House Bill hb1643c1

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    Florida House of Representatives - 2002             CS/HB 1643

        By the Council for Smarter Government and Representative
    Clarke





  1                      A bill to be entitled

  2         An act relating to transferring and reassigning

  3         divisions, functions, and responsibilities of

  4         the Department of Labor and Employment

  5         Security; providing for a type two transfer of

  6         the Division of Workers' Compensation to the

  7         Department of Insurance; providing for a type

  8         two transfer of workers' compensation medical

  9         services to the Agency for Health Care

10         Administration; providing for a type two

11         transfer of workers' compensation

12         rehabilitation and reemployment services to the

13         Department of Education; providing for a type

14         two transfer of the administration of child

15         labor laws to the Department of Business and

16         Professional Regulation; providing for

17         comparable pay grades for the transferred

18         positions; authorizing the Department of

19         Insurance to reclassify and reorganize

20         positions within the department and establish

21         regional offices; authorizing the Department of

22         Insurance to enter into contracts; providing

23         for existing contracts to be subject to review

24         and cancellation; providing for a type two

25         transfer of certain functions of the Office of

26         the Secretary and the Office of Administrative

27         Services of the Department of Labor and

28         Employment Security relating to labor

29         organizations and migrant and farm labor

30         registration to the Department of Business and

31         Professional Regulation; providing for a type

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  1         two transfer of other workplace regulation

  2         functions to the Department of Business and

  3         Professional Regulation; authorizing the

  4         department to take certain action for certain

  5         purposes; providing for the transfer of the

  6         Unemployment Appeals Commission to the Agency

  7         for Workforce Innovation by a type two

  8         transfer; providing for the transfer of the

  9         Office of Information Systems to the State

10         Technology Office by a type two transfer;

11         requiring the Department of Insurance to submit

12         a transfer plan and budget amendment to request

13         that ownership of the Workers' Compensation

14         Integrated System be transferred to the

15         Department of Insurance under certain

16         circumstances; authorizing the Department of

17         Banking and Finance, in conjunction with the

18         Office of the Attorney General, to use

19         unexpended funds to settle certain claims;

20         providing for the continuation of contracts or

21         agreements of the Department of Labor and

22         Employment Security; providing for a successor

23         department, agency, or entity to be substituted

24         for the Department of Labor and Employment

25         Security as a party in interest in pending

26         proceedings; exempting specified state

27         agencies, on a temporary basis, from provisions

28         relating to procurement of property and

29         services and leasing of space; authorizing

30         specified state agencies to develop temporary

31         emergency rules relating to the implementation

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  1         of the act; authorizing the Department of

  2         Business and Professional Regulation to

  3         transfer certain resources and make certain

  4         budget revisions for certain purposes; amending

  5         s. 20.13, F.S.; establishing the Division of

  6         Workers' Compensation within the Department of

  7         Insurance; amending s. 20.50, F.S.; revising

  8         provisions relating to the Agency for Workforce

  9         Innovation to conform; revising

10         responsibilities of certain offices within the

11         agency; specifying that the Unemployment

12         Appeals Commission is not subject to the

13         agency; amending ss. 110.205, 112.19, 112.191,

14         121.125, 122.03, and 238.06, F.S., to conform;

15         amending s. 440.02, F.S.; providing a

16         definition for the term "agency"; conforming

17         definitions of "department" and "division" to

18         the transfer of the Division of Workers'

19         Compensation; amending ss. 440.021, 440.05,

20         440.09, 440.10, 440.102, 440.103, 440.104,

21         440.105, 440.106, 440.107, 440.108, 440.12, and

22         440.125, F.S.; conforming references to reflect

23         the transfer of the Division of Workers'

24         Compensation; amending s. 440.13, F.S.,

25         relating to medical services and supplies under

26         the workers' compensation law; reassigning

27         certain functions from the Division of Workers'

28         Compensation to the Agency for Health Care

29         Administration; conforming agency references to

30         reflect the transfer of the Division of

31         Workers' Compensation; amending ss. 440.134 and

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  1         440.14, F.S.; conforming provisions to changes

  2         made by the act; amending s. 440.15, F.S.;

  3         providing for the agency to specify certain

  4         forms and procedures governing wage loss and

  5         impairment benefits; conforming a cross

  6         reference; amending ss. 440.185, 440.191,

  7         440.192, and 440.1925, F.S.; conforming

  8         provisions to changes made by the act; amending

  9         ss. 440.20, 440.207, and 440.211, F.S.,

10         relating to payment of compensation; conforming

11         provisions to changes made by the act; amending

12         s. 440.24, F.S.; providing for the sale of

13         securities on deposit to satisfy a compensation

14         order; amending ss. 440.25 and 440.271, F.S.,

15         relating to mediation, hearings, and appeals;

16         conforming provisions to changes made by the

17         act; amending ss. 440.345 and 440.35, F.S.,

18         relating to the reporting of attorney's fees

19         and employer records of injury or death;

20         conforming provisions to changes made by the

21         act; amending ss. 440.38, 440.381, and 440.385,

22         F.S., relating to security for compensation by

23         insurance carriers and self-insurers, audits of

24         payroll and classifications, and the creation,

25         board of directors, powers and duties,

26         insolvency fund, and plan of operation for the

27         Florida Self-Insurance Guaranty Association;

28         conforming references to reflect the transfer

29         of the Division of Workers' Compensation;

30         amending ss. 440.40, 440.41, and 440.42, F.S.,

31         relating to employers posting notice of

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  1         compensation, substitution of carriers for

  2         employers with respect to notice and the effect

  3         of an order, and expiration of insurance

  4         policies, to conform; amending s. 440.44, F.S.,

  5         relating to the administration of the Workers'

  6         Compensation Law; conforming references to

  7         reflect the transfer of the Division of

  8         Workers' Compensation; amending s. 440.45,

  9         F.S., relating to the Office of the Judges of

10         Compensation Claims; clarifying the

11         responsibilities of the director of the

12         Division of Administrative Hearings as agency

13         head of the Office of the Judges of

14         Compensation Claims; amending s. 440.49, F.S.,

15         relating to the Special Disability Trust Fund;

16         conforming references to reflect the transfer

17         of the Division of Workers' Compensation;

18         reassigning responsibility for a report on the

19         Special Disability Trust Fund to the Department

20         of Insurance; amending s. 440.491, F.S.,

21         relating to the reemployment of injured

22         workers; conforming references to the transfer

23         of rehabilitation and reemployment services to

24         the Department of Education; amending ss.

25         440.50, 440.51, and 440.52, F.S., relating to

26         the Workers' Compensation Administration Trust

27         Fund, expenses of administration, and certain

28         responsibilities of insurance carriers;

29         conforming references to reflect the transfer

30         of the Division of Workers' Compensation;

31         amending s. 440.525, F.S., relating to the

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  1         examination of carriers; conforming agency

  2         references to the transfer of programs from the

  3         Department of Labor and Employment Security to

  4         the Department of Insurance; amending s.

  5         440.572, F.S., to conform; amending s. 440.59,

  6         F.S., relating to division reporting

  7         requirements; eliminating unnecessary reporting

  8         requirements; amending ss. 440.591 and 440.593,

  9         F.S., relating to authorization to self-insure,

10         reporting requirements, and rulemaking

11         authority; conforming provisions to changes

12         made by the act; amending s. 443.012, F.S.;

13         providing for the Unemployment Appeals

14         Commission to be created within the Agency for

15         Workforce Innovation rather than the Department

16         of Labor and Employment Security; conforming

17         provisions; amending s. 443.036, F.S.;

18         conforming the definition of "commission" to

19         the transfer of the Unemployment Appeals

20         Commission to the Agency for Workforce

21         Innovation; amending s. 447.02, F.S.;

22         conforming the definition of "department" to

23         the transfer of the regulation of labor

24         organizations to the Department of Business and

25         Professional Regulation; amending s. 447.305,

26         F.S.; providing that notification of

27         registrations and renewals of registration

28         shall be furnished to the Department of

29         Business and Professional Regulation, to

30         conform; amending s. 450.012, F.S.; conforming

31         the definition of "department" to the transfer

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  1         of the regulation of child labor to the

  2         Department of Business and Professional

  3         Regulation; amending s. 450.191, F.S., relating

  4         to the duties of the Executive Office of the

  5         Governor with respect to migrant labor;

  6         conforming provisions to changes made by the

  7         act; amending s. 450.28, F.S.; conforming the

  8         definition of "department" to the transfer of

  9         the regulation of farm labor to the Department

10         of Business and Professional Regulation;

11         amending s. 624.3161, F.S., relating to

12         insurance market conduct examinations;

13         conforming provisions to changes made by the

14         act; amending s. 626.88, F.S., relating to

15         self-insurance definitions; conforming

16         provisions to changes made by the act; amending

17         s. 626.989, F.S., relating to Division of

18         Insurance Fraud reporting requirements;

19         conforming provisions to changes made by the

20         act and establishing reporting deadlines;

21         amending s. 627.0915, F.S.; conforming

22         departmental references to changes made by the

23         act; amending s. 627.914, F.S., relating to

24         reporting requirements by self-insurers;

25         conforming provisions to changes made by the

26         act; repealing s. 20.171, F.S., relating to the

27         establishment and the authority and

28         organizational structure of the Department of

29         Labor and Employment Security; repealing s.

30         440.4416, F.S., relating to the Workers'

31

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  1         Compensation Oversight Board; providing for

  2         severability; providing effective dates.

  3

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

  5

  6         Section 1.  (1)  All powers, duties, functions, rules,

  7  records, personnel, property, and unexpended balances of

  8  appropriations, allocations, and other funds of the Division

  9  of Workers' Compensation are transferred by a type two

10  transfer, as defined in s. 20.06(2), Florida Statutes, from

11  the Department of Labor and Employment Security to the

12  Department of Insurance, except as otherwise provided in this

13  subsection, as follows: the full-time equivalent positions,

14  and the associated funding for salaries, benefits, and

15  expenses related to oversight of medical services in workers'

16  compensation provider relations, dispute and complaint

17  resolution, program evaluation, data management, and review of

18  carrier medical bill payments, are transferred by a type two

19  transfer, as defined in s. 20.06(2), Florida Statutes, from

20  the Department of Labor and Employment Security to the Agency

21  for Health Care Administration; the full-time equivalent

22  positions, and the associated funding for salaries, benefits,

23  and expenses related to the rehabilitation and reemployment of

24  injured workers are transferred by a type two transfer, as

25  defined in s. 20.06(2), Florida Statutes, from the Department

26  of Labor and Employment Security to the Department of

27  Education; and the full-time equivalent positions, and the

28  associated funding for salaries, benefits, and expenses

29  related to the administration of child labor laws under

30  chapter 450, Florida Statutes, are transferred by a type two

31  transfer, as defined in s. 20.06(2), Florida Statutes, from

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  1  the Department of Labor and Employment Security to the

  2  Department of Business and Professional Regulation. To the

  3  extent feasible, the positions transferred to the Department

  4  of Insurance will be reclassified to pay grades comparable to

  5  the positions established by the Department of Labor and

  6  Employment Security, based on the classification codes and

  7  specifications of the positions for work to be performed at

  8  the Department of Insurance.  The number of positions the

  9  department establishes may not exceed the number of authorized

10  positions and the salary and benefits that were authorized for

11  the Division of Workers' Compensation within the Department of

12  Labor and Employment Security prior to the transfer.  The

13  Department of Insurance is further authorized to reassign,

14  reorganize, reclassify, or otherwise transfer positions to

15  appropriate administrative subdivisions within the department

16  and to establish such regional offices as are necessary to

17  properly enforce and administer its responsibilities under the

18  Florida Insurance Code and chapter 440, Florida Statutes. The

19  department may also enter into contracts with public or

20  private entities to administer its duties and responsibilities

21  associated with the transfer of the Division of Workers'

22  Compensation.

23         (2)  All powers, duties, functions, rules, records,

24  personnel, property, and unexpended balances of

25  appropriations, allocations, and other funds of the Office of

26  the Secretary and the Office of Administrative Services of the

27  Department of Labor and Employment Security related to the

28  regulation of labor organizations under chapter 447, Florida

29  Statutes, and the administration of migrant labor and farm

30  labor laws under chapter 450, Florida Statutes, are

31  transferred by a type two transfer, as defined in s. 20.06(2),

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  1  Florida Statutes, from the Department of Labor and Employment

  2  Security to the Department of Business and Professional

  3  Regulation.

  4         (3)  Any other powers, duties, functions, rules,

  5  records, property, and unexpended balances of appropriations,

  6  allocations, and other funds of the Department of Labor and

  7  Employment Security not otherwise transferred by this act

  8  relating to workplace regulation and enforcement, including,

  9  but not limited to, those under chapter 448, Florida Statutes,

10  are transferred by a type two transfer, as defined in s.

11  20.06(2), Florida Statutes, from the Department of Labor and

12  Employment Security to the Department of Business and

13  Professional Regulation. The Department of Business and

14  Professional Regulation is authorized to reassign, reorganize,

15  reclassify, or otherwise transfer positions to appropriate

16  administrative subdivisions within the department to

17  accomplish its workplace regulation responsibilities.

18         (4)  All powers, duties, functions, rules, records,

19  personnel, property, and unexpended balances of

20  appropriations, allocations, and other funds of the

21  Unemployment Appeals Commission relating to the commission's

22  specified authority, powers, duties, and responsibilities are

23  transferred by a type two transfer, as defined in s. 20.06(2),

24  Florida Statutes, to the Agency for Workforce Innovation.

25         (5)  The Office of Information Systems is transferred

26  by a type two transfer, as defined in s. 20.06(2), Florida

27  Statutes, from the Department of Labor and Employment Security

28  to the State Technology Office. Upon completion of this

29  transfer, the State Technology Office and the Department of

30  Insurance shall enter into discussions to determine whether it

31  would be technologically feasible and cost-effective to

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  1  separate the workers' compensation related systems and

  2  transfer ownership of these systems to the Department of

  3  Insurance.  If the Department of Insurance determines that it

  4  would be technologically feasible and cost effective to

  5  transfer ownership of the workers' compensation related

  6  systems from the State Technology Office to the Department of

  7  Insurance, the Department of Insurance shall submit a transfer

  8  plan and budget amendment requesting the transfer of these

  9  systems.  The transfer plan and budget amendment must be

10  approved by the Legislative Budget Commission.

11         (6)(a)  The records, property, and unexpended balances

12  of appropriations, allocations, and other funds and resources

13  of the Office of the Secretary and the Office of

14  Administrative Services of the Department of Labor and

15  Employment Security which support the activities and functions

16  transferred under subsection (1) to the Department of

17  Insurance are transferred as provided in s. 20.06(2), Florida

18  Statutes, to the Department of Insurance.

19         (b)  The records, property, and unexpended balances of

20  appropriations, allocations, and other funds and resources of

21  the Office of the Secretary and the Office of Administrative

22  Services of the Department of Labor and Employment Security

23  which support the activities and functions transferred under

24  subsection (1) to the Agency for Health Care Administration

25  are transferred as provided in s. 20.06(2), Florida Statutes,

26  to the Agency for Health Care Administration.

27         (c)  The records, property, and unexpended balances of

28  appropriations, allocations, and other funds and resources of

29  the Office of the Secretary and the Office of Administrative

30  Services of the Department of Labor and Employment Security

31  which support the activities and functions transferred under

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  1  subsection (1) to the Department of Education are transferred

  2  as provided in s. 20.06(2), Florida Statutes, to the

  3  Department of Education.

  4         (d)  The records, property, and unexpended balances of

  5  appropriations, allocations, and other funds and resources of

  6  the Office of the Secretary and the Office of Administrative

  7  Services of the Department of Labor and Employment Security

  8  which support the activities and functions transferred under

  9  subsections (1), (2), and (3) to the Department of Business

10  and Professional Regulation are transferred as provided in s.

11  20.06(2), Florida Statutes, to the Department of Business and

12  Professional Regulation.

13         (e)  The records, property, and unexpended balances of

14  appropriations, allocations, and other funds and resources of

15  the Office of the Secretary and the Office of Administrative

16  Services of the Department of Labor and Employment Security

17  which support the activities and functions transferred under

18  subsection (4) to the Agency for Workforce Innovation are

19  transferred as provided in s. 20.06(2), Florida Statutes, to

20  the Agency for Workforce Innovation.

21         (f)  The records, property, and unexpended balances of

22  appropriations, allocations, and other funds and resources of

23  the Office of the Secretary and the Office of Administrative

24  Services of the Department of Labor and Employment Security

25  which support the activities and functions transferred under

26  subsection (5) to the State Technology Office are transferred

27  as provided in s. 20.06(2), Florida Statutes, to the State

28  Technology Office.

29         (7)  The Department of Management Services shall become

30  the custodian of any property of the Department of Labor and

31  Employment Security which is not otherwise transferred for the

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  1  purposes of chapter 273, Florida Statutes. The Department of

  2  Management Services is authorized to permit the use of such

  3  property by organizations as necessary to implement the

  4  provisions of this act.

  5         (8)  The Department of Banking and Finance, in

  6  conjunction with the Office of the Attorney General, may use

  7  any unexpended balances of the Department of Labor and

  8  Employment Security to settle any claims or leases, pay out

  9  personnel annual leave or sick leave, or close out other costs

10  owed by the department, regardless of whether such costs

11  relate to federal, state, or local governments, department

12  employees, or the private sector. Any remaining balances of

13  the department shall be transferred as directed by this act or

14  by budget amendment.

