Although the Florida Legislative session ended May 5th, HB 487 was signed into law at the end of last week (5/25/23). There are two parts of the bill that deal directly with Florida Workers’ Compensation, but no drastic changes.
- Expert Medical Advisor (440.13(9)) changes- If there is a conflict in the opinions between authorized medical providers and/or either side’s IME or another authorized doctor, the statute previously said said the JCC shall appoint a tiebreaker EMA doctor to resolve the conflict. The EMA doctor’s opinion was presumed correct. This was a great tool for us if we did not like the treater’s opinion, we could obtain an IME and then have the JCC appoint a doctor to resolve it. Often it was a great way to move a claim toward settlement rather than the claimant wanting to chance the EMA. It however also allowed the claimant’s to operate in the same manner and increase our exposure potentially.
Well the new statute removes the word “shall” and replaces it with “may”. This means it will be up to the individual JCC’s discretion as to whether a tiebreaker doctor is needed to help the Judge make a determination. This means we may not always be able to automatically obtain an EMA, and we may have to take more issues to trial.
- Fee Schedule for medical services changes (440.13(12)) Disclaimer: I do not claim to be a Fee Schedule expert. The changes appear to be more in the realm of how the fees will be determined. The 3-member panel will no longer set physician and non-hospital services rates, but the department will issue a schedule of maximum allowances every July 1. The unchanged portion of the statute still states the maximum reimbursement for a physician remains at 110% of the Medicare rates, and surgeries remain at 140%.
So we will see then what the new rates will be and whether it will have any impact on costs and/or physicians willingness to accept WC patients, but it appears the caps remain the same.
Here is a link to the final bill. The WC items above are on pages 9-13.
Morgan Indek | Managing Partner