Florida Regulations 59A-31.013

(1) Prior to the issuance of a determination, the petitioner may voluntarily withdraw its Petition for Resolution of Reimbursement Dispute.

(2) The withdrawal of a petition shall be in writing and must clearly indicate:

(a) The name of the health care provider or facility requesting withdrawal;

(b) The name of the carrier against whom the petition has been initiated;

(c) The date(s) of service covered by the petition; and

(d) The identity of the injured employee to whom medical services were delivered.

(3) The result of receipt by the Agency of a request for withdrawal of a petition shall be dismissal of the determination case by the Agency.

Specific Authority 440.13(7)(e), 440.591 FS. Law Implemented 440.13(7)(a), (c) FS.

History: New 11-28-06.