15         (9)  Notwithstanding any other provision of law, any

16  binding contract or interagency agreement existing on or

17  before July 1, 2002, between the Department of Labor and

18  Employment Security, or an entity or agent of the department,

19  and any other agency, entity, or person shall continue as a

20  binding contract or agreement for the remainder of the term of

21  such contract or agreement with the successor department,

22  agency, or entity responsible for the program, activity, or

23  functions relative to the contract or agreement.

24         (10)  This act does not affect the validity of any

25  judicial or administrative proceeding involving the Department

26  of Labor and Employment Security which is pending as of the

27  effective date of any transfer under this act. The successor

28  department, agency, or entity responsible for the program,

29  activity, or function relative to the proceeding shall be

30  substituted, as of the effective date of the applicable

31  transfer under this act, for the Department of Labor and

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  1  Employment Security as a party in interest in any such

  2  proceedings.

  3         (11)  To expedite the acquisition of goods and services

  4  for implementation of the provisions of this act, the

  5  Department of Insurance, the Agency for Health Care

  6  Administration, the Department of Education, the Department of

  7  Business and Professional Regulation, the Agency for Workforce

  8  Innovation, and the State Technology Office are exempt from

  9  the provisions of chapter 287, Florida Statutes, when

10  contracting for the purchase or lease of goods or services

11  under this act. This subsection shall take effect upon this

12  act becoming a law and shall expire July 1, 2002.

13         (12)  To expedite the leasing of facilities for

14  implementation of the provisions of this act, the Department

15  of Revenue, the Agency for Health Care Administration, the

16  Department of Education, the Department of Business and

17  Professional Regulation, the Agency for Workforce Innovation,

18  and the State Technology Office are exempt from the

19  requirements of any state laws relating to the leasing of

20  space, including, but not limited to, the requirements imposed

21  by s. 255.25, Florida Statutes, and any rules adopted under

22  such laws; however, all leases entered into under this act on

23  or before June 30, 2002, must be submitted for approval to the

24  Department of Management Services at the earliest practicable

25  time. This subsection shall take effect upon this act becoming

26  a law and shall expire July 1, 2002.

27         (13)  Notwithstanding any provisions of chapter 120,

28  Florida Statutes, to the contrary, the Department of

29  Insurance, the Agency for Health Care Administration, the

30  Department of Education, the Department of Business and

31  Professional Regulation, the Agency for Workforce Innovation,

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  1  and the State Technology Office are authorized to develop

  2  emergency rules relating to and in furtherance of the orderly

  3  implementation of the provisions of this act. This subsection

  4  shall take effect upon this act becoming a law, and these

  5  emergency rules shall be valid for a period of 90 days after

  6  July 1, 2002.

  7         (14)  So that the farm labor, child labor, and

  8  workplace regulation programs may be fully integrated into the

  9  mission of the Department of Business and Professional

10  Regulation in an effective manner, notwithstanding the

11  provisions of ss. 216.292 and 216.351, Florida Statutes, upon

12  this act becoming a law, the Department of Business and

13  Professional Regulation may transfer resources between

14  services and make revisions to the authorized budget as

15  necessary to reengineer business processes for the purpose of

16  reducing costs and increasing program efficiencies.  These

17  actions are subject to the review and approval provisions in

18  s. 216.172, Florida Statutes.

19         Section 2.  Paragraph (k) is added to subsection (2) of

20  section 20.13, Florida Statutes, to read:

21         20.13  Department of Insurance.--There is created a

22  Department of Insurance.

23         (2)  The following divisions of the Department of

24  Insurance are established:

25         (k)  Division of Workers' Compensation.

26         Section 3.  Subsections (2) and (3) of section 20.50,

27  Florida Statutes, are amended to read:

28         20.50  Agency for Workforce Innovation.--There is

29  created the Agency for Workforce Innovation within the

30  Department of Management Services. The agency shall be a

31  separate budget entity, and the director of the agency shall

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  1  be the agency head for all purposes. The agency shall not be

  2  subject to control, supervision, or direction by the

  3  Department of Management Services in any manner, including,

  4  but not limited to, personnel, purchasing, transactions

  5  involving real or personal property, and budgetary matters.

  6         (2)  The Agency for Workforce Innovation shall be the

  7  designated administrative agency for receipt of federal

  8  workforce development grants and other federal funds, and

  9  shall carry out the duties and responsibilities assigned by

10  the Governor under each federal grant assigned to the agency.

11  The agency shall be a separate budget entity and shall expend

12  each revenue source as provided by federal and state law and

13  as provided in plans developed by and agreements with

14  Workforce Florida, Inc. The agency shall prepare and submit as

15  a separate budget entity a unified budget request for

16  workforce development, in accordance with chapter 216 for, and

17  in conjunction with, Workforce Florida, Inc., and its board.

18  The head of the agency is the Director of Workforce

19  Innovation, who shall be appointed by the Governor.

20  Accountability and reporting functions of the agency shall be

21  administered by the director or his or her designee. Included

22  in these functions are budget management, financial

23  management, audit, performance management standards and

24  controls, assessing outcomes of service delivery, and

25  financial administration of workforce programs pursuant to s.

26  445.004(5) and (9). Within the agency's overall organizational

27  structure, the agency shall include the following offices

28  which shall have the specified responsibilities:

29         (a)  The Office of Workforce Services shall administer

30  state merit system program staff within the unemployment

31  compensation program, the Rapid Response program, the Work

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  1  Opportunity Tax Credit program, the Alien Labor Certification

  2  program, and any other programs that are delivered directly by

  3  agency staff rather than through the one-stop workforce

  4  service delivery system, pursuant to policies of Workforce

  5  Florida, Inc. The office shall be responsible for delivering

  6  services through the one-stop delivery system and for ensuring

  7  that participants in welfare transition programs receive case

  8  management services, diversion assistance, support services,

  9  including subsidized child care and transportation services,

10  Medicaid services, and transition assistance to enable them to

11  succeed in the workforce.  The office shall be directed by the

12  Deputy Director for Workforce Services, who shall be appointed

13  by and serve at the pleasure of the director.

14         (b)  The Office of Program Support Workforce Investment

15  and Accountability shall administer state merit system program

16  staff within the workforce service delivery system, pursuant

17  to policies of Workforce Florida, Inc. The office shall be

18  responsible for delivering services through the one-stop

19  delivery system and for ensuring that participants in welfare

20  transition programs receive case management services,

21  diversion assistance, support services, including subsidized

22  child care and transportation services, Medicaid services, and

23  transition assistance to enable them to succeed in the

24  workforce.  The office shall also be responsible for program

25  quality assurance, grants and contract management procurement,

26  contracting, financial management, accounting, audits, and

27  reporting verification. The office shall be directed by the

28  Deputy Director for Program Support Workforce Investment and

29  Accountability, who shall be appointed by and serve at the

30  pleasure of the director.  The office shall be responsible

31  for:

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  1         1.  Establishing standards and controls for reporting

  2  budgeting, expenditure, and performance information for

  3  assessing outcomes, service delivery, and financial

  4  administration of workforce programs pursuant to s. 445.004(5)

  5  and (9).

  6         1.2.  Establishing monitoring, quality assurance, and

  7  quality improvement systems that routinely assess the quality

  8  and effectiveness of contracted programs and services.

  9         2.3.  Annual review of each regional workforce board

10  and administrative entity to ensure adequate systems of

11  reporting and control are in place, and monitoring, quality

12  assurance, and quality improvement activities are conducted

13  routinely, and corrective action is taken to eliminate

14  deficiencies.

15         (c)  The Office of Agency Support Workforce Information

16  Services shall be responsible for procurement, human resource

17  services, and information services including delivering

18  deliver information on labor markets, employment, occupations,

19  and performance, and shall implement and maintain information

20  systems that are required for the effective operation of the

21  one-stop delivery system and the school readiness services

22  system, including, but not limited to, those systems described

23  in s. 445.009. The office will be under the direction of the

24  Deputy Director for Agency Support Workforce Information

25  Services, who shall be appointed by and serve at the pleasure

26  of the director.  The office shall be responsible for

27  establishing:

28         1.  Information systems and controls that report

29  reliable, timely and accurate fiscal and performance data for

30  assessing outcomes, service delivery, and financial

31

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  1  administration of workforce programs pursuant to s. 445.004(5)

  2  and (9).

  3         2.  Information systems that support service

  4  integration and case management by providing for case tracking

  5  for participants in welfare transition programs.

  6         3.  Information systems that support school readiness

  7  services.

  8         (d)  The Unemployment Appeals Commission, authorized by

  9  s. 443.012, shall not be subject to the control, supervision,

10  or direction by the Agency for Workforce Innovation in the

11  performance of its powers and duties but shall receive any and

12  all support and assistance from the agency that may be

13  required for the performance of its duties.

14         (3)  The Agency for Workforce Innovation shall serve as

15  the designated agency for purposes of each federal workforce

16  development grant assigned to it for administration. The

17  agency shall carry out the duties assigned to it by the

18  Governor, under the terms and conditions of each grant. The

19  agency shall have the level of authority and autonomy

20  necessary to be the designated recipient of each federal grant

21  assigned to it, and shall disperse such grants pursuant to the

22  plans and policies of Workforce Florida, Inc. The director

23  may, upon delegation from the Governor and pursuant to

24  agreement with Workforce Florida, Inc., sign contracts,

25  grants, and other instruments as necessary to execute

26  functions assigned to the agency. Notwithstanding other

27  provisions of law, the following federal grants and other

28  funds are assigned for administration to the Agency for

29  Workforce Innovation:

30         (a)  Programs authorized under Title I of the Workforce

31  Investment Act of 1998, Pub. L. No. 105-220, except for

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  1  programs funded directly by the United States Department of

  2  Labor under Title I, s. 167.

  3         (b)  Programs authorized under the Wagner-Peyser Act of

  4  1933, as amended, 29 U.S.C. ss. 49 et seq.

  5         (c)  Welfare-to-work grants administered by the United

  6  States Department of Labor under Title IV, s. 403, of the

  7  Social Security Act, as amended.

  8         (d)  Activities authorized under Title II of the Trade

  9  Act of 1974, as amended, 2 U.S.C. ss. 2271 et seq., and the

10  Trade Adjustment Assistance Program.

11         (e)  Activities authorized under chapter 41 of Title 38

12  U.S.C., including job counseling, training, and placement for

13  veterans.

14         (f)  Employment and training activities carried out

15  under the Community Services Block Grant Act, 42 U.S.C. ss.

16  9901 et seq.

17         (g)  Employment and training activities carried out

18  under funds awarded to this state by the United States

19  Department of Housing and Urban Development.

20         (h)  Designated state and local program expenditures

21  under part A of Title IV of the Social Security Act for

22  welfare transition workforce services associated with the

23  Temporary Assistance for Needy Families Program.

24         (i)  Programs authorized under the National and

25  Community Service Act of 1990, 42 U.S.C. ss. 12501 et seq.,

26  and the Service-America programs, the National Service Trust

27  programs, the Civilian Community Corps, the Corporation for

28  National and Community Service, the American Conservation and

29  Youth Service Corps, and the Points of Light Foundation

30  programs, if such programs are awarded to the state.

31

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  1         (j)  The Unemployment Compensation program provided

  2  pursuant to chapter 443.

  3         (k)(j)  Other programs funded by federal or state

  4  appropriations, as determined by the Legislature in the

  5  General Appropriations Act or by law.

  6         Section 4.  Paragraph (m) of subsection (2) of section

  7  110.205, Florida Statutes, is amended to read:

  8         110.205  Career service; exemptions.--

  9         (2)  EXEMPT POSITIONS.--The exempt positions that are

10  not covered by this part include the following:

11         (m)  All assistant division director, deputy division

12  director, and bureau chief positions in any department, and

13  those positions determined by the department to have

14  managerial responsibilities comparable to such positions,

15  which positions include, but are not limited to, positions in

16  the Department of Health, the Department of Children and

17  Family Services, and the Department of Corrections that are

18  assigned primary duties of serving as the superintendent or

19  assistant superintendent, or warden or assistant warden, of an

20  institution; positions in the Department of Corrections that

21  are assigned primary duties of serving as the circuit

22  administrator or deputy circuit administrator; positions in

23  the Department of Transportation that are assigned primary

24  duties of serving as regional toll managers and managers of

25  offices as defined in s. 20.23(3)(d)3. and (4)(d); positions

26  in the Department of Environmental Protection that are

27  assigned the duty of an Environmental Administrator or program

28  administrator; those positions described in s. 20.171 as

29  included in the Senior Management Service; and positions in

30  the Department of Health that are assigned the duties of

31  Environmental Administrator, Assistant County Health

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  1  Department Director, and County Health Department Financial

  2  Administrator. Unless otherwise fixed by law, the department

  3  shall set the salary and benefits of these positions in

  4  accordance with the rules established for the Selected Exempt

  5  Service.

  6         Section 5.  Paragraph (h) of subsection (2) of section

  7  112.19, Florida Statutes, is amended to read:

  8         112.19  Law enforcement, correctional, and correctional

  9  probation officers; death benefits.--

10         (2)

11         (h)1.  Any employer who employs a full-time law

12  enforcement, correctional, or correctional probation officer

13  who, on or after January 1, 1995, suffers a catastrophic

14  injury, as defined in s. 440.02 s. 440.02(37), in the line of

15  duty shall pay the entire premium of the employer's health

16  insurance plan for the injured employee, the injured

17  employee's spouse, and for each dependent child of the injured

18  employee until the child reaches the age of majority or until

19  the end of the calendar year in which the child reaches the

20  age of 25 if the child continues to be dependent for support,

21  or the child is a full-time or part-time student and is

22  dependent for support.  The term "health insurance plan" does

23  not include supplemental benefits that are not part of the

24  basic group health insurance plan.  If the injured employee

25  subsequently dies, the employer shall continue to pay the

26  entire health insurance premium for the surviving spouse until

27  remarried, and for the dependent children, under the

28  conditions outlined in this paragraph. However:

29         a.  Health insurance benefits payable from any other

30  source shall reduce benefits payable under this section.

31

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  1         b.  It is unlawful for a person to willfully and

  2  knowingly make, or cause to be made, or to assist, conspire

  3  with, or urge another to make, or cause to be made, any false,

  4  fraudulent, or misleading oral or written statement to obtain

  5  health insurance coverage as provided under this paragraph.  A

  6  person who violates this sub-subparagraph commits a

  7  misdemeanor of the first degree, punishable as provided in s.

  8  775.082 or s. 775.083.

  9         c.  In addition to any applicable criminal penalty,

10  upon conviction for a violation as described in

11  sub-subparagraph b., a law enforcement, correctional, or

12  correctional probation officer or other beneficiary who

13  receives or seeks to receive health insurance benefits under

14  this paragraph shall forfeit the right to receive such health

15  insurance benefits, and shall reimburse the employer for all

16  benefits paid due to the fraud or other prohibited activity.

17  For purposes of this sub-subparagraph, "conviction" means a

18  determination of guilt that is the result of a plea or trial,

19  regardless of whether adjudication is withheld.

20         2.  In order for the officer, spouse, and dependent

21  children to be eligible for such insurance coverage, the

22  injury must have occurred as the result of the officer's

23  response to fresh pursuit, the officer's response to what is

24  reasonably believed to be an emergency, or an unlawful act

25  perpetrated by another.  Except as otherwise provided herein,

26  nothing in this paragraph shall be construed to limit health

27  insurance coverage for which the officer, spouse, or dependent

28  children may otherwise be eligible, except that a person who

29  qualifies under this section shall not be eligible for the

30  health insurance subsidy provided under chapter 121, chapter

31  175, or chapter 185.

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  1         Section 6.  Paragraph (g) of subsection (2) of section

  2  112.191, Florida Statutes, is amended to read:

  3         112.191  Firefighters; death benefits.--

  4         (2)

  5         (g)1.  Any employer who employs a full-time firefighter

  6  who, on or after January 1, 1995, suffers a catastrophic

  7  injury, as defined in s. 440.02 s. 440.02(37), in the line of

  8  duty shall pay the entire premium of the employer's health

  9  insurance plan for the injured employee, the injured

10  employee's spouse, and for each dependent child of the injured

11  employee until the child reaches the age of majority or until

12  the end of the calendar year in which the child reaches the

13  age of 25 if the child continues to be dependent for support,

14  or the child is a full-time or part-time student and is

15  dependent for support. The term "health insurance plan" does

16  not include supplemental benefits that are not part of the

17  basic group health insurance plan.  If the injured employee

18  subsequently dies, the employer shall continue to pay the

19  entire health insurance premium for the surviving spouse until

20  remarried, and for the dependent children, under the

21  conditions outlined in this paragraph. However:

22         a.  Health insurance benefits payable from any other

23  source shall reduce benefits payable under this section.

24         b.  It is unlawful for a person to willfully and

25  knowingly make, or cause to be made, or to assist, conspire

26  with, or urge another to make, or cause to be made, any false,

27  fraudulent, or misleading oral or written statement to obtain

28  health insurance coverage as provided under this paragraph.  A

29  person who violates this sub-subparagraph commits a

30  misdemeanor of the first degree, punishable as provided in s.

