual for Hospitals by reference, thus replacing the existing 2006 Manual.
Florida Hospital Association representatives present at the Workshop expressed concerns with the pricing and commented that the Medicare multiplier percentages are not consistent with their analysis. Presiding Division Officials commented that they would look further into these concerns.
Other industry representatives who attended the Workshop also expressed concerns over ambiguous provisions related to provisions in the proposed Rule for outpatient reimbursement. Division Officials were open to suggested changes offered by interested parties.
An FCCI and Zenith representative applauded the proposed Rule because it provides pricing certainty, even if Florida pricing is above the national average.
The record will remain open for additional written comments through close of business on July, 17, 2009.
To view the Notice of Proposed Rule and complete Rule text, click here.
Should you have any questions or comments, please contact Colodny Fass.
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