House Bill 0537

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    Florida House of Representatives - 2000                 HB 537

        By Representative Futch






  1                      A bill to be entitled

  2         An act relating to workers' compensation

  3         medical care; amending s. 440.13, F.S.;

  4         requiring direct access to certain chiropractic

  5         physicians; providing for additional

  6         chiropractic services under certain

  7         circumstances; deleting an exclusion of certain

  8         chiropractic services from medically necessary

  9         treatment, care, and services; amending s.

10         440.134, F.S.; including chiropractic

11         physicians within medical care coordinator

12         provisions; requiring direct access to certain

13         chiropractic physicians under managed care

14         arrangements; providing for additional

15         chiropractic services under certain

16         circumstances; providing an effective date.

17

18  Be It Enacted by the Legislature of the State of Florida:

19

20         Section 1.  Paragraph (a) of subsection (2) of section

21  440.13, Florida Statutes, is amended to read:

22         440.13  Medical services and supplies; penalty for

23  violations; limitations.--

24         (2)  MEDICAL TREATMENT; DUTY OF EMPLOYER TO FURNISH.--

25         (a)  Subject to the limitations specified elsewhere in

26  this chapter, the employer shall furnish to the employee such

27  medically necessary remedial treatment, care, and attendance

28  for such period as the nature of the injury or the process of

29  recovery may require, including medicines, medical supplies,

30  durable medical equipment, orthoses, prostheses, and other

31  medically necessary apparatus. Remedial treatment, care, and

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    Florida House of Representatives - 2000                 HB 537

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  1  attendance, including work-hardening programs or

  2  pain-management programs accredited by the Commission on

  3  Accreditation of Rehabilitation Facilities or Joint Commission

  4  on the Accreditation of Health Organizations or

  5  pain-management programs affiliated with medical schools,

  6  shall be considered as covered treatment only when such care

  7  is given based on a referral by a physician as defined in this

  8  chapter. Each facility shall maintain outcome data, including

  9  work status at discharges, total program charges, total number

10  of visits, and length of stay. The department shall utilize

11  such data and report to the President of the Senate and the

12  Speaker of the House of Representatives regarding the efficacy

13  and cost-effectiveness of such program, no later than October

14  1, 1994. An injured worker shall have direct access to any

15  chiropractic physician, who is a certified health care

16  provider, for the first 18 visits of chiropractic services,

17  after which the certified health care provider shall determine

18  whether the injured worker needs additional chiropractic

19  services. Medically necessary treatment, care, and attendance

20  does not include chiropractic services in excess of 18

21  treatments or rendered 8 weeks beyond the date of the initial

22  chiropractic treatment, whichever comes first, unless the

23  carrier authorizes additional treatment or the employee is

24  catastrophically injured.

25         Section 2.  Paragraph (i) of subsection (1) and

26  paragraph (b) of subsection (2) of section 440.134, Florida

27  Statutes, are amended, subsections (7), (8), (9), (10), and

28  (11) of said section are renumbered as paragraphs (d), (e),

29  (f), (g), and (h), respectively, of subsection (6) of said

30  section, subsections (12)-(25) of said section are renumbered

31  as subsections (7)-(20), respectively, and renumbered

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    Florida House of Representatives - 2000                 HB 537

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  1  paragraph (g) of subsection (6) of said section is amended, to

  2  read:

  3         440.134  Workers' compensation managed care

  4  arrangement.--

  5         (1)  As used in this section, the term:

  6         (i)  "Medical care coordinator" means a primary care

  7  provider within a provider network who is responsible for

  8  managing the medical care of an injured worker including

  9  determining other health care providers and health care

10  facilities to which the injured employee will be referred for

11  evaluation or treatment. A medical care coordinator shall be a

12  physician licensed under chapter 458, or an osteopathic

13  physician licensed under chapter 459, or a chiropractic

14  physician licensed under chapter 460.

15         (2)

16         (b)  Effective January 1, 1997, the employer shall,

17  subject to the limitations specified elsewhere in this

18  chapter, furnish to the employee solely through managed care

19  arrangements such medically necessary remedial treatment,

20  care, and attendance for such period as the nature of the

21  injury or the process of recovery requires. An injured worker

22  shall have direct access to any chiropractic physician on the

23  managed care panel for the first 18 visits of chiropractic

24  services, after which a chiropractic medical care coordinator

25  shall determine whether the injured worker needs additional

26  chiropractic services.

27         (6)  The proposed managed care plan of operation must

28  include:

29         (g)(10)  Written procedures and methods for the

30  management of an injured worker's medical care by a medical

31  care coordinator including:

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    Florida House of Representatives - 2000                 HB 537

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  1         1.(a)  The mechanism for assuring that covered

  2  employees receive all initial covered services from a primary

  3  care provider participating in the provider network, except

  4  for emergency care.

  5         2.(b)  The mechanism for assuring that all continuing

  6  covered services be received from the same primary care

  7  provider participating in the provider network that provided

  8  the initial covered services, except when services from

  9  another provider are authorized by the medical care

10  coordinator pursuant to paragraph (d).

11         3.(c)  The policies and procedures for allowing an

12  employee one change to another provider within the same

13  specialty and provider network as the authorized treating

14  physician during the course of treatment for a work-related

15  injury, if a request is made to the medical care coordinator

16  by the employee; and requiring that special provision be made

17  for more than one such referral through the arrangement's

18  grievance procedures.

19         4.(d)  The process for assuring that all referrals

20  authorized by a medical care coordinator are made to the

21  participating network providers, unless medically necessary

22  treatment, care, and attendance are not available and

23  accessible to the injured worker in the provider network.

24         Section 3.  This act shall take effect upon becoming a

25  law.

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    Florida House of Representatives - 2000                 HB 537

    531-174-00






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  2                          HOUSE SUMMARY

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      Requires that an injured worker have direct access to
  4    chiropractic physicians and provides for additional
      chiropractic services. Includes chiropractic physicians
  5    within the definition of medical care coordinator and
      requires that an injured worker have direct access to
  6    chiropractic physicians under managed care arrangements.

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