31  775.082 or s. 775.083.

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  1         c.  In addition to any applicable criminal penalty,

  2  upon conviction for a violation as described in

  3  sub-subparagraph b., a firefighter or other beneficiary who

  4  receives or seeks to receive health insurance benefits under

  5  this paragraph shall forfeit the right to receive such health

  6  insurance benefits, and shall reimburse the employer for all

  7  benefits paid due to the fraud or other prohibited activity.

  8  For purposes of this sub-subparagraph, "conviction" means a

  9  determination of guilt that is the result of a plea or trial,

10  regardless of whether adjudication is withheld.

11         2.  In order for the firefighter, spouse, and dependent

12  children to be eligible for such insurance coverage, the

13  injury must have occurred as the result of the firefighter's

14  response to what is reasonably believed to be an emergency

15  involving the protection of life or property, or an unlawful

16  act perpetrated by another.  Except as otherwise provided

17  herein, nothing in this paragraph shall be construed to limit

18  health insurance coverage for which the firefighter, spouse,

19  or dependent children may otherwise be eligible, except that a

20  person who qualifies for benefits under this section shall not

21  be eligible for the health insurance subsidy provided under

22  chapter 121, chapter 175, or chapter 185.

23

24  Notwithstanding any provision of this section to the contrary,

25  the death benefits provided in paragraphs (b), (c), and (f)

26  shall also be applicable and paid in cases where a firefighter

27  received bodily injury prior to July 1, 1993, and subsequently

28  died on or after July 1, 1993, as a result of such

29  in-line-of-duty injury.

30         Section 7.  Section 121.125, Florida Statutes, is

31  amended to read:

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  1         121.125  Credit for workers' compensation payment

  2  periods.--A member of the retirement system created by this

  3  chapter who has been eligible or becomes eligible to receive

  4  workers' compensation payments for an injury or illness

  5  occurring during his or her employment while a member of any

  6  state retirement system shall, upon return to active

  7  employment with a covered employer for 1 calendar month or

  8  upon approval for disability retirement in accordance with s.

  9  121.091(4), receive full retirement credit for the period

10  prior to such return to active employment or disability

11  retirement for which the workers' compensation payments were

12  received.  However, no member may receive retirement credit

13  for any such period occurring after the earlier of the date of

14  maximum medical improvement has been attained as defined in s.

15  440.02 s. 440.02(9) or the date termination has occurred as

16  defined in s. 121.021(39). The employer of record at the time

17  of the worker's compensation injury or illness shall make the

18  required retirement contributions based on the member's rate

19  of monthly compensation immediately prior to his or her

20  receiving workers' compensation payments for retirement credit

21  received by the member.

22         Section 8.  Subsection (7) of section 122.03, Florida

23  Statutes, is amended to read:

24         122.03  Contributions; participants; prior service

25  credit.--

26         (7)  A member of the retirement system created by this

27  chapter who has been eligible or becomes eligible to receive

28  workers' compensation payments for an injury or illness

29  occurring during his or her employment while a member of any

30  state retirement system shall, upon his or her return to

31  active employment with a covered employer for 1 calendar month

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  1  or upon his or her approval for disability retirement in

  2  accordance with s. 122.09, receive full retirement credit for

  3  the period prior to such return to active employment or

  4  disability retirement for which the workers' compensation

  5  payments were received.  However, no member may receive

  6  retirement credit for any such period occurring after the

  7  earlier of the date of maximum medical improvement has been

  8  attained as defined in s. 440.02 s. 440.02(9) or the date

  9  termination has occurred as defined in s. 121.021(39). The

10  employer of record at the time of the worker's compensation

11  injury or illness shall make the required employee and

12  employer retirement contributions based on the member's rate

13  of monthly compensation immediately prior to receipt of

14  workers' compensation payments.

15         Section 9.  Subsection (10) of section 238.06, Florida

16  Statutes, is amended to read:

17         238.06  Membership application, creditable service, and

18  time for making contributions.--

19         (10)  A member of the retirement system created by this

20  chapter who has been eligible or becomes eligible to receive

21  workers' compensation payments for an injury or illness

22  occurring during his or her employment while a member of any

23  state retirement system shall, upon his or her return to

24  active employment with a covered employer for 1 calendar month

25  or upon his or her approval for disability retirement in

26  accordance with s. 238.07, receive full retirement credit for

27  the period prior to such return to active employment or

28  disability retirement for which the workers' compensation

29  payments were received.  However, no member may receive

30  retirement credit for any such period occurring after the

31  earlier of the date of maximum medical improvement has been

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  1  attained as defined in s. 440.02 s. 440.02(9) or the date

  2  termination has occurred as defined in s. 121.021(39). The

  3  employer of record at the time of the worker's compensation

  4  injury or illness shall make the required employee and

  5  employer retirement contributions based on the member's rate

  6  of monthly compensation immediately prior to his or her

  7  receiving workers' compensation payments.

  8         Section 10.  Subsections (3) through (39) of section

  9  440.02, Florida Statutes, are renumbered as subsections (4)

10  through (40), respectively, a new subsection (3) is added to

11  said section, and present subsections (11), (13), and (14) of

12  said section are amended, to read:

13         440.02  Definitions.--When used in this chapter, unless

14  the context clearly requires otherwise, the following terms

15  shall have the following meanings:

16         (3)  "Agency" means the Agency for Health Care

17  Administration.

18         (12)(11)  "Department" means the Department of

19  Insurance Labor and Employment Security.

20         (14)(13)  "Division" means the Division of Workers'

21  Compensation of the Department of Insurance Labor and

22  Employment Security.

23         (15)(14)(a)  "Employee" means any person engaged in any

24  employment under any appointment or contract of hire or

25  apprenticeship, express or implied, oral or written, whether

26  lawfully or unlawfully employed, and includes, but is not

27  limited to, aliens and minors.

28         (b)  "Employee" includes any person who is an officer

29  of a corporation and who performs services for remuneration

30  for such corporation within this state, whether or not such

31  services are continuous.

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  1         1.  Any officer of a corporation may elect to be exempt

  2  from this chapter by filing written notice of the election

  3  with the department division as provided in s. 440.05.

  4         2.  As to officers of a corporation who are actively

  5  engaged in the construction industry, no more than three

  6  officers may elect to be exempt from this chapter by filing

  7  written notice of the election with the department division as

  8  provided in s. 440.05.

  9         3.  An officer of a corporation who elects to be exempt

10  from this chapter by filing a written notice of the election

11  with the department division as provided in s. 440.05 is not

12  an employee.

13

14  Services are presumed to have been rendered to the corporation

15  if the officer is compensated by other than dividends upon

16  shares of stock of the corporation which the officer owns.

17         (c)  "Employee" includes a sole proprietor or a partner

18  who devotes full time to the proprietorship or partnership

19  and, except as provided in this paragraph, elects to be

20  included in the definition of employee by filing notice

21  thereof as provided in s. 440.05. Partners or sole proprietors

22  actively engaged in the construction industry are considered

23  employees unless they elect to be excluded from the definition

24  of employee by filing written notice of the election with the

25  department division as provided in s. 440.05. However, no more

26  than three partners in a partnership that is actively engaged

27  in the construction industry may elect to be excluded. A sole

28  proprietor or partner who is actively engaged in the

29  construction industry and who elects to be exempt from this

30  chapter by filing a written notice of the election with the

31  department division as provided in s. 440.05 is not an

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  1  employee. For purposes of this chapter, an independent

  2  contractor is an employee unless he or she meets all of the

  3  conditions set forth in subparagraph (d)1.

  4         (d)  "Employee" does not include:

  5         1.  An independent contractor, if:

  6         a.  The independent contractor maintains a separate

  7  business with his or her own work facility, truck, equipment,

  8  materials, or similar accommodations;

  9         b.  The independent contractor holds or has applied for

10  a federal employer identification number, unless the

11  independent contractor is a sole proprietor who is not

12  required to obtain a federal employer identification number

13  under state or federal requirements;

14         c.  The independent contractor performs or agrees to

15  perform specific services or work for specific amounts of

16  money and controls the means of performing the services or

17  work;

18         d.  The independent contractor incurs the principal

19  expenses related to the service or work that he or she

20  performs or agrees to perform;

21         e.  The independent contractor is responsible for the

22  satisfactory completion of work or services that he or she

23  performs or agrees to perform and is or could be held liable

24  for a failure to complete the work or services;

25         f.  The independent contractor receives compensation

26  for work or services performed for a commission or on a

27  per-job or competitive-bid basis and not on any other basis;

28         g.  The independent contractor may realize a profit or

29  suffer a loss in connection with performing work or services;

30         h.  The independent contractor has continuing or

31  recurring business liabilities or obligations; and

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  1         i.  The success or failure of the independent

  2  contractor's business depends on the relationship of business

  3  receipts to expenditures.

  4

  5  However, the determination as to whether an individual

  6  included in the Standard Industrial Classification Manual of

  7  1987, Industry Numbers 0711, 0721, 0722, 0751, 0761, 0762,

  8  0781, 0782, 0783, 0811, 0831, 0851, 2411, 2421, 2435, 2436,

  9  2448, or 2449, or a newspaper delivery person, is an

10  independent contractor is governed not by the criteria in this

11  paragraph but by common-law principles, giving due

12  consideration to the business activity of the individual.

13         2.  A real estate salesperson or agent, if that person

14  agrees, in writing, to perform for remuneration solely by way

15  of commission.

16         3.  Bands, orchestras, and musical and theatrical

17  performers, including disk jockeys, performing in licensed

18  premises as defined in chapter 562, if a written contract

19  evidencing an independent contractor relationship is entered

20  into before the commencement of such entertainment.

21         4.  An owner-operator of a motor vehicle who transports

22  property under a written contract with a motor carrier which

23  evidences a relationship by which the owner-operator assumes

24  the responsibility of an employer for the performance of the

25  contract, if the owner-operator is required to furnish the

26  necessary motor vehicle equipment and all costs incidental to

27  the performance of the contract, including, but not limited

28  to, fuel, taxes, licenses, repairs, and hired help; and the

29  owner-operator is paid a commission for transportation service

30  and is not paid by the hour or on some other time-measured

31  basis.

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  1         5.  A person whose employment is both casual and not in

  2  the course of the trade, business, profession, or occupation

  3  of the employer.

  4         6.  A volunteer, except a volunteer worker for the

  5  state or a county, municipality, or other governmental entity.

  6  A person who does not receive monetary remuneration for

  7  services is presumed to be a volunteer unless there is

  8  substantial evidence that a valuable consideration was

  9  intended by both employer and employee. For purposes of this

10  chapter, the term "volunteer" includes, but is not limited to:

11         a.  Persons who serve in private nonprofit agencies and

12  who receive no compensation other than expenses in an amount

13  less than or equivalent to the standard mileage and per diem

14  expenses provided to salaried employees in the same agency or,

15  if such agency does not have salaried employees who receive

16  mileage and per diem, then such volunteers who receive no

17  compensation other than expenses in an amount less than or

18  equivalent to the customary mileage and per diem paid to

19  salaried workers in the community as determined by the

20  department division; and

21         b.  Volunteers participating in federal programs

22  established under Pub. L. No. 93-113.

23         7.  Any officer of a corporation who elects to be

24  exempt from this chapter.

25         8.  A sole proprietor or officer of a corporation who

26  actively engages in the construction industry, and a partner

27  in a partnership that is actively engaged in the construction

28  industry, who elects to be exempt from the provisions of this

29  chapter. Such sole proprietor, officer, or partner is not an

30  employee for any reason until the notice of revocation of

31  election filed pursuant to s. 440.05 is effective.

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  1         9.  An exercise rider who does not work for a single

  2  horse farm or breeder, and who is compensated for riding on a

  3  case-by-case basis, provided a written contract is entered

  4  into prior to the commencement of such activity which

  5  evidences that an employee/employer relationship does not

  6  exist.

  7         10.  A taxicab, limousine, or other passenger

  8  vehicle-for-hire driver who operates said vehicles pursuant to

  9  a written agreement with a company which provides any

10  dispatch, marketing, insurance, communications, or other

11  services under which the driver and any fees or charges paid

12  by the driver to the company for such services are not

13  conditioned upon, or expressed as a proportion of, fare

14  revenues.

15         11.  A person who performs services as a sports

16  official for an entity sponsoring an interscholastic sports

17  event or for a public entity or private, nonprofit

18  organization that sponsors an amateur sports event.  For

19  purposes of this subparagraph, such a person is an independent

20  contractor. For purposes of this subparagraph, the term

21  "sports official" means any person who is a neutral

22  participant in a sports event, including, but not limited to,

23  umpires, referees, judges, linespersons, scorekeepers, or

24  timekeepers. This subparagraph does not apply to any person

25  employed by a district school board who serves as a sports

26  official as required by the employing school board or who

27  serves as a sports official as part of his or her

28  responsibilities during normal school hours.

29         Section 11.  Section 440.021, Florida Statutes, is

30  amended to read:

31

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  1         440.021  Exemption of workers' compensation from

  2  chapter 120.--Workers' compensation adjudications by judges of

  3  compensation claims are exempt from chapter 120, and no judge

  4  of compensation claims shall be considered an agency or a part

  5  thereof. Communications of the result of investigations by the

  6  department division pursuant to s. 440.185(4) are exempt from

  7  chapter 120. In all instances in which the department division

  8  institutes action to collect a penalty or interest which may

  9  be due pursuant to this chapter, the penalty or interest shall

10  be assessed without hearing, and the party against which such

11  penalty or interest is assessed shall be given written notice

12  of such assessment and shall have the right to protest within

13  20 days of such notice. Upon receipt of a timely notice of

14  protest and after such investigation as may be necessary, the

15  department division shall, if it agrees with such protest,

16  notify the protesting party that the assessment has been

17  revoked.  If the department division does not agree with the

18  protest, it shall refer the matter to the judge of

19  compensation claims for determination pursuant to s.

20  440.25(2)-(5).  Such action of the division is exempt from the

21  provisions of chapter 120.

22         Section 12.  Section 440.05, Florida Statutes, is

23  amended to read:

24         440.05  Election of exemption; revocation of election;

25  notice; certification.--

26         (1)  Each corporate officer who elects not to accept

27  the provisions of this chapter or who, after electing such

28  exemption, revokes that exemption shall mail to the department

29  division in Tallahassee notice to such effect in accordance

30  with a form to be prescribed by the department division.

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  1         (2)  Each sole proprietor or partner who elects to be

  2  included in the definition of "employee" or who, after such

  3  election, revokes that election must mail to the department

  4  division in Tallahassee notice to such effect, in accordance

  5  with a form to be prescribed by the department division.

  6         (3)  Each sole proprietor, partner, or officer of a

  7  corporation who is actively engaged in the construction

  8  industry and who elects an exemption from this chapter or who,

  9  after electing such exemption, revokes that exemption, must

10  mail a written notice to such effect to the department

11  division on a form prescribed by the department division. The

12  notice of election to be exempt from the provisions of this

13  chapter must be notarized and under oath. The notice of

14  election to be exempt which is submitted to the division by

15  the sole proprietor, partner, or officer of a corporation must

16  list the name, federal tax identification number, social

17  security number, all certified or registered licenses issued

18  pursuant to chapter 489 held by the person seeking the

19  exemption, a copy of relevant documentation as to employment

20  status filed with the Internal Revenue Service as specified by

21  the department division, a copy of the relevant occupational

22  license in the primary jurisdiction of the business, and, for

23  corporate officers and partners, the registration number of

24  the corporation or partnership filed with the Division of

25  Corporations of the Department of State. The notice of

26  election to be exempt must identify each sole proprietorship,

27  partnership, or corporation that employs the person electing

28  the exemption and must list the social security number or

29  federal tax identification number of each such employer and

30  the additional documentation required by this section. In

31  addition, the notice of election to be exempt must provide

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  1  that the sole proprietor, partner, or officer electing an

  2  exemption is not entitled to benefits under this chapter, must

  3  provide that the election does not exceed exemption limits for

  4  officers and partnerships provided in s. 440.02, and must

  5  certify that any employees of the sole proprietor, partner, or

  6  officer electing an exemption are covered by workers'

  7  compensation insurance. Upon receipt of the notice of the

  8  election to be exempt, receipt of all application fees, and a

  9  determination by the department division that the notice meets

10  the requirements of this subsection, the department division

11  shall issue a certification of the election to the sole

12  proprietor, partner, or officer, unless the department

13  division determines that the information contained in the

14  notice is invalid. The division shall revoke a certificate of

15  election to be exempt from coverage upon a determination by

16  the department division that the person does not meet the

17  requirements for exemption or that the information contained

18  in the notice of election to be exempt is invalid. The

19  certificate of election must list the names of the sole

20  proprietorship, partnership, or corporation listed in the

21  request for exemption. A new certificate of election must be

22  obtained each time the person is employed by a new sole

23  proprietorship, partnership, or corporation that is not listed

24  on the certificate of election. A copy of the certificate of

25  election must be sent to each workers' compensation carrier

26  identified in the request for exemption. Upon filing a notice

27  of revocation of election, a sole proprietor, partner, or

28  officer who is a subcontractor must notify her or his

29  contractor.  Upon revocation of a certificate of election of

30  exemption by the department division, the department division

31

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  1  shall notify the workers' compensation carriers identified in

  2  the request for exemption.

