Florida Senate - 2011 SB 1068
By Senator Hays
20-01162-11 20111068__
1 A bill to be entitled
2 An act relating to the Department of Financial
3 Services; amending s. 20.121, F.S.; revising duties of
4 the Division of Consumer Services; amending ss. 284.01
5 and 284.36, F.S.; revising criteria for premiums
6 charged to agencies and departments for purposes of
7 the State Risk Management Trust Fund; amending s.
8 284.42, F.S.; revising reporting requirements for the
9 Department of Financial Services and the Department of
10 Management Services on the state insurance program;
11 requiring the Division of Risk Management to analyze
12 and report on certain agency return-to-work programs
13 and activities; amending s. 284.50, F.S.; requiring
14 certain agencies to establish and maintain return-to
15 work programs for certain employees; providing program
16 goals; requiring the Division of Risk Management to
17 evaluate agency risk management programs; requiring
18 reports; requiring agencies to respond to the
19 division’s evaluation and recommendations within a
20 specified time; requiring the division to submit the
21 evaluation report to the legislative appropriations
22 committees in certain circumstances; amending s.
23 440.13, F.S.; revising requirements for determining
24 the amount of a reimbursement for repackaged or
25 relabeled prescription medication; providing
26 limitations; amending s. 440.50, F.S.; providing for
27 reversion of certain unencumbered and undisbursed
28 funds to the Workers’ Compensation Administration
29 Trust Fund; providing an effective date.
30
31 Be It Enacted by the Legislature of the State of Florida:
32
33 Section 1. Paragraph (h) of subsection (2) of section
34 20.121, Florida Statutes, is amended to read:
35 20.121 Department of Financial Services.—There is created a
36 Department of Financial Services.
37 (2) DIVISIONS.—The Department of Financial Services shall
38 consist of the following divisions:
39 (h) The Division of Consumer Services.
40 1. The Division of Consumer Services shall perform the
41 following functions concerning products or services regulated by
42 the department of Financial Services or by either office of the
43 Office of Insurance Regulation Financial Services Commission:
44 a. Receive inquiries and complaints from consumers.
45 b. Prepare and disseminate such information as the
46 department deems appropriate to inform or assist consumers.
47 c. Provide direct assistance and advocacy for consumers who
48 request such assistance or advocacy.
49 d. With respect to apparent or potential violations of law
50 or applicable rules by a person or entity licensed by the
51 department or office by either office of the commission, report
52 such apparent or potential violations violation to the office or
53 the appropriate division of the department or office of the
54 commission, which may take such further action as it deems
55 appropriate.
56 e. Designate an employee of the division as primary contact
57 for consumers on issues relating to sinkholes.
58 2. Any person licensed or issued a certificate of authority
59 by the department or by the Office of Insurance Regulation shall
60 respond, in writing, to the Division of Consumer Services within
61 20 days after receipt of a written request for information from
62 the division concerning a consumer complaint. The response must
63 address the issues and allegations raised in the this complaint.
64 The division may, in its discretion, impose an administrative
65 penalty for failure to comply with this subparagraph of in an
66 amount up to $2,500 per violation upon any entity licensed by
67 the department or the office of Insurance Regulation and $250
68 for the first violation, $500 for the second violation, and up
69 to $1,000 per violation thereafter upon any individual licensed
70 by the department or the office of Insurance Regulation.
71 3. The department may adopt rules to administer implement
72 the provisions of this paragraph.
73 4. The powers, duties, and responsibilities expressed or
74 granted in this paragraph do shall not limit the powers, duties,
75 and responsibilities of the Department of Financial Services,
76 the Financial Services Commission, the Office of Insurance
77 Regulation, or the Office of Financial Regulation set forth
78 elsewhere in the Florida Statutes.
79 Section 2. Subsection (5) of section 284.01, Florida
80 Statutes, is amended to read:
81 284.01 State Risk Management Trust Fund; coverages to be
82 provided.—
83 (5) Premiums charged to agencies for coverage shall be
84 adopted promulgated on a retrospective rating arrangement based
85 upon actual losses accruing to the fund and loss prevention
86 results, taking into account reasonable expectations,
87 maintenance, and stability of the fund and cost of reinsurance.
88 Section 3. Section 284.36, Florida Statutes, is amended to
89 read:
90 284.36 Appropriation deposits; premium payment.—Premiums
91 for coverage by the State Risk Management Trust Fund as
92 calculated on all coverages shall be billed and charged to each
93 state agency according to coverages obtained by the fund for
94 their benefit, and such obligations shall be paid promptly by
95 each agency from its operating budget upon presentation of a
96 bill therefor. After the first year of operation, premiums to be
97 charged to all departments of the state are to be computed on a
98 retrospective rating arrangement based upon actual losses
99 accruing to the fund and loss prevention results, taking into
100 account reasonable expectations, the maintenance and stability
101 of the fund, and the cost of insurance.
102 Section 4. Section 284.42, Florida Statutes, is amended to
103 read:
104 284.42 Reports on state insurance program.—
105 (1) The Department of Financial Services, with the
106 Department of Management Services, shall conduct make an
107 analysis of the state insurance program each year and submit the
108 results on or before January 1 in a report to the Governor, the
109 President of the Senate, and the Speaker of the House of
110 Representatives annually, which must shall include:
111 (a) Complete underwriting information as to the nature of
112 the risks accepted for self-insurance and those risks that are
113 transferred to the insurance market.
