Fla. Legislative and Regulatory Update

Tuesday, May 13, 2008 | 0

By McConnaughhay, Duffy, Coonrod, Pope & Weaver

The Florida Legislature concluded the 2008 regular session without making any substantial changes in the workers’ compensation system.

Lawmakers addressed only four issues, including one proposal sought by the Division of Workers’ Compensation that completed a statutory transfer of the Agency for Health Care Administration Workers’ Compensation Medical Services Unit to the division.

Chief Financial Officer Alex Sink largely prevailed in her move to block a proposed transfer of $129.5 million from the Workers’ Compensation Administrative Trust Fund (WCATF) to the state’s general revenue fund. On the insurance front, lawmakers passed one minor bill that allows the state’s four current self-insurance funds to distribute policyholder dividends without gaining prior approval by the Office of Insurance Regulation.

On the issue of workplace safety, lawmakers created the Florida Public Task Force on Work Place Safety, which will be housed in the University of South Florida’s Safety Consulting Program.

Rejected by lawmakers were several bills addressing insurance coverage requirements of professional employer leasing organizations and their client companies. The legislative activity comes as the system awaits a Florida Supreme Court ruling in <i>Emma Murray v. Mariner Health/ACE USA,/i> (SC07-244), which could strike down part or all of the claimant attorney fee provisions enacted in the 2003 reforms.

Lawmakers signed-off on the one legislative proposal recommended by the DWC, which codifies an interagency agreement that brought AHCA’s Workers’ Compensation Medical Services Unit under the division’s umbrella. The law change reverses a move made by the legislature in the late 1990s that transferred the medical services unit from the DWC to AHCA. At the time, the
rationale for the transfer was that it would streamline the regulatory process necessitated by a mandate that all workers’ comp medical services must be delivered through a managed care network. Lawmakers later lifted the requirement of mandatory managed care in favor of a voluntary system for providing medical services. With the mandate removed, regulators maintained it created an unnecessary split in the regulatory and rulemaking process.

Under Chapter 440.13, Florida Statutes, AHCA oversees the certification of health care providers, expert medical advisors, and maintains the database of certified providers. The unit also handles medical reimbursement and utilization disputes between health care providers and insurers. The bill doesn’t affect the internal operations of the DWC with respect to the medical services unit,
which has been fully integrated into the division. The main impact of the bill is a change in the rulemaking process.

Under the current process, many of the DWC and AHCA rules either overlap or to some extent affect similar areas. For example, AHCA has the statutory authority to set out fines in cases where providers are engaged in improper business practices, while the DWC has the ability to levy fines against insurers for not complying with the law. The bill removes all references to AHCA in Chapter440, Florida Statutes, bringing all laws and rules under the DWC’s purview.

<i>McConnaughhay, Duffy, Coonrod, Pope & Weaver is a Florida workers' compensation defense firm with offices throughout the state. This column is reprinted from their newsletter with the firm's permission.</i>