  3         (4)  The notice of election to be exempt from the

  4  provisions of this chapter must contain a notice that clearly

  5  states in substance the following: "Any person who, knowingly

  6  and with intent to injure, defraud, or deceive the department

  7  division or any employer or employee, insurance company, or

  8  purposes program, files a notice of election to be exempt

  9  containing any false or misleading information is guilty of a

10  felony of the third degree." Each person filing a notice of

11  election to be exempt shall personally sign the notice and

12  attest that he or she has reviewed, understands, and

13  acknowledges the foregoing notice.

14         (5)  A notice given under subsection (1), subsection

15  (2), or subsection (3) shall become effective when issued by

16  the department division or 30 days after an application for an

17  exemption is received by the department division, whichever

18  occurs first. However, if an accident or occupational disease

19  occurs less than 30 days after the effective date of the

20  insurance policy under which the payment of compensation is

21  secured or the date the employer qualified as a self-insurer,

22  such notice is effective as of 12:01 a.m. of the day following

23  the date it is mailed to the department division in

24  Tallahassee.

25         (6)  A construction industry certificate of election to

26  be exempt which is issued in accordance with this section

27  shall be valid for 2 years after the effective date stated

28  thereon. Both the effective date and the expiration date must

29  be listed on the face of the certificate by the department

30  division. The construction industry certificate must expire at

31  midnight, 2 years from its issue date, as noted on the face of

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  1  the exemption certificate. Any person who has received from

  2  the department division a construction industry certificate of

  3  election to be exempt which is in effect on December 31, 1998,

  4  shall file a new notice of election to be exempt by the last

  5  day in his or her birth month following December 1, 1998. A

  6  construction industry certificate of election to be exempt may

  7  be revoked before its expiration by the sole proprietor,

  8  partner, or officer for whom it was issued or by the division

  9  for the reasons stated in this section.  At least 60 days

10  prior to the expiration date of a construction industry

11  certificate of exemption issued after December 1, 1998, the

12  department division shall send notice of the expiration date

13  and an application for renewal to the certificateholder at the

14  address on the certificate.

15         (7)  Any contractor responsible for compensation under

16  s. 440.10 may register in writing with the workers'

17  compensation carrier for any subcontractor and shall

18  thereafter be entitled to receive written notice from the

19  carrier of any cancellation or nonrenewal of the policy.

20         (8)(a)  The department division must assess a fee of

21  $50 with each request for a construction industry certificate

22  of election to be exempt or renewal of election to be exempt

23  under this section.

24         (b)  The funds collected by the department division

25  shall be used to administer this section, to audit the

26  businesses that pay the fee for compliance with any

27  requirements of this chapter, and to enforce compliance with

28  the provisions of this chapter.

29         (9)  The department division may by rule prescribe

30  forms and procedures for filing an election of exemption,

31  revocation of election to be exempt, and notice of election of

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  1  coverage for all employers and require specified forms to be

  2  submitted by all employers in filing for the election of

  3  exemption. The department division may by rule prescribe forms

  4  and procedures for issuing a certificate of the election of

  5  exemption.

  6         Section 13.  Paragraph (d) of subsection (7) of section

  7  440.09, Florida Statutes, is amended to read:

  8         440.09  Coverage.--

  9         (7)

10         (d)  The agency division shall provide by rule for the

11  authorization and regulation of drug-testing policies,

12  procedures, and methods. Testing of injured employees shall

13  not commence until such rules are adopted.

14         Section 14.  Paragraphs (f) and (g) of subsection (1)

15  of section 440.10, Florida Statutes, are amended to read:

16         440.10  Liability for compensation.--

17         (1)

18         (f)  If an employer willfully fails to secure

19  compensation as required by this chapter, the department

20  division may assess against the employer a penalty not to

21  exceed $5,000 for each employee of that employer who is

22  classified by the employer as an independent contractor but

23  who is found by the department division to not meet the

24  criteria for an independent contractor that are set forth in

25  s. 440.02.

26         (g)  For purposes of this section, a person is

27  conclusively presumed to be an independent contractor if:

28         1.  The independent contractor provides the general

29  contractor with an affidavit stating that he or she meets all

30  the requirements of s. 440.02(14)(d); and

31

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  1         2.  The independent contractor provides the general

  2  contractor with a valid certificate of workers' compensation

  3  insurance or a valid certificate of exemption issued by the

  4  department division.

  5

  6  A sole proprietor, partner, or officer of a corporation who

  7  elects exemption from this chapter by filing a certificate of

  8  election under s. 440.05 may not recover benefits or

  9  compensation under this chapter.  An independent contractor

10  who provides the general contractor with both an affidavit

11  stating that he or she meets the requirements of s.

12  440.02(14)(d) and a certificate of exemption is not an

13  employee under s. 440.02(14)(c) and may not recover benefits

14  under this chapter.  For purposes of determining the

15  appropriate premium for workers' compensation coverage,

16  carriers may not consider any person who meets the

17  requirements of this paragraph to be an employee.

18         Section 15.  Subsection (2), paragraph (a) of

19  subsection (3), and paragraph (g) of subsection (7) of section

20  440.102, Florida Statutes, are amended to read:

21         440.102  Drug-free workplace program requirements.--The

22  following provisions apply to a drug-free workplace program

23  implemented pursuant to law or to rules adopted by the Agency

24  for Health Care Administration:

25         (2)  DRUG TESTING.--An employer may test an employee or

26  job applicant for any drug described in paragraph (1)(c). In

27  order to qualify as having established a drug-free workplace

28  program which affords an employer the ability to qualify for

29  the discounts provided under s. 627.0915 and deny medical and

30  indemnity benefits, under this chapter all drug testing

31  conducted by employers shall be in conformity with the

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  1  standards and procedures established in this section and all

  2  applicable rules adopted pursuant to this section. However, an

  3  employer does not have a legal duty under this section to

  4  request an employee or job applicant to undergo drug testing.

  5  If an employer fails to maintain a drug-free workplace program

  6  in accordance with the standards and procedures established in

  7  this section and in applicable rules, the employer shall not

  8  be eligible for discounts under s. 627.0915. All employers

  9  qualifying for and receiving discounts provided under s.

10  627.0915 must be reported annually by the insurer to the

11  department division.

12         (3)  NOTICE TO EMPLOYEES AND JOB APPLICANTS.--

13         (a)  One time only, prior to testing, an employer shall

14  give all employees and job applicants for employment a written

15  policy statement which contains:

16         1.  A general statement of the employer's policy on

17  employee drug use, which must identify:

18         a.  The types of drug testing an employee or job

19  applicant may be required to submit to, including

20  reasonable-suspicion drug testing or drug testing conducted on

21  any other basis.

22         b.  The actions the employer may take against an

23  employee or job applicant on the basis of a positive confirmed

24  drug test result.

25         2.  A statement advising the employee or job applicant

26  of the existence of this section.

27         3.  A general statement concerning confidentiality.

28         4.  Procedures for employees and job applicants to

29  confidentially report to a medical review officer the use of

30  prescription or nonprescription medications to a medical

31  review officer both before and after being tested.

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  1         5.  A list of the most common medications, by brand

  2  name or common name, as applicable, as well as by chemical

  3  name, which may alter or affect a drug test. A list of such

  4  medications as developed by the Agency for Health Care

  5  Administration shall be available to employers through the

  6  Division of Workers' Compensation of the department of Labor

  7  and Employment Security.

  8         6.  The consequences of refusing to submit to a drug

  9  test.

10         7.  A representative sampling of names, addresses, and

11  telephone numbers of employee assistance programs and local

12  drug rehabilitation programs.

13         8.  A statement that an employee or job applicant who

14  receives a positive confirmed test result may contest or

15  explain the result to the medical review officer within 5

16  working days after receiving written notification of the test

17  result; that if an employee's or job applicant's explanation

18  or challenge is unsatisfactory to the medical review officer,

19  the medical review officer shall report a positive test result

20  back to the employer; and that a person may contest the drug

21  test result pursuant to law or to rules adopted by the Agency

22  for Health Care Administration.

23         9.  A statement informing the employee or job applicant

24  of his or her responsibility to notify the laboratory of any

25  administrative or civil action brought pursuant to this

26  section.

27         10.  A list of all drugs for which the employer will

28  test, described by brand name or common name, as applicable,

29  as well as by chemical name.

30

31

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  1         11.  A statement regarding any applicable collective

  2  bargaining agreement or contract and the right to appeal to

  3  the Public Employees Relations Commission or applicable court.

  4         12.  A statement notifying employees and job applicants

  5  of their right to consult with a medical review officer for

  6  technical information regarding prescription or

  7  nonprescription medication.

  8         (7)  EMPLOYER PROTECTION.--

  9         (g)  This section does not prohibit an employer from

10  conducting medical screening or other tests required,

11  permitted, or not disallowed by any statute, rule, or

12  regulation for the purpose of monitoring exposure of employees

13  to toxic or other unhealthy substances in the workplace or in

14  the performance of job responsibilities. Such screening or

15  testing is limited to the specific substances expressly

16  identified in the applicable statute, rule, or regulation,

17  unless prior written consent of the employee is obtained for

18  other tests. Such screening or testing need not be in

19  compliance with the rules adopted by the Agency for Health

20  Care Administration under this chapter or under s. 112.0455. A

21  public employer may, through the use of an unbiased selection

22  procedure, conduct random drug tests of employees occupying

23  safety-sensitive or special-risk positions if the testing is

24  performed in accordance with drug-testing rules adopted by the

25  Agency for Health Care Administration and the department of

26  Labor and Employment Security. If applicable, random drug

27  testing must be specified in a collective bargaining agreement

28  as negotiated by the appropriate certified bargaining agent

29  before such testing is implemented.

30         Section 16.  Section 440.103, Florida Statutes, is

31  amended to read:

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  1         440.103  Building permits; identification of minimum

  2  premium policy.--Except as otherwise provided in this chapter,

  3  every employer shall, as a condition to receiving a building

  4  permit, show proof that it has secured compensation for its

  5  employees under this chapter as provided in ss. 440.10 and

  6  440.38. Such proof of compensation must be evidenced by a

  7  certificate of coverage issued by the carrier, a valid

  8  exemption certificate approved by the department or the former

  9  Division of Workers' Compensation of the Department of Labor

10  and Employment Security, or a copy of the employer's authority

11  to self-insure and shall be presented each time the employer

12  applies for a building permit. As provided in s. 627.413(5),

13  each certificate of coverage must show, on its face, whether

14  or not coverage is secured under the minimum premium

15  provisions of rules adopted by rating organizations licensed

16  by the department of Insurance. The words "minimum premium

17  policy" or equivalent language shall be typed, printed,

18  stamped, or legibly handwritten.

19         Section 17.  Subsection (1) of section 440.104, Florida

20  Statutes, is amended to read:

21         440.104  Competitive bidder; civil actions.--

22         (1)  Any person engaged in the construction industry,

23  as provided in s. 440.02 s. 440.02(7), who loses a competitive

24  bid for a contract shall have a cause of action for damages

25  against the person awarded the contract for which the bid was

26  made, if the person making the losing bid establishes that the

27  winning bidder knew or should have known that he or she was in

28  violation of s. 440.10, s. 440.105, or s. 440.38 while

29  performing the work under the contract.

30         Section 18.  Paragraph (a) of subsection (2) of section

31  440.105, Florida Statutes, is amended to read:

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  1         440.105  Prohibited activities; reports; penalties;

  2  limitations.--

  3         (2)  Whoever violates any provision of this subsection

  4  commits a misdemeanor of the second degree, punishable as

  5  provided in s. 775.082 or s. 775.083.

  6         (a)  It shall be unlawful for any employer to

  7  knowingly:

  8         1.  Coerce or attempt to coerce, as a precondition to

  9  employment or otherwise, an employee to obtain a certificate

10  of election of exemption pursuant to s. 440.05.

11         2.  Discharge or refuse to hire an employee or job

12  applicant because the employee or applicant has filed a claim

13  for benefits under this chapter.

14         3.  Discharge, discipline, or take any other adverse

15  personnel action against any employee for disclosing

16  information to the department division or any law enforcement

17  agency relating to any violation or suspected violation of any

18  of the provisions of this chapter or rules promulgated

19  hereunder.

20         4.  Violate a stop-work order issued by the department

21  division pursuant to s. 440.107.

22         Section 19.  Subsections (3) and (4) of section

23  440.106, Florida Statutes, are amended to read:

24         440.106  Civil remedies; administrative penalties.--

25         (3)  Whenever any group or individual self-insurer,

26  carrier, rating bureau, or agent or other representative of

27  any carrier or rating bureau is determined to have violated s.

28  440.105, the department of Insurance may revoke or suspend the

29  authority or certification of any group or individual

30  self-insurer, carrier, agent, or broker.

31

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  1         (4)  The department division shall report any

  2  contractor determined in violation of requirements of this

  3  chapter to the appropriate state licensing board for

  4  disciplinary action.

  5         Section 20.  Section 440.107, Florida Statutes, is

  6  amended to read:

  7         440.107  Department Division powers to enforce employer

  8  compliance with coverage requirements.--

  9         (1)  The Legislature finds that the failure of an

10  employer to comply with the workers' compensation coverage

11  requirements under this chapter poses an immediate danger to

12  public health, safety, and welfare. The Legislature authorizes

13  the department division to secure employer compliance with the

14  workers' compensation coverage requirements and authorizes the

15  department division to conduct investigations for the purpose

16  of ensuring employer compliance.

17         (2)  The department division and its authorized

18  representatives may enter and inspect any place of business at

19  any reasonable time for the limited purpose of investigating

20  compliance with workers' compensation coverage requirements

21  under this chapter. Each employer shall keep true and accurate

22  business records that contain such information as the

23  department division prescribes by rule. The business records

24  must contain information necessary for the department division

25  to determine compliance with workers' compensation coverage

26  requirements and must be maintained within this state by the

27  business, in such a manner as to be accessible within a

28  reasonable time upon request by the department division. The

29  business records must be open to inspection and be available

30  for copying by the department division at any reasonable time

31  and place and as often as necessary. The department division

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  1  may require from any employer any sworn or unsworn reports,

  2  pertaining to persons employed by that employer, deemed

  3  necessary for the effective administration of the workers'

  4  compensation coverage requirements.

  5         (3)  In discharging its duties, the department division

  6  may administer oaths and affirmations, certify to official

  7  acts, issue subpoenas to compel the attendance of witnesses

  8  and the production of books, papers, correspondence,

  9  memoranda, and other records deemed necessary by the

10  department division as evidence in order to ensure proper

11  compliance with the coverage provisions of this chapter.

12         (4)  If a person has refused to obey a subpoena to

13  appear before the department division or its authorized

14  representative and produce evidence requested by the

15  department division or to give testimony about the matter that

16  is under investigation, a court has jurisdiction to issue an

17  order requiring compliance with the subpoena if the court has

18  jurisdiction in the geographical area where the inquiry is

19  being carried on or in the area where the person who has

20  refused the subpoena is found, resides, or transacts business.

21  Failure to obey such a court order may be punished by the

22  court as contempt.

23         (5)  Whenever the department division determines that

24  an employer who is required to secure the payment to his or

25  her employees of the compensation provided for by this chapter

26  has failed to do so, such failure shall be deemed an immediate

27  serious danger to public health, safety, or welfare sufficient

28  to justify service by the department division of a stop-work

29  order on the employer, requiring the cessation of all business

30  operations at the place of employment or job site. The order

31  shall take effect upon the date of service upon the employer,

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  1  unless the employer provides evidence satisfactory to the

  2  department division of having secured any necessary insurance

  3  or self-insurance and pays a civil penalty to the department

  4  division, to be deposited by the department division into the

  5  Workers' Compensation Administration Trust Fund, in the amount

  6  of $100 per day for each day the employer was not in

  7  compliance with this chapter.

  8         (6)  The department division may file a complaint in

  9  the circuit court in and for Leon County to enjoin any

10  employer, who has failed to secure compensation as required by

11  this chapter, from employing individuals and from conducting

12  business until the employer presents evidence satisfactory to

13  the department division of having secured payment for

14  compensation and pays a civil penalty to the department

15  division, to be deposited by the department division into the

16  Workers' Compensation Administration Trust Fund, in the amount

17  of $100 per day for each day the employer was not in

18  compliance with this chapter.

19         (7)  In addition to any penalty, stop-work order, or

20  injunction, the department division may assess against any

21  employer, who has failed to secure the payment of compensation

22  as required by this chapter, a penalty in the amount of:

23         (a)  Twice the amount the employer would have paid

24  during periods it illegally failed to secure payment of

25  compensation in the preceding 3-year period based on the

26  employer's payroll during the preceding 3-year period; or

27         (b)  One thousand dollars, whichever is greater.

28

29  Any penalty assessed under this subsection is due within 30

30  days after the date on which the employer is notified, except

31  that, if the department division has posted a stop-work order

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  1  or obtained injunctive relief against the employer, payment is

  2  due, in addition to those conditions set forth in this

  3  section, as a condition to relief from a stop-work order or an

  4  injunction. Interest shall accrue on amounts not paid when due

  5  at the rate of 1 percent per month.