114 (b) The funds allocated to the Florida Casualty Risk
115 Management Trust Fund and premiums paid for insurance through
116 the market.
117 (c) The method of handling legal matters and the cost
118 allocated.
119 (d) The method and cost of handling inspection and
120 engineering of risks.
121 (e) The cost of risk management service purchased.
122 (f) The cost of managing the State Insurance Program by the
123 Department of Financial Services and the Department of
124 Management Services.
125 (2) The Department of Financial Services and the Department
126 of Management Services departments shall make available complete
127 claims history including description of loss, claims paid and
128 reserved, and the cost of all claims handled by the state.
129 (3) Beginning January 1, 2012, the Division of Risk
130 Management shall include in its annual report an analysis of
131 agency return-to-work efforts, including, but not limited to,
132 agency return-to-work program performance metrics and a status
133 report on participating return-to-work programs. The report must
134 specify benchmarks, including, but not limited to, the average
135 lost-time claims per year, per agency; the total number of lost
136 claims; and specific agency measurable outcomes indicating the
137 change in performance from year to year.
138 Section 5. Subsections (3) and (4) are added to section
139 284.50, Florida Statutes, to read:
140 284.50 Loss prevention program; safety coordinators;
141 Interagency Advisory Council on Loss Prevention; employee
142 recognition program.—
143 (3) All agencies that are provided workers’ compensation
144 insurance coverage by the State Risk Management Trust Fund which
145 employ more than 6,000 full-time employees shall establish and
146 maintain return-to-work programs for employees who are receiving
147 workers’ compensation benefits. Such programs shall have the
148 primary goal of enabling injured employees to remain at work or
149 return to work to perform job duties within the physical or
150 mental functional limitations and restrictions established by
151 the employees’ treating physicians. If such limitations or
152 restrictions are not established in writing by an employee’s
153 treating physician, the employee shall be deemed to be able to
154 fully perform the same job duties he or she performed before the
155 injury.
156 (4) The Division of Risk Management shall evaluate each
157 agency’s risk management programs, including, but not limited
158 to, return-to-work, safety, and loss prevention programs, at
159 least once every 5 years. Reports, including any recommended
160 corrective action resulting from such evaluations, shall be
161 provided to the head of the agency being evaluated, the Chief
162 Financial Officer, and the director of the Division of Risk
163 Management. The agency head must provide to the Division of Risk
164 Management a response to all report recommendations within 45
165 days and a plan to implement any corrective action to be taken
166 as part of the response. If the agency disagrees with any final
167 report recommendations, including any recommended corrective
168 action, or if the agency fails to implement any recommended
169 corrective action within a reasonable time, the division shall
170 submit the evaluation report to the appropriate legislative
171 appropriations committees.
172 Section 6. Paragraph (c) of subsection (12) of section
173 440.13, Florida Statutes, is amended to read:
174 440.13 Medical services and supplies; penalty for
175 violations; limitations.—
176 (12) CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM
177 REIMBURSEMENT ALLOWANCES.—
178 (c) As to reimbursement for a prescription medication,
179 regardless of the location or provider from whom the claimant
180 receives the prescription medication, the reimbursement amount
181 for a prescription shall be the average wholesale price plus
182 $4.18 for the dispensing fee, unless except where the carrier
183 has contracted for a lower amount. If the drug has been
184 repackaged or relabeled, the reimbursement amount shall be
185 calculated by multiplying the number of units dispensed times
186 the per-unit average wholesale price set by the original
187 manufacturer of the underlying drug, which may not be the
188 manufacturer of the repackaged or relabeled drug, plus a $4.18
189 dispensing fee, unless the carrier has contracted for a lower
190 amount. The repackaged or relabeled drug price may not exceed
191 the amount otherwise payable had the drug not been repackaged or
192 relabeled. Fees for pharmaceuticals and pharmaceutical services
193 shall be reimbursable at the applicable fee schedule amount. If
194 Where the employer or carrier has contracted for such services
195 and the employee elects to obtain them through a provider not a
196 party to the contract, the carrier shall reimburse at the
197 schedule, negotiated, or contract price, whichever is lower. No
198 Such contract may not shall rely on a provider that is not
199 reasonably accessible to the employee.
200 Section 7. Subsection (5) is added to section 440.50,
201 Florida Statutes, to read:
202 440.50 Workers’ Compensation Administration Trust Fund.—
203 (5) Funds appropriated by operating appropriation or
204 nonoperating transfer from the Workers’ Compensation
205 Administration Trust Fund to the Department of Education, the
206 Agency for Health Care Administration, the Department of
207 Business and Professional Regulation, the Department of
208 Management Services, the First District Court of Appeal, and the
209 Justice Administrative Commission which remain unencumbered as
210 of June 30 or undisbursed as of September 30 each year revert to
211 the Workers’ Compensation Administration Trust Fund.
212 Section 8. This act shall take effect July 1, 2011.