  6         (8)  The department division may bring an action in

  7  circuit court to recover penalties assessed under this

  8  section, including any interest owed to the department

  9  division pursuant to this section. In any action brought by

10  the department division pursuant to this section in which it

11  prevails, the circuit court shall award costs, including the

12  reasonable costs of investigation and a reasonable attorney's

13  fee.

14         (9)  Any judgment obtained by the department division

15  and any penalty due pursuant to the service of a stop-work

16  order or otherwise due under this section shall, until

17  collected, constitute a lien upon the entire interest of the

18  employer, legal or equitable, in any property, real or

19  personal, tangible or intangible; however, such lien is

20  subordinate to claims for unpaid wages and any prior recorded

21  liens, and a lien created by this section is not valid against

22  any person who, subsequent to such lien and in good faith and

23  for value, purchases real or personal property from such

24  employer or becomes the mortgagee on real or personal property

25  of such employer, or against a subsequent attaching creditor,

26  unless, with respect to real estate of the employer, a notice

27  of the lien is recorded in the public records of the county

28  where the real estate is located, and with respect to personal

29  property of the employer, the notice is recorded with the

30  Secretary of State.

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  1         (10)  Any law enforcement agency in the state may, at

  2  the request of the department division, render any assistance

  3  necessary to carry out the provisions of this section,

  4  including, but not limited to, preventing any employee or

  5  other person from remaining at a place of employment or job

  6  site after a stop-work order or injunction has taken effect.

  7         (11)  Actions by the department division under this

  8  section must be contested as provided in chapter 120. All

  9  civil penalties assessed by the department division must be

10  paid into the Workers' Compensation Administration Trust Fund.

11  The department division shall return any sums previously paid,

12  upon conclusion of an action, if the department division fails

13  to prevail and if so directed by an order of court or an

14  administrative hearing officer. The requirements of this

15  subsection may be met by posting a bond in an amount equal to

16  twice the penalty and in a form approved by the department

17  division.

18         Section 21.  Subsection (1) of section 440.108, Florida

19  Statutes, is amended to read:

20         440.108  Investigatory records relating to workers'

21  compensation employer compliance; confidentiality.--

22         (1)  All investigatory records of the department

23  Division of Workers' Compensation made or received pursuant to

24  s. 440.107 and any records necessary to complete an

25  investigation are confidential and exempt from the provisions

26  of s. 119.07(1) and s. 24(a), Art. I of the State Constitution

27  until the investigation is completed or ceases to be active.

28  For purposes of this section, an investigation is considered

29  "active" while such investigation is being conducted by the

30  department division with a reasonable, good faith belief that

31  it may lead to the filing of administrative, civil, or

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  1  criminal proceedings. An investigation does not cease to be

  2  active if the agency is proceeding with reasonable dispatch

  3  and there is a good faith belief that action may be initiated

  4  by the agency or other administrative or law enforcement

  5  agency. After an investigation is completed or ceases to be

  6  active, records relating to the investigation remain

  7  confidential and exempt from the provisions of s. 119.07(1)

  8  and s. 24(a), Art. I of the State Constitution if disclosure

  9  would:

10         (a)  Jeopardize the integrity of another active

11  investigation;

12         (b)  Reveal a trade secret, as defined in s. 688.002;

13         (c)  Reveal business or personal financial information;

14         (d)  Reveal the identity of a confidential source;

15         (e)  Defame or cause unwarranted damage to the good

16  name or reputation of an individual or jeopardize the safety

17  of an individual; or

18         (f)  Reveal investigative techniques or procedures.

19         Section 22.  Subsection (2) of section 440.12, Florida

20  Statutes, is amended to read:

21         440.12  Time for commencement and limits on weekly rate

22  of compensation.--

23         (2)  Compensation for disability resulting from

24  injuries which occur after December 31, 1974, shall not be

25  less than $20 per week.  However, if the employee's wages at

26  the time of injury are less than $20 per week, he or she shall

27  receive his or her full weekly wages.  If the employee's wages

28  at the time of the injury exceed $20 per week, compensation

29  shall not exceed an amount per week which is:

30         (a)  Equal to 100 percent of the statewide average

31  weekly wage, determined as hereinafter provided for the year

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  1  in which the injury occurred; however, the increase to 100

  2  percent from 66 2/3 percent of the statewide average weekly

  3  wage shall apply only to injuries occurring on or after August

  4  1, 1979; and

  5         (b)  Adjusted to the nearest dollar.

  6

  7  For the purpose of this subsection, the "statewide average

  8  weekly wage" means the average weekly wage paid by employers

  9  subject to the Florida Unemployment Compensation Law as

10  reported to the Agency for Workforce Innovation department for

11  the four calendar quarters ending each June 30, which average

12  weekly wage shall be determined by the Agency for Workforce

13  Innovation department on or before November 30 of each year

14  and shall be used in determining the maximum weekly

15  compensation rate with respect to injuries occurring in the

16  calendar year immediately following. The statewide average

17  weekly wage determined by the Agency for Workforce Innovation

18  department shall be reported annually to the Legislature.

19         Section 23.  Section 440.125, Florida Statutes, is

20  amended to read:

21         440.125  Medical records and reports; identifying

22  information in employee medical bills; confidentiality.--

23         (1)  Any medical records and medical reports of an

24  injured employee and any information identifying an injured

25  employee in medical bills which are provided to the

26  department, agency, or Department of Education Division of

27  Workers' Compensation of the Department of Labor and

28  Employment Security pursuant to s. 440.13 are confidential and

29  exempt from the provisions of s. 119.07(1) and s. 24(a), Art.

30  I of the State Constitution, except as otherwise provided by

31  this chapter.

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  1         (2)  The Legislature finds that it is a public

  2  necessity that an injured employee's medical records and

  3  medical reports and information identifying the employee in

  4  medical bills held by the department, agency, or Department of

  5  Education Division of Workers' Compensation pursuant to s.

  6  440.13 be confidential and exempt from the public records law.

  7  Public access to such information is an invasion of the

  8  injured employee's right to privacy in that personal,

  9  sensitive information would be revealed, and public knowledge

10  of such information could lead to discrimination against the

11  employee by coworkers and others. Additionally, there is

12  little utility in providing public access to such information

13  in that the effectiveness and efficiency of the workers'

14  compensation program can be otherwise adequately monitored and

15  evaluated.

16         (3)  The department may share any confidential and

17  exempt information received pursuant to s. 440.13 with the

18  Agency for Health Care Administration in furtherance of the

19  agency's official duties under ss. 440.13 and 440.134. The

20  agency shall maintain the confidential and exempt status of

21  the information.

22         Section 24.  Subsections (1), (3), (4), (5), (6), (7),

23  (8), (9), (11), (12), (13), and (15) of section 440.13,

24  Florida Statutes, are amended to read:

25         440.13  Medical services and supplies; penalty for

26  violations; limitations.--

27         (1)  DEFINITIONS.--As used in this section, the term:

28         (a)  "Alternate medical care" means a change in

29  treatment or health care provider.

30         (b)  "Attendant care" means care rendered by trained

31  professional attendants which is beyond the scope of household

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  1  duties. Family members may provide nonprofessional attendant

  2  care, but may not be compensated under this chapter for care

  3  that falls within the scope of household duties and other

  4  services normally and gratuitously provided by family members.

  5  "Family member" means a spouse, father, mother, brother,

  6  sister, child, grandchild, father-in-law, mother-in-law, aunt,

  7  or uncle.

  8         (c)  "Carrier" means, for purposes of this section,

  9  insurance carrier, self-insurance fund or individually

10  self-insured employer, or assessable mutual insurer.

11         (d)  "Catastrophic injury" means an injury as defined

12  in s. 440.02.

13         (e)  "Certified health care provider" means a health

14  care provider who has been certified by the agency division or

15  who has entered an agreement with a licensed managed care

16  organization to provide treatment to injured workers under

17  this section. Certification of such health care provider must

18  include documentation that the health care provider has read

19  and is familiar with the portions of the statute, impairment

20  guides, and rules which govern the provision of remedial

21  treatment, care, and attendance.

22         (f)  "Compensable" means a determination by a carrier

23  or judge of compensation claims that a condition suffered by

24  an employee results from an injury arising out of and in the

25  course of employment.

26         (g)  "Emergency services and care" means emergency

27  services and care as defined in s. 395.002.

28         (h)  "Health care facility" means any hospital licensed

29  under chapter 395 and any health care institution licensed

30  under chapter 400.

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  1         (i)  "Health care provider" means a physician or any

  2  recognized practitioner who provides skilled services pursuant

  3  to a prescription or under the supervision or direction of a

  4  physician and who has been certified by the agency division as

  5  a health care provider. The term "health care provider"

  6  includes a health care facility.

  7         (j)  "Independent medical examiner" means a physician

  8  selected by either an employee or a carrier to render one or

  9  more independent medical examinations in connection with a

10  dispute arising under this chapter.

11         (k)  "Independent medical examination" means an

12  objective evaluation of the injured employee's medical

13  condition, including, but not limited to, impairment or work

14  status, performed by a physician or an expert medical advisor

15  at the request of a party, a judge of compensation claims, or

16  the agency division to assist in the resolution of a dispute

17  arising under this chapter.

18         (l)  "Instance of overutilization" means a specific

19  inappropriate service or level of service provided to an

20  injured employee.

21         (m)  "Medically necessary" means any medical service or

22  medical supply which is used to identify or treat an illness

23  or injury, is appropriate to the patient's diagnosis and

24  status of recovery, and is consistent with the location of

25  service, the level of care provided, and applicable practice

26  parameters. The service should be widely accepted among

27  practicing health care providers, based on scientific

28  criteria, and determined to be reasonably safe. The service

29  must not be of an experimental, investigative, or research

30  nature, except in those instances in which prior approval of

31  the Agency for Health Care Administration has been obtained.

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  1  The Agency for Health Care Administration shall adopt rules

  2  providing for such approval on a case-by-case basis when the

  3  service or supply is shown to have significant benefits to the

  4  recovery and well-being of the patient.

  5         (n)  "Medicine" means a drug prescribed by an

  6  authorized health care provider and includes only generic

  7  drugs or single-source patented drugs for which there is no

  8  generic equivalent, unless the authorized health care provider

  9  writes or states that the brand-name drug as defined in s.

10  465.025 is medically necessary, or is a drug appearing on the

11  schedule of drugs created pursuant to s. 465.025(6), or is

12  available at a cost lower than its generic equivalent.

13         (o)  "Palliative care" means noncurative medical

14  services that mitigate the conditions, effects, or pain of an

15  injury.

16         (p)  "Pattern or practice of overutilization" means

17  repetition of instances of overutilization within a specific

18  medical case or multiple cases by a single health care

19  provider.

20         (q)  "Peer review" means an evaluation by two or more

21  physicians licensed under the same authority and with the same

22  or similar specialty as the physician under review, of the

23  appropriateness, quality, and cost of health care and health

24  services provided to a patient, based on medically accepted

25  standards.

26         (r)  "Physician" or "doctor" means a physician licensed

27  under chapter 458, an osteopathic physician licensed under

28  chapter 459, a chiropractic physician licensed under chapter

29  460, a podiatric physician licensed under chapter 461, an

30  optometrist licensed under chapter 463, or a dentist licensed

31

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  1  under chapter 466, each of whom must be certified by the

  2  agency division as a health care provider.

  3         (s)  "Reimbursement dispute" means any disagreement

  4  between a health care provider or health care facility and

  5  carrier concerning payment for medical treatment.

  6         (t)  "Utilization control" means a systematic process

  7  of implementing measures that assure overall management and

  8  cost containment of services delivered.

  9         (u)  "Utilization review" means the evaluation of the

10  appropriateness of both the level and the quality of health

11  care and health services provided to a patient, including, but

12  not limited to, evaluation of the appropriateness of

13  treatment, hospitalization, or office visits based on

14  medically accepted standards. Such evaluation must be

15  accomplished by means of a system that identifies the

16  utilization of medical services based on medically accepted

17  standards as established by medical consultants with

18  qualifications similar to those providing the care under

19  review, and that refers patterns and practices of

20  overutilization to the agency division.

21         (3)  PROVIDER ELIGIBILITY; AUTHORIZATION.--

22         (a)  As a condition to eligibility for payment under

23  this chapter, a health care provider who renders services must

24  be a certified health care provider and must receive

25  authorization from the carrier before providing treatment.

26  This paragraph does not apply to emergency care. The agency

27  division shall adopt rules to implement the certification of

28  health care providers.

29         (b)  A health care provider who renders emergency care

30  must notify the carrier by the close of the third business day

31  after it has rendered such care. If the emergency care results

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  1  in admission of the employee to a health care facility, the

  2  health care provider must notify the carrier by telephone

  3  within 24 hours after initial treatment. Emergency care is not

  4  compensable under this chapter unless the injury requiring

  5  emergency care arose as a result of a work-related accident.

  6  Pursuant to chapter 395, all licensed physicians and health

  7  care providers in this state shall be required to make their

  8  services available for emergency treatment of any employee

  9  eligible for workers' compensation benefits. To refuse to make

10  such treatment available is cause for revocation of a license.

11         (c)  A health care provider may not refer the employee

12  to another health care provider, diagnostic facility, therapy

13  center, or other facility without prior authorization from the

14  carrier, except when emergency care is rendered. Any referral

15  must be to a health care provider that has been certified by

16  the agency division, unless the referral is for emergency

17  treatment.

18         (d)  A carrier must respond, by telephone or in

19  writing, to a request for authorization by the close of the

20  third business day after receipt of the request. A carrier who

21  fails to respond to a written request for authorization for

22  referral for medical treatment by the close of the third

23  business day after receipt of the request consents to the

24  medical necessity for such treatment. All such requests must

25  be made to the carrier. Notice to the carrier does not include

26  notice to the employer.

27         (e)  Carriers shall adopt procedures for receiving,

28  reviewing, documenting, and responding to requests for

29  authorization. Such procedures shall be for a health care

30  provider certified under this section.

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  1         (f)  By accepting payment under this chapter for

  2  treatment rendered to an injured employee, a health care

  3  provider consents to the jurisdiction of the agency division

  4  as set forth in subsection (11) and to the submission of all

  5  records and other information concerning such treatment to the

  6  agency division in connection with a reimbursement dispute,

  7  audit, or review as provided by this section. The health care

  8  provider must further agree to comply with any decision of the

  9  agency division rendered under this section.

10         (g)  The employee is not liable for payment for medical

11  treatment or services provided pursuant to this section except

12  as otherwise provided in this section.

13         (h)  The provisions of s. 456.053 are applicable to

14  referrals among health care providers, as defined in

15  subsection (1), treating injured workers.

16         (i)  Notwithstanding paragraph (d), a claim for

17  specialist consultations, surgical operations,

18  physiotherapeutic or occupational therapy procedures, X-ray

19  examinations, or special diagnostic laboratory tests that cost

20  more than $1,000 and other specialty services that the agency

21  division identifies by rule is not valid and reimbursable

22  unless the services have been expressly authorized by the

23  carrier, or unless the carrier has failed to respond within 10

24  days to a written request for authorization, or unless

25  emergency care is required. The insurer shall not refuse to

26  authorize such consultation or procedure unless the health

27  care provider or facility is not authorized or certified or

28  unless an expert medical advisor has determined that the

29  consultation or procedure is not medically necessary or

30  otherwise compensable under this chapter. Authorization of a

31  treatment plan does not constitute express authorization for

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  1  purposes of this section, except to the extent the carrier

  2  provides otherwise in its authorization procedures. This

  3  paragraph does not limit the carrier's obligation to identify

  4  and disallow overutilization or billing errors.

  5         (j)  Notwithstanding anything in this chapter to the

  6  contrary, a sick or injured employee shall be entitled, at all

  7  times, to free, full, and absolute choice in the selection of

  8  the pharmacy or pharmacist dispensing and filling

  9  prescriptions for medicines required under this chapter. It is

10  expressly forbidden for the agency division, an employer, or a

11  carrier, or any agent or representative of the agency

12  division, an employer, or a carrier to select the pharmacy or

13  pharmacist which the sick or injured employee must use;

14  condition coverage or payment on the basis of the pharmacy or

15  pharmacist utilized; or to otherwise interfere in the

16  selection by the sick or injured employee of a pharmacy or

17  pharmacist.

18         (4)  NOTICE OF TREATMENT TO CARRIER; FILING WITH

19  DEPARTMENT DIVISION.--

20         (a)  Any health care provider providing necessary

21  remedial treatment, care, or attendance to any injured worker

22  shall submit treatment reports to the carrier in a format

23  prescribed by the department in consultation with the agency

24  division. A claim for medical or surgical treatment is not

25  valid or enforceable against such employer or employee,

26  unless, by the close of the third business day following the

27  first treatment, the physician providing the treatment

28  furnishes to the employer or carrier a preliminary notice of

29  the injury and treatment on forms prescribed by the department

30  in consultation with the agency division and, within 15 days

31  thereafter, furnishes to the employer or carrier a complete

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  1  report, and subsequent thereto furnishes progress reports, if

  2  requested by the employer or insurance carrier, at intervals

  3  of not less than 3 weeks apart or at less frequent intervals

  4  if requested on forms prescribed by the department in

  5  consultation with the agency division.

  6         (b)  Upon the request of the department Division of

  7  Workers' Compensation, each medical report or bill obtained or

  8  received by the employer, the carrier, or the injured

  9  employee, or the attorney for the employer, carrier, or

10  injured employee, with respect to the remedial treatment,

11  care, and attendance of the injured employee, including any

12  report of an examination, diagnosis, or disability evaluation,

13  must be filed with the department Division of Workers'

14  Compensation pursuant to rules adopted by the department in

15  consultation with the agency division. The health care

16  provider shall also furnish to the injured employee or to his

17  or her attorney, on demand, a copy of his or her office chart,

18  records, and reports, and may charge the injured employee an

19  amount authorized by the department division for the copies.

20  Each such health care provider shall provide to the agency or

21  department division information about the remedial treatment,

22  care, and attendance which the agency or department division

23  reasonably requests.

24         (c)  It is the policy for the administration of the

25  workers' compensation system that there be reasonable access

26  to medical information by all parties to facilitate the

27  self-executing features of the law. Notwithstanding the

28  limitations in s. 456.057 and subject to the limitations in s.

29  381.004, upon the request of the employer, the carrier, an

30  authorized qualified rehabilitation provider, or the attorney

31  for the employer or carrier, the medical records of an injured

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  1  employee must be furnished to those persons and the medical

  2  condition of the injured employee must be discussed with those

  3  persons, if the records and the discussions are restricted to

  4  conditions relating to the workplace injury. Any such

  5  discussions may be held before or after the filing of a claim

  6  without the knowledge, consent, or presence of any other party

  7  or his or her agent or representative. A health care provider

  8  who willfully refuses to provide medical records or to discuss

  9  the medical condition of the injured employee, after a

10  reasonable request is made for such information pursuant to

11  this subsection, shall be subject by the agency division to

12  one or more of the penalties set forth in paragraph (8)(b).

13         (5)  INDEPENDENT MEDICAL EXAMINATIONS.--

14         (a)  In any dispute concerning overutilization, medical

15  benefits, compensability, or disability under this chapter,

16  the carrier or the employee may select an independent medical

17  examiner. The examiner may be a health care provider treating

18  or providing other care to the employee. An independent

19  medical examiner may not render an opinion outside his or her

20  area of expertise, as demonstrated by licensure and applicable

21  practice parameters.

22         (b)  Each party is bound by his or her selection of an

23  independent medical examiner and is entitled to an alternate

24  examiner only if:

25         1.  The examiner is not qualified to render an opinion

26  upon an aspect of the employee's illness or injury which is

27  material to the claim or petition for benefits;

28         2.  The examiner ceases to practice in the specialty

29  relevant to the employee's condition;

30

31

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  1         3.  The examiner is unavailable due to injury, death,

  2  or relocation outside a reasonably accessible geographic area;

  3  or

  4         4.  The parties agree to an alternate examiner.

  5

  6  Any party may request, or a judge of compensation claims may

  7  require, designation of an agency a division medical advisor

  8  as an independent medical examiner. The opinion of the

  9  advisors acting as examiners shall not be afforded the

10  presumption set forth in paragraph (9)(c).

11         (c)  The carrier may, at its election, contact the

12  claimant directly to schedule a reasonable time for an

13  independent medical examination. The carrier must confirm the

14  scheduling agreement in writing within 5 days and notify

15  claimant's counsel, if any, at least 7 days before the date

16  upon which the independent medical examination is scheduled to

17  occur. An attorney representing a claimant is not authorized

18  to schedule independent medical evaluations under this

19  subsection.

20         (d)  If the employee fails to appear for the

21  independent medical examination without good cause and fails

22  to advise the physician at least 24 hours before the scheduled

23  date for the examination that he or she cannot appear, the

24  employee is barred from recovering compensation for any period

25  during which he or she has refused to submit to such

26  examination. Further, the employee shall reimburse the carrier

27  50 percent of the physician's cancellation or no-show fee

28  unless the carrier that schedules the examination fails to

29  timely provide to the employee a written confirmation of the

30  date of the examination pursuant to paragraph (c) which

31  includes an explanation of why he or she failed to appear. The

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  1  employee may appeal to a judge of compensation claims for

  2  reimbursement when the carrier withholds payment in excess of

  3  the authority granted by this section.

  4         (e)  No medical opinion other than the opinion of a

  5  medical advisor appointed by the judge of compensation claims

  6  or agency division, an independent medical examiner, or an

  7  authorized treating provider is admissible in proceedings

  8  before the judges of compensation claims.

  9         (f)  Attorney's fees incurred by an injured employee in

10  connection with delay of or opposition to an independent

11  medical examination, including, but not limited to, motions

12  for protective orders, are not recoverable under this chapter.

13         (6)  UTILIZATION REVIEW.--Carriers shall review all

14  bills, invoices, and other claims for payment submitted by

15  health care providers in order to identify overutilization and

16  billing errors, and may hire peer review consultants or

17  conduct independent medical evaluations. Such consultants,

18  including peer review organizations, are immune from liability

19  in the execution of their functions under this subsection to

20  the extent provided in s. 766.101. If a carrier finds that

21  overutilization of medical services or a billing error has

22  occurred, it must disallow or adjust payment for such services

23  or error without order of a judge of compensation claims or

24  the agency division, if the carrier, in making its

25  determination, has complied with this section and rules

26  adopted by the agency division.

27         (7)  UTILIZATION AND REIMBURSEMENT DISPUTES.--

28         (a)  Any health care provider, carrier, or employer who

29  elects to contest the disallowance or adjustment of payment by

30  a carrier under subsection (6) must, within 30 days after

31  receipt of notice of disallowance or adjustment of payment,

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  1  petition the agency division to resolve the dispute. The

  2  petitioner must serve a copy of the petition on the carrier

  3  and on all affected parties by certified mail. The petition

  4  must be accompanied by all documents and records that support

  5  the allegations contained in the petition. Failure of a

  6  petitioner to submit such documentation to the agency division

  7  results in dismissal of the petition.

  8         (b)  The carrier must submit to the agency division

  9  within 10 days after receipt of the petition all documentation

10  substantiating the carrier's disallowance or adjustment.

11  Failure of the carrier to submit the requested documentation

12  to the agency division within 10 days constitutes a waiver of

13  all objections to the petition.

14         (c)  Within 60 days after receipt of all documentation,

15  the agency division must provide to the petitioner, the

16  carrier, and the affected parties a written determination of

17  whether the carrier properly adjusted or disallowed payment.

18  The agency division must be guided by standards and policies

19  set forth in this chapter, including all applicable

20  reimbursement schedules, in rendering its determination.

21         (d)  If the agency division finds an improper

22  disallowance or improper adjustment of payment by an insurer,

23  the insurer shall reimburse the health care provider,

24  facility, insurer, or employer within 30 days, subject to the

25  penalties provided in this subsection.

26         (e)  The agency division shall adopt rules to carry out

27  this subsection. The rules may include provisions for

28  consolidating petitions filed by a petitioner and expanding

29  the timetable for rendering a determination upon a

30  consolidated petition.

31

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  1         (f)  Any carrier that engages in a pattern or practice

  2  of arbitrarily or unreasonably disallowing or reducing

  3  payments to health care providers may be subject to one or

  4  more of the following penalties imposed by the agency

  5  division:

  6         1.  Repayment of the appropriate amount to the health

  7  care provider.

  8         2.  An administrative fine assessed by the agency

  9  division in an amount not to exceed $5,000 per instance of

10  improperly disallowing or reducing payments.

11         3.  Award of the health care provider's costs,

12  including a reasonable attorney's fee, for prosecuting the

13  petition.

14         (8)  PATTERN OR PRACTICE OF OVERUTILIZATION.--

15         (a)  Carriers must report to the agency division all

16  instances of overutilization including, but not limited to,

17  all instances in which the carrier disallows or adjusts

18  payment. The agency division shall determine whether a pattern

19  or practice of overutilization exists.

20         (b)  If the agency division determines that a health

21  care provider has engaged in a pattern or practice of

22  overutilization or a violation of this chapter or rules

23  adopted by the agency division, it may impose one or more of

24  the following penalties:

25         1.  An order of the agency division barring the

26  provider from payment under this chapter;

27         2.  Deauthorization of care under review;

28         3.  Denial of payment for care rendered in the future;

29         4.  Decertification of a health care provider certified

30  as an expert medical advisor under subsection (9) or of a

31  rehabilitation provider certified under s. 440.49;

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  1         5.  An administrative fine assessed by the agency

  2  division in an amount not to exceed $5,000 per instance of

  3  overutilization or violation; and

  4         6.  Notification of and review by the appropriate

  5  licensing authority pursuant to s. 440.106(3).

  6         (9)  EXPERT MEDICAL ADVISORS.--

  7         (a)  The agency division shall certify expert medical

  8  advisors in each specialty to assist the agency division and

  9  the judges of compensation claims within the advisor's area of

10  expertise as provided in this section. The agency division

11  shall, in a manner prescribed by rule, in certifying,

12  recertifying, or decertifying an expert medical advisor,

13  consider the qualifications, training, impartiality, and

14  commitment of the health care provider to the provision of

15  quality medical care at a reasonable cost. As a prerequisite

16  for certification or recertification, the agency division

17  shall require, at a minimum, that an expert medical advisor

18  have specialized workers' compensation training or experience

19  under the workers' compensation system of this state and board

20  certification or board eligibility.

21         (b)  The agency division shall contract with or employ

22  expert medical advisors to provide peer review or medical

23  consultation to the agency division or to a judge of

24  compensation claims in connection with resolving disputes

25  relating to reimbursement, differing opinions of health care

26  providers, and health care and physician services rendered

27  under this chapter. Expert medical advisors contracting with

28  the agency division shall, as a term of such contract, agree

29  to provide consultation or services in accordance with the

30  timetables set forth in this chapter and to abide by rules

31  adopted by the agency division, including, but not limited to,

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  1  rules pertaining to procedures for review of the services

  2  rendered by health care providers and preparation of reports

  3  and recommendations for submission to the agency division.

  4         (c)  If there is disagreement in the opinions of the

  5  health care providers, if two health care providers disagree

  6  on medical evidence supporting the employee's complaints or

  7  the need for additional medical treatment, or if two health

  8  care providers disagree that the employee is able to return to

  9  work, the agency division may, and the judge of compensation

10  claims shall, upon his or her own motion or within 15 days

11  after receipt of a written request by either the injured

12  employee, the employer, or the carrier, order the injured

13  employee to be evaluated by an expert medical advisor. The

14  opinion of the expert medical advisor is presumed to be

15  correct unless there is clear and convincing evidence to the

16  contrary as determined by the judge of compensation claims.

17  The expert medical advisor appointed to conduct the evaluation

18  shall have free and complete access to the medical records of

19  the employee. An employee who fails to report to and cooperate

20  with such evaluation forfeits entitlement to compensation

21  during the period of failure to report or cooperate.

22         (d)  The expert medical advisor must complete his or

23  her evaluation and issue his or her report to the agency

24  division or to the judge of compensation claims within 45 days

25  after receipt of all medical records. The expert medical

26  advisor must furnish a copy of the report to the carrier and

27  to the employee.

28         (e)  An expert medical advisor is not liable under any

29  theory of recovery for evaluations performed under this

30  section without a showing of fraud or malice. The protections

31  of s. 766.101 apply to any officer, employee, or agent of the

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  1  agency division and to any officer, employee, or agent of any

  2  entity with which the agency division has contracted under

  3  this subsection.

  4         (f)  If the agency division or a judge of compensation

  5  claims determines that the services of a certified expert

  6  medical advisor are required to resolve a dispute under this

  7  section, the carrier must compensate the advisor for his or

  8  her time in accordance with a schedule adopted by the agency

  9  division. The agency division may assess a penalty not to

10  exceed $500 against any carrier that fails to timely

11  compensate an advisor in accordance with this section.

12         (11)  AUDITS BY AGENCY FOR HEALTH CARE ADMINISTRATION

13  DIVISION; JURISDICTION.--

14         (a)  The Agency for Health Care Administration Division

15  of Workers' Compensation of the Department of Labor and

16  Employment Security may investigate health care providers to

17  determine whether providers are complying with this chapter

18  and with rules adopted by the agency division, whether the

19  providers are engaging in overutilization, and whether

20  providers are engaging in improper billing practices. If the

21  agency division finds that a health care provider has

22  improperly billed, overutilized, or failed to comply with

23  agency division rules or the requirements of this chapter it

24  must notify the provider of its findings and may determine

25  that the health care provider may not receive payment from the

26  carrier or may impose penalties as set forth in subsection (8)

27  or other sections of this chapter. If the health care provider

28  has received payment from a carrier for services that were

29  improperly billed or for overutilization, it must return those

30  payments to the carrier. The agency division may assess a

31  penalty not to exceed $500 for each overpayment that is not

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  1  refunded within 30 days after notification of overpayment by

  2  the agency division or carrier.

  3         (b)  The agency division shall monitor and audit

  4  carriers to determine if medical bills are paid in accordance

  5  with this section and agency division rules. Any employer, if

  6  self-insured, or carrier found by the agency division not to

  7  be within 90 percent compliance as to the payment of medical

  8  bills after July 1, 1994, must be assessed a fine not to

  9  exceed 1 percent of the prior year's assessment levied against

10  such entity under s. 440.51 for every quarter in which the

11  entity fails to attain 90-percent compliance. The agency

12  division shall fine or otherwise discipline an employer or

13  carrier, pursuant to rules adopted by the agency division, for

14  each late payment of compensation that is below the minimum

15  90-percent performance standard. Any carrier that is found to

16  be not in compliance in subsequent consecutive quarters must

17  implement a medical-bill review program approved by the agency

18  division, and the carrier is subject to disciplinary action by

19  the Department of Insurance.

20         (c)  The agency division has exclusive jurisdiction to

21  decide any matters concerning reimbursement, to resolve any

22  overutilization dispute under subsection (7), and to decide

23  any question concerning overutilization under subsection (8),

24  which question or dispute arises after January 1, 1994.

25         (d)  The following agency division actions do not

26  constitute agency action subject to review under ss. 120.569

27  and 120.57 and do not constitute actions subject to s. 120.56:

28  referral by the entity responsible for utilization review; a

29  decision by the agency division to refer a matter to a peer

30  review committee; establishment by a health care provider or

31  entity of procedures by which a peer review committee reviews

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  1  the rendering of health care services; and the review

  2  proceedings, report, and recommendation of the peer review

  3  committee.

  4         (12)  CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM

  5  REIMBURSEMENT ALLOWANCES.--

  6         (a)  A three-member panel is created, consisting of the

  7  Insurance Commissioner, or the Insurance Commissioner's

  8  designee, and two members to be appointed by the Governor,

  9  subject to confirmation by the Senate, one member who, on

10  account of present or previous vocation, employment, or

11  affiliation, shall be classified as a representative of

12  employers, the other member who, on account of previous

13  vocation, employment, or affiliation, shall be classified as a

14  representative of employees. The panel shall determine

15  statewide schedules of maximum reimbursement allowances for

16  medically necessary treatment, care, and attendance provided

17  by physicians, hospitals, ambulatory surgical centers,

18  work-hardening programs, pain programs, and durable medical

19  equipment. The maximum reimbursement allowances for inpatient

20  hospital care shall be based on a schedule of per diem rates,

21  to be approved by the three-member panel no later than March

22  1, 1994, to be used in conjunction with a precertification

23  manual as determined by the agency division. All compensable

24  charges for hospital outpatient care shall be reimbursed at 75

25  percent of usual and customary charges. Until the three-member

26  panel approves a schedule of per diem rates for inpatient

27  hospital care and it becomes effective, all compensable

28  charges for hospital inpatient care must be reimbursed at 75

29  percent of their usual and customary charges. Annually, the

30  three-member panel shall adopt schedules of maximum

31  reimbursement allowances for physicians, hospital inpatient

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  1  care, hospital outpatient care, ambulatory surgical centers,

  2  work-hardening programs, and pain programs. However, the

  3  maximum percentage of increase in the individual reimbursement

  4  allowance may not exceed the percentage of increase in the

  5  Consumer Price Index for the previous year. An individual

  6  physician, hospital, ambulatory surgical center, pain program,

  7  or work-hardening program shall be reimbursed either the usual

  8  and customary charge for treatment, care, and attendance, the

  9  agreed-upon contract price, or the maximum reimbursement

10  allowance in the appropriate schedule, whichever is less.

11         (b)  As to reimbursement for a prescription medication,

12  the reimbursement amount for a prescription shall be the

13  average wholesale price times 1.2 plus $4.18 for the

14  dispensing fee, except where the carrier has contracted for a

15  lower amount. Fees for pharmaceuticals and pharmaceutical

16  services shall be reimbursable at the applicable fee schedule

17  amount. Where the employer or carrier has contracted for such

18  services and the employee elects to obtain them through a

19  provider not a party to the contract, the carrier shall

20  reimburse at the schedule, negotiated, or contract price,

21  whichever is lower.

22         (c)  Reimbursement for all fees and other charges for

23  such treatment, care, and attendance, including treatment,

24  care, and attendance provided by any hospital or other health

25  care provider, ambulatory surgical center, work-hardening

26  program, or pain program, must not exceed the amounts provided

27  by the uniform schedule of maximum reimbursement allowances as

28  determined by the panel or as otherwise provided in this

29  section. This subsection also applies to independent medical

30  examinations performed by health care providers under this

31  chapter. Until the three-member panel approves a uniform

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  1  schedule of maximum reimbursement allowances and it becomes

  2  effective, all compensable charges for treatment, care, and

  3  attendance provided by physicians, ambulatory surgical

  4  centers, work-hardening programs, or pain programs shall be

  5  reimbursed at the lowest maximum reimbursement allowance

  6  across all 1992 schedules of maximum reimbursement allowances

  7  for the services provided regardless of the place of service.

  8  In determining the uniform schedule, the panel shall first

  9  approve the data which it finds representative of prevailing

10  charges in the state for similar treatment, care, and

11  attendance of injured persons. Each health care provider,

12  health care facility, ambulatory surgical center,

13  work-hardening program, or pain program receiving workers'

14  compensation payments shall maintain records verifying their

15  usual charges. In establishing the uniform schedule of maximum

16  reimbursement allowances, the panel must consider:

17         1.  The levels of reimbursement for similar treatment,

18  care, and attendance made by other health care programs or

19  third-party providers;

20         2.  The impact upon cost to employers for providing a

21  level of reimbursement for treatment, care, and attendance

22  which will ensure the availability of treatment, care, and

23  attendance required by injured workers;

24         3.  The financial impact of the reimbursement

25  allowances upon health care providers and health care

26  facilities, including trauma centers as defined in s.

27  395.4001, and its effect upon their ability to make available

28  to injured workers such medically necessary remedial

29  treatment, care, and attendance. The uniform schedule of

30  maximum reimbursement allowances must be reasonable, must

31  promote health care cost containment and efficiency with

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  1  respect to the workers' compensation health care delivery

  2  system, and must be sufficient to ensure availability of such

  3  medically necessary remedial treatment, care, and attendance

  4  to injured workers; and

  5         4.  The most recent average maximum allowable rate of

  6  increase for hospitals determined by the Health Care Board

  7  under chapter 408.

  8         (13)  REMOVAL OF PHYSICIANS FROM LISTS OF THOSE

  9  AUTHORIZED TO RENDER MEDICAL CARE.--The agency division shall

10  remove from the list of physicians or facilities authorized to

11  provide remedial treatment, care, and attendance under this

12  chapter the name of any physician or facility found after

13  reasonable investigation to have:

14         (a)  Engaged in professional or other misconduct or

15  incompetency in connection with medical services rendered

16  under this chapter;

17         (b)  Exceeded the limits of his or her or its

18  professional competence in rendering medical care under this

19  chapter, or to have made materially false statements regarding

20  his or her or its qualifications in his or her application;

21         (c)  Failed to transmit copies of medical reports to

22  the employer or carrier, or failed to submit full and truthful

23  medical reports of all his or her or its findings to the

24  employer or carrier as required under this chapter;

25         (d)  Solicited, or employed another to solicit for

26  himself or herself or itself or for another, professional

27  treatment, examination, or care of an injured employee in

28  connection with any claim under this chapter;

29         (e)  Refused to appear before, or to answer upon

30  request of, the agency division or any duly authorized officer

31  of the state, any legal question, or to produce any relevant

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  1  book or paper concerning his or her conduct under any

  2  authorization granted to him or her under this chapter;

  3         (f)  Self-referred in violation of this chapter or

  4  other laws of this state; or

  5         (g)  Engaged in a pattern of practice of

  6  overutilization or a violation of this chapter or rules

  7  adopted by the agency division.

  8         (15)  PRACTICE PARAMETERS.--

  9         (a)  The Agency for Health Care Administration, in

10  conjunction with the department division and appropriate

11  health professional associations and health-related

12  organizations shall develop and may adopt by rule

13  scientifically sound practice parameters for medical

14  procedures relevant to workers' compensation claimants.

15  Practice parameters developed under this section must focus on

16  identifying effective remedial treatments and promoting the

17  appropriate utilization of health care resources. Priority

18  must be given to those procedures that involve the greatest

19  utilization of resources either because they are the most

20  costly or because they are the most frequently performed.

21  Practice parameters for treatment of the 10 top procedures

22  associated with workers' compensation injuries including the

23  remedial treatment of lower-back injuries must be developed by

24  December 31, 1994.

25         (b)  The guidelines may be initially based on

26  guidelines prepared by nationally recognized health care

27  institutions and professional organizations but should be

28  tailored to meet the workers' compensation goal of returning

29  employees to full employment as quickly as medically possible,

30  taking into consideration outcomes data collected from managed

31

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  1  care providers and any other inpatient and outpatient

  2  facilities serving workers' compensation claimants.

  3         (c)  Procedures must be instituted which provide for

  4  the periodic review and revision of practice parameters based

  5  on the latest outcomes data, research findings, technological

  6  advancements, and clinical experiences, at least once every 3

  7  years.

  8         (d)  Practice parameters developed under this section

  9  must be used by carriers and the agency division in evaluating

10  the appropriateness and overutilization of medical services

11  provided to injured employees.

12         Section 25.  Subsection (23) of section 440.134,

13  Florida Statutes, is amended to read:

14         440.134  Workers' compensation managed care

15  arrangement.--

16         (23)  The agency shall immediately notify the

17  department of Insurance and the Department of Labor and

18  Employment Security whenever it issues an administrative

19  complaint or an order or otherwise initiates legal proceedings

20  resulting in, or which may result in, suspension or revocation

21  of an insurer's authorization.

22         Section 26.  Subsections (3) and (4) of section 440.14,

23  Florida Statutes, are amended to read:

24         440.14  Determination of pay.--

25         (3)  The department division shall establish by rule a

26  form which shall contain a simplified checklist of those items

27  which may be included as "wage" for determining the average

28  weekly wage.

29         (4)  Upon termination of the employee or upon

30  termination of the payment of fringe benefits of any employee

31  who is collecting indemnity benefits pursuant to s. 440.15(2)

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  1  or (3)(b), the employer shall within 7 days of such

  2  termination file a corrected 13-week wage statement reflecting

  3  the wages paid and the fringe benefits that had been paid to

  4  the injured employee, as provided defined in s. 440.02(27).

  5         Section 27.  Paragraphs (d) and (f) of subsection (1),

  6  paragraphs (c) and (d) of subsection (2), subsections (3),

  7  (4), and (6), and paragraphs (b) and (c) of subsection (10) of

  8  section 440.15, Florida Statutes, are amended to read:

  9         440.15  Compensation for disability.--Compensation for

10  disability shall be paid to the employee, subject to the

11  limits provided in s. 440.12(2), as follows:

12         (1)  PERMANENT TOTAL DISABILITY.--

13         (d)  If an employee who is being paid compensation for

14  permanent total disability becomes rehabilitated to the extent

15  that she or he establishes an earning capacity, the employee

16  shall be paid, instead of the compensation provided in

17  paragraph (a), benefits pursuant to subsection (3). The

18  department division shall adopt rules to enable a permanently

19  and totally disabled employee who may have reestablished an

20  earning capacity to undertake a trial period of reemployment

21  without prejudicing her or his return to permanent total

22  status in the case that such employee is unable to sustain an

23  earning capacity.

24         (f)1.  If permanent total disability results from

25  injuries that occurred subsequent to June 30, 1955, and for

26  which the liability of the employer for compensation has not

27  been discharged under s. 440.20(11), the injured employee

28  shall receive additional weekly compensation benefits equal to

29  5 percent of her or his weekly compensation rate, as

30  established pursuant to the law in effect on the date of her

31  or his injury, multiplied by the number of calendar years

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  1  since the date of injury. The weekly compensation payable and

  2  the additional benefits payable under this paragraph, when

  3  combined, may not exceed the maximum weekly compensation rate

  4  in effect at the time of payment as determined pursuant to s.

  5  440.12(2). Entitlement to these supplemental payments shall

  6  cease at age 62 if the employee is eligible for social

  7  security benefits under 42 U.S.C. ss. 402 and 423, whether or

  8  not the employee has applied for such benefits. These

  9  supplemental benefits shall be paid by the department division

10  out of the Workers' Compensation Administration Trust Fund

11  when the injury occurred subsequent to June 30, 1955, and

12  before July 1, 1984. These supplemental benefits shall be paid

13  by the employer when the injury occurred on or after July 1,

14  1984. Supplemental benefits are not payable for any period

15  prior to October 1, 1974.

16         2.a.  The department division shall provide by rule for

17  the periodic reporting to the department division of all

18  earnings of any nature and social security income by the

19  injured employee entitled to or claiming additional

20  compensation under subparagraph 1. Neither the department

21  division nor the employer or carrier shall make any payment of

22  those additional benefits provided by subparagraph 1. for any

23  period during which the employee willfully fails or refuses to

24  report upon request by the department division in the manner

25  prescribed by such rules.

26         b.  The department division shall provide by rule for

27  the periodic reporting to the employer or carrier of all

28  earnings of any nature and social security income by the

29  injured employee entitled to or claiming benefits for

30  permanent total disability. The employer or carrier is not

31  required to make any payment of benefits for permanent total

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  1  disability for any period during which the employee willfully

  2  fails or refuses to report upon request by the employer or

  3  carrier in the manner prescribed by such rules or if any

  4  employee who is receiving permanent total disability benefits

  5  refuses to apply for or cooperate with the employer or carrier

  6  in applying for social security benefits.

  7         3.  When an injured employee receives a full or partial

  8  lump-sum advance of the employee's permanent total disability

  9  compensation benefits, the employee's benefits under this

10  paragraph shall be computed on the employee's weekly

11  compensation rate as reduced by the lump-sum advance.

12         (2)  TEMPORARY TOTAL DISABILITY.--

13         (c)  Temporary total disability benefits paid pursuant

14  to this subsection shall include such period as may be

15  reasonably necessary for training in the use of artificial

16  members and appliances, and shall include such period as the

17  employee may be receiving training and education under a

18  program pursuant to s. 440.491. Notwithstanding s. 440.02(9),

19  the date of maximum medical improvement for purposes of

20  paragraph (3)(b) shall be no earlier than the last day for

21  which such temporary disability benefits are paid.

22         (d)  The department division shall, by rule, provide

23  for the periodic reporting to the department division,

24  employer, or carrier of all earned income, including income

25  from social security, by the injured employee who is entitled

26  to or claiming benefits for temporary total disability. The

27  employer or carrier is not required to make any payment of

28  benefits for temporary total disability for any period during

29  which the employee willfully fails or refuses to report upon

30  request by the employer or carrier in the manner prescribed by

31  the rules. The rule must require the claimant to personally

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  1  sign the claim form and attest that she or he has reviewed,

  2  understands, and acknowledges the foregoing.

  3         (3)  PERMANENT IMPAIRMENT AND WAGE-LOSS BENEFITS.--

  4         (a)  Impairment benefits.--

  5         1.  Once the employee has reached the date of maximum

  6  medical improvement, impairment benefits are due and payable

  7  within 20 days after the carrier has knowledge of the

  8  impairment.

  9         2.  The three-member panel, in cooperation with the

10  department division, shall establish and use a uniform

11  permanent impairment rating schedule. This schedule must be

12  based on medically or scientifically demonstrable findings as

13  well as the systems and criteria set forth in the American

14  Medical Association's Guides to the Evaluation of Permanent

15  Impairment; the Snellen Charts, published by American Medical

16  Association Committee for Eye Injuries; and the Minnesota

17  Department of Labor and Industry Disability Schedules. The

18  schedule should be based upon objective findings. The schedule

19  shall be more comprehensive than the AMA Guides to the

20  Evaluation of Permanent Impairment and shall expand the areas

21  already addressed and address additional areas not currently

22  contained in the guides. On August 1, 1979, and pending the

23  adoption, by rule, of a permanent schedule, Guides to the

24  Evaluation of Permanent Impairment, copyright 1977, 1971,

25  1988, by the American Medical Association, shall be the

26  temporary schedule and shall be used for the purposes hereof.

27  For injuries after July 1, 1990, pending the adoption by

28  department division rule of a uniform disability rating

29  schedule, the Minnesota Department of Labor and Industry

30  Disability Schedule shall be used unless that schedule does

31  not address an injury. In such case, the Guides to the

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  1  Evaluation of Permanent Impairment by the American Medical

  2  Association shall be used. Determination of permanent

  3  impairment under this schedule must be made by a physician

  4  licensed under chapter 458, a doctor of osteopathic medicine

  5  licensed under chapters 458 and 459, a chiropractic physician

  6  licensed under chapter 460, a podiatric physician licensed

  7  under chapter 461, an optometrist licensed under chapter 463,

  8  or a dentist licensed under chapter 466, as appropriate

  9  considering the nature of the injury. No other persons are

10  authorized to render opinions regarding the existence of or

11  the extent of permanent impairment.

12         3.  All impairment income benefits shall be based on an

13  impairment rating using the impairment schedule referred to in

14  subparagraph 2. Impairment income benefits are paid weekly at

15  the rate of 50 percent of the employee's average weekly

16  temporary total disability benefit not to exceed the maximum

17  weekly benefit under s. 440.12. An employee's entitlement to

18  impairment income benefits begins the day after the employee

19  reaches maximum medical improvement or the expiration of

20  temporary benefits, whichever occurs earlier, and continues

21  until the earlier of:

22         a.  The expiration of a period computed at the rate of

23  3 weeks for each percentage point of impairment; or

24         b.  The death of the employee.

25         4.  After the employee has been certified by a doctor

26  as having reached maximum medical improvement or 6 weeks

27  before the expiration of temporary benefits, whichever occurs

28  earlier, the certifying doctor shall evaluate the condition of

29  the employee and assign an impairment rating, using the

30  impairment schedule referred to in subparagraph 2.

31  Compensation is not payable for the mental, psychological, or

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  1  emotional injury arising out of depression from being out of

  2  work. If the certification and evaluation are performed by a

  3  doctor other than the employee's treating doctor, the

  4  certification and evaluation must be submitted to the treating

  5  doctor, and the treating doctor must indicate agreement or

  6  disagreement with the certification and evaluation. The

  7  certifying doctor shall issue a written report to the

  8  department division, the employee, and the carrier certifying

  9  that maximum medical improvement has been reached, stating the

10  impairment rating, and providing any other information

11  required by the department by rule division. If the employee

12  has not been certified as having reached maximum medical

13  improvement before the expiration of 102 weeks after the date

14  temporary total disability benefits begin to accrue, the

15  carrier shall notify the treating doctor of the requirements

16  of this section.

17         5.  The carrier shall pay the employee impairment

18  income benefits for a period based on the impairment rating.

19         6.  The department division may by rule specify forms

20  and procedures governing the method of payment of wage loss

21  and impairment benefits for dates of accidents before January

22  1, 1994, and for dates of accidents on or after January 1,

23  1994.

24         (b)  Supplemental benefits.--

25         1.  All supplemental benefits must be paid in

26  accordance with this subsection. An employee is entitled to

27  supplemental benefits as provided in this paragraph as of the

28  expiration of the impairment period, if:

29         a.  The employee has an impairment rating from the

30  compensable injury of 20 percent or more as determined

31  pursuant to this chapter;

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  1         b.  The employee has not returned to work or has

  2  returned to work earning less than 80 percent of the

  3  employee's average weekly wage as a direct result of the

  4  employee's impairment; and

  5         c.  The employee has in good faith attempted to obtain

  6  employment commensurate with the employee's ability to work.

  7         2.  If an employee is not entitled to supplemental

  8  benefits at the time of payment of the final weekly impairment

  9  income benefit because the employee is earning at least 80

10  percent of the employee's average weekly wage, the employee

11  may become entitled to supplemental benefits at any time

12  within 1 year after the impairment income benefit period ends

13  if:

14         a.  The employee earns wages that are less than 80

15  percent of the employee's average weekly wage for a period of

16  at least 90 days;

17         b.  The employee meets the other requirements of

18  subparagraph 1.; and

19         c.  The employee's decrease in earnings is a direct

20  result of the employee's impairment from the compensable

21  injury.

22         3.  If an employee earns wages that are at least 80

23  percent of the employee's average weekly wage for a period of

24  at least 90 days during which the employee is receiving

25  supplemental benefits, the employee ceases to be entitled to

26  supplemental benefits for the filing period. Supplemental

27  benefits that have been terminated shall be reinstated when

28  the employee satisfies the conditions enumerated in

29  subparagraph 2. and files the statement required under

30  subparagraph 5. Notwithstanding any other provision, if an

31  employee is not entitled to supplemental benefits for 12

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  1  consecutive months, the employee ceases to be entitled to any

  2  additional income benefits for the compensable injury. If the

  3  employee is discharged within 12 months after losing

  4  entitlement under this subsection, benefits may be reinstated

  5  if the employee was discharged at that time with the intent to

  6  deprive the employee of supplemental benefits.

  7         4.  During the period that impairment income benefits

  8  or supplemental income benefits are being paid, the carrier

  9  has the affirmative duty to determine at least annually

10  whether any extended unemployment or underemployment is a

11  direct result of the employee's impairment. To accomplish this

12  purpose, the division may require periodic reports from the

13  employee and the carrier, and it may, at the carrier's

14  expense, require any physical or other examinations,

15  vocational assessments, or other tests or diagnoses necessary

16  to verify that the carrier is performing its duty. Not more

17  than once in each 12 calendar months, the employee and the

18  carrier may each request that the division review the status

19  of the employee and determine whether the carrier has

20  performed its duty with respect to whether the employee's

21  unemployment or underemployment is a direct result of

22  impairment from the compensable injury.

23         4.5.  After the initial determination of supplemental

24  benefits, the employee must file a statement with the carrier

25  stating that the employee has earned less than 80 percent of

26  the employee's average weekly wage as a direct result of the

27  employee's impairment, stating the amount of wages the

28  employee earned in the filing period, and stating that the

29  employee has in good faith sought employment commensurate with

30  the employee's ability to work. The statement must be filed

31  quarterly on a form and in the manner prescribed by the

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  1  department division. The department division may modify the

  2  filing period as appropriate to an individual case. Failure to

  3  file a statement relieves the carrier of liability for

  4  supplemental benefits for the period during which a statement

  5  is not filed.

  6         5.6.  The carrier shall begin payment of supplemental

  7  benefits not later than the seventh day after the expiration

  8  date of the impairment income benefit period and shall

  9  continue to timely pay those benefits. The carrier may request

10  a mediation conference for the purpose of contesting the

11  employee's entitlement to or the amount of supplemental income

12  benefits.

13         6.7.  Supplemental benefits are calculated quarterly

14  and paid monthly. For purposes of calculating supplemental

15  benefits, 80 percent of the employee's average weekly wage and

16  the average wages the employee has earned per week are

17  compared quarterly. For purposes of this paragraph, if the

18  employee is offered a bona fide position of employment that

19  the employee is capable of performing, given the physical

20  condition of the employee and the geographic accessibility of

21  the position, the employee's weekly wages are considered

22  equivalent to the weekly wages for the position offered to the

23  employee.

24         7.8.  Supplemental benefits are payable at the rate of

25  80 percent of the difference between 80 percent of the

26  employee's average weekly wage determined pursuant to s.

27  440.14 and the weekly wages the employee has earned during the

28  reporting period, not to exceed the maximum weekly income

29  benefit under s. 440.12.

30         8.9.  The department division may by rule define terms

31  that are necessary for the administration of this section and

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  1  forms and procedures governing the method of payment of

  2  supplemental benefits for dates of accidents before January 1,

  3  1994, and for dates of accidents on or after January 1, 1994.

  4         (c)  Duration of temporary impairment and supplemental

  5  income benefits.--The employee's eligibility for temporary

  6  benefits, impairment income benefits, and supplemental

  7  benefits terminates on the expiration of 401 weeks after the

  8  date of injury.

  9         (4)  TEMPORARY PARTIAL DISABILITY.--

10         (a)  In case of temporary partial disability,

11  compensation shall be equal to 80 percent of the difference

12  between 80 percent of the employee's average weekly wage and

13  the salary, wages, and other remuneration the employee is able

14  to earn, as compared weekly; however, the weekly benefits may

15  not exceed an amount equal to 66 2/3  percent of the

16  employee's average weekly wage at the time of injury. In order

17  to simplify the comparison of the preinjury average weekly

18  wage with the salary, wages, and other remuneration the

19  employee is able to earn, the department division may by rule

20  provide for the modification of the weekly comparison so as to

21  coincide as closely as possible with the injured worker's pay

22  periods. The amount determined to be the salary, wages, and

23  other remuneration the employee is able to earn shall in no

24  case be less than the sum actually being earned by the

25  employee, including earnings from sheltered employment.

26         (b)  Such benefits shall be paid during the continuance

27  of such disability, not to exceed a period of 104 weeks, as

28  provided by this subsection and subsection (2). Once the

29  injured employee reaches the maximum number of weeks,

30  temporary disability benefits cease and the injured worker's

31  permanent impairment must be determined. The department

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  1  division may by rule specify forms and procedures governing

  2  the method of payment of temporary disability benefits for

  3  dates of accidents before January 1, 1994, and for dates of

  4  accidents on or after January 1, 1994.

  5         (6)  OBLIGATION TO REHIRE.--If the employer has not in

  6  good faith made available to the employee, within a 100-mile

  7  radius of the employee's residence, work appropriate to the

  8  employee's physical limitations within 30 days after the

  9  carrier notifies the employer of maximum medical improvement

10  and the employee's physical limitations, the employer shall

11  pay to the department division for deposit into the Workers'

12  Compensation Administration Trust Fund a fine of $250 for

13  every $5,000 of the employer's workers' compensation premium

14  or payroll, not to exceed $2,000 per violation, as the

15  department division requires by rule. The employer is not

16  subject to this subsection if the employee is receiving

17  permanent total disability benefits or if the employer has 50

18  or fewer employees.

19         (10)  EMPLOYEE ELIGIBLE FOR BENEFITS UNDER THIS CHAPTER

20  AND FEDERAL OLD-AGE, SURVIVORS, AND DISABILITY INSURANCE

21  ACT.--

22         (b)  If the provisions of 42 U.S.C. s. 424(a) are

23  amended to provide for a reduction or increase of the

24  percentage of average current earnings that the sum of

25  compensation benefits payable under this chapter and the

26  benefits payable under 42 U.S.C. ss. 402 and 423 can equal,

27  the amount of the reduction of benefits provided in this

28  subsection shall be reduced or increased accordingly. The

29  department division may by rule specify forms and procedures

30  governing the method for calculating and administering the

31  offset of benefits payable under this chapter and benefits

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  1  payable under 42 U.S.C. ss. 402 and 423. The department

  2  division shall have first priority in taking any available

  3  social security offsets on dates of accidents occurring before

  4  July 1, 1984.

  5         (c)  No disability compensation benefits payable for

  6  any week, including those benefits provided by paragraph

  7  (1)(f), shall be reduced pursuant to this subsection until the

  8  Social Security Administration determines the amount otherwise

  9  payable to the employee under 42 U.S.C. ss. 402 and 423 and

10  the employee has begun receiving such social security benefit

11  payments. The employee shall, upon demand by the department

12  division, the employer, or the carrier, authorize the Social

13  Security Administration to release disability information

14  relating to her or him and authorize the Division of

15  Unemployment Compensation to release unemployment compensation

16  information relating to her or him, in accordance with rules

17  to be adopted promulgated by the department division

18  prescribing the procedure and manner for requesting the

19  authorization and for compliance by the employee. Neither the

20  department division nor the employer or carrier shall make any

21  payment of benefits for total disability or those additional

22  benefits provided by paragraph (1)(f) for any period during

23  which the employee willfully fails or refuses to authorize the

24  release of information in the manner and within the time

25  prescribed by such rules. The authority for release of

26  disability information granted by an employee under this

27  paragraph shall be effective for a period not to exceed 12

28  months, such authority to be renewable as the department

29  division may prescribe by rule.

30

31

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  1         Section 28.  Subsections (2), (3), (4), (5), (7), and

  2  (10) of section 440.185, Florida Statutes, are amended to

  3  read:

  4         440.185  Notice of injury or death; reports; penalties

  5  for violations.--

  6         (2)  Within 7 days after actual knowledge of injury or

  7  death, the employer shall report such injury or death to its

  8  carrier, in a format prescribed by the department division,

  9  and shall provide a copy of such report to the employee or the

10  employee's estate. The report of injury shall contain the

11  following information:

12         (a)  The name, address, and business of the employer;

13         (b)  The name, social security number, street, mailing

14  address, telephone number, and occupation of the employee;

15         (c)  The cause and nature of the injury or death;

16         (d)  The year, month, day, and hour when, and the

17  particular locality where, the injury or death occurred; and

18         (e)  Such other information as the department division

19  may require.

20

21  The carrier shall, within 14 days after the employer's receipt

22  of the form reporting the injury, file the information

23  required by this subsection with the department division in

24  Tallahassee. However, the department division may by rule

25  provide for a different reporting system for those types of

26  injuries which it determines should be reported in a different

27  manner and for those cases which involve minor injuries

28  requiring professional medical attention in which the employee

29  does not lose more than 7 days of work as a result of the

30  injury and is able to return to the job immediately after

31  treatment and resume regular work.

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  1         (3)  In addition to the requirements of subsection (2),

  2  the employer shall notify the department division within 24

  3  hours by telephone or telegraph of any injury resulting in

  4  death.  However, this special notice shall not be required

  5  when death results subsequent to the submission to the

  6  department division of a previous report of the injury

  7  pursuant to subsection (2).

  8         (4)  Within 3 days after the employer or the employee

  9  informs the carrier of an injury the carrier shall mail to the

10  injured worker an informational brochure approved by the

11  department division which sets forth in clear and

12  understandable language an explanation of the rights,

13  benefits, procedures for obtaining benefits and assistance,

14  criminal penalties, and obligations of injured workers and

15  their employers under the Florida Workers' Compensation Law.

16  Annually, the carrier or its third-party administrator shall

17  mail to the employer an informational brochure approved by the

18  department division which sets forth in clear and

19  understandable language an explanation of the rights,

20  benefits, procedures for obtaining benefits and assistance,

21  criminal penalties, and obligations of injured workers and

22  their employers under the Florida Workers' Compensation Law.

23  All such informational brochures shall contain a notice that

24  clearly states in substance the following: "Any person who,

25  knowingly and with intent to injure, defraud, or deceive any

26  employer or employee, insurance company, or self-insured

27  program, files a statement of claim containing any false or

28  misleading information commits a felony of the third degree."

29         (5)  Additional reports with respect to such injury and

30  of the condition of such employee, including copies of medical

31  reports, funeral expenses, and wage statements, shall be filed

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  1  by the employer or carrier to the department division at such

  2  times and in such manner as the department division may

  3  prescribe by rule.  In carrying out its responsibilities under

  4  this chapter, the department or agency division may by rule

  5  provide for the obtaining of any medical records relating to

  6  medical treatment provided pursuant to this chapter,

  7  notwithstanding the provisions of ss. 90.503 and 395.3025(4).

  8         (7)  Every carrier shall file with the department

  9  division within 21 days after the issuance of a policy or

10  contract of insurance such policy information as the

11  department division requires, including notice of whether the

12  policy is a minimum premium policy. Notice of cancellation or

13  expiration of a policy as set out in s. 440.42(3) shall be

14  mailed to the department division in accordance with rules

15  adopted by the department division under chapter 120. The

16  department division may contract with a private entity for the

17  collection of policy information required to be filed by

18  carriers under this subsection and the receipt of notices of

19  cancellation or expiration of a policy required to be filed by

20  carriers under s. 440.42(3). The submission of policy

21  information or notices of cancellation or expiration to the

22  contracted private entity satisfies the filing requirements of

23  this subsection and s. 440.42(3).

24         (10)  The department division may by rule prescribe

25  forms and procedures governing the submission of the change in

26  claims administration report and the risk class code and

27  standard industry code report for all lost time and denied

28  lost-time cases. The department division may by rule define

29  terms that are necessary for the effective administration of

30  this section.

31

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  1         Section 29.  Subsection (1) and paragraph (d) of

  2  subsection (2) of section 440.191, Florida Statutes, are

  3  amended to read:

  4         440.191  Employee Assistance and Ombudsman Office.--

  5         (1)(a)  In order to effect the self-executing features

  6  of the Workers' Compensation Law, this chapter shall be

  7  construed to permit injured employees and employers or the

  8  employer's carrier to resolve disagreements without undue

  9  expense, costly litigation, or delay in the provisions of

10  benefits. It is the duty of all who participate in the

11  workers' compensation system, including, but not limited to,

12  carriers, service providers, health care providers, attorneys,

13  employers, and employees, to attempt to resolve disagreements

14  in good faith and to cooperate with the department's

15  division's efforts to resolve disagreements between the

16  parties. The department division may by rule prescribe

17  definitions that are necessary for the effective

18  administration of this section.

19         (b)  An Employee Assistance and Ombudsman Office is

20  created within the department Division of Workers'

21  Compensation to inform and assist injured workers, employers,

22  carriers, and health care providers in fulfilling their

23  responsibilities under this chapter. The department division

24  may by rule specify forms and procedures for administering

25  requests for assistance provided by this section.

26         (c)  The Employee Assistance and Ombudsman Office,

27  Division of Workers' Compensation, shall be a resource

28  available to all employees who participate in the workers'

29  compensation system and shall take all steps necessary to

30  educate and disseminate information to employees and

31  employers.

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  1         (2)

  2         (d)  The Employee Assistance and Ombudsman Office may

  3  assign an ombudsman to assist the employee in resolving the

  4  dispute. If the dispute is not resolved within 30 days after

  5  the employee contacts the office, the ombudsman shall, at the

  6  employee's request, assist the employee in drafting a petition

  7  for benefits and explain the procedures for filing petitions.

  8  The department division may by rule determine the method used

  9  to calculate the 30-day period. The Employee Assistance and

10  Ombudsman Office may not represent employees before the judges

11  of compensation claims. An employer or carrier may not pay any

12  attorneys' fees on behalf of the employee for services

13  rendered or costs incurred in connection with this section,

14  unless expressly authorized elsewhere in this chapter.

15         Section 30.  Subsection (1) of section 440.192, Florida

16  Statutes, is amended to read:

17         440.192  Procedure for resolving benefit disputes.--

18         (1)  Subject to s. 440.191, any employee who has not

19  received a benefit to which the employee believes she or he is

20  entitled under this chapter shall file by certified mail, or

21  by electronic means approved by the Deputy Chief Judge, with

22  the Office of the Judges of Compensation Claims a petition for

23  benefits which meets the requirements of this section.  The

24  department division shall inform employees of the location of

25  the Office of the Judges of Compensation Claims for purposes

26  of filing a petition for benefits.  The employee shall also

27  serve copies of the petition for benefits by certified mail,

28  or by electronic means approved by the Deputy Chief Judge,

29  upon the employer and the employer's carrier. The Deputy Chief

30  Judge shall refer the petitions to the judges of compensation

31  claims.

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  1         Section 31.  Subsections (1), (3), and (4) of section

  2  440.1925, Florida Statutes, are amended to read:

  3         440.1925  Procedure for resolving maximum medical

  4  improvement or permanent impairment disputes.--

  5         (1)  Notwithstanding the limitations on carrier

  6  independent medical examinations in s. 440.13, an employee or

  7  carrier who wishes to obtain an opinion other than the opinion

  8  of the treating physician or an agency a division advisor on

  9  the issue of permanent impairment may obtain one independent

10  medical examination, except that the employee or carrier who

11  selects the treating physician is not entitled to obtain an

12  alternate opinion on the issue of permanent impairment, unless

13  the parties otherwise agree. This section and s. 440.13(2) do

14  not permit an employee or a carrier to obtain an additional

15  medical opinion on the issue of permanent impairment by

16  requesting an alternate treating physician pursuant to s.

17  440.13.

18         (3)  Disputes shall be resolved under this section

19  when:

20         (a)  A carrier that is entitled to obtain a

21  determination of an employee's date of maximum medical

22  improvement or permanent impairment has done so;

23         (b)  The independent medical examiner's opinion on the

24  date of the employee's maximum medical improvement and degree

25  or permanent impairment differs from the opinion of the

26  employee's treating physician on either of those issues, or

27  from the opinion of the expert medical advisor appointed by

28  the agency division on the degree of permanent impairment; or

29         (c)  The carrier denies any portion of an employee's

30  claim petition for benefits due to disputed maximum medical

31  improvement or permanent impairment issues.

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  1         (4)  Only opinions of the employee's treating

  2  physician, an agency a division medical advisor, or an

  3  independent medical examiner are admissible in proceedings

  4  before a judge of compensation claims to resolve maximum

  5  medical improvement or impairment disputes.

  6         Section 32.  Subsections (3), (6), (8), (9), (10),

  7  (11), (12), (15), (16), and (17) of section 440.20, Florida

  8  Statutes, are amended to read:

  9         440.20  Time for payment of compensation; penalties for

10  late payment.--

11         (3)  Upon making payment, or upon suspension or

12  cessation of payment for any reason, the carrier shall

13  immediately notify the department division that it has

14  commenced, suspended, or ceased payment of compensation. The

15  department division may require such notification in any

16  format and manner it deems necessary to obtain accurate and

17  timely reporting.

18         (6)  If any installment of compensation for death or

19  dependency benefits, disability, permanent impairment, or wage

20  loss payable without an award is not paid within 7 days after

21  it becomes due, as provided in subsection (2), subsection (3),

22  or subsection (4), there shall be added to such unpaid

23  installment a punitive penalty of an amount equal to 20

24  percent of the unpaid installment or $5, which shall be paid

25  at the same time as, but in addition to, such installment of

26  compensation, unless notice is filed under subsection (4) or

27  unless such nonpayment results from conditions over which the

28  employer or carrier had no control. When any installment of

29  compensation payable without an award has not been paid within

30  7 days after it became due and the claimant concludes the

31  prosecution of the claim before a judge of compensation claims

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  1  without having specifically claimed additional compensation in

  2  the nature of a penalty under this section, the claimant will

  3  be deemed to have acknowledged that, owing to conditions over

  4  which the employer or carrier had no control, such installment

  5  could not be paid within the period prescribed for payment and

  6  to have waived the right to claim such penalty. However,

  7  during the course of a hearing, the judge of compensation

  8  claims shall on her or his own motion raise the question of

  9  whether such penalty should be awarded or excused. The

10  department division may assess without a hearing the punitive

11  penalty against either the employer or the insurance carrier,

12  depending upon who was at fault in causing the delay. The

13  insurance policy cannot provide that this sum will be paid by

14  the carrier if the department division or the judge of

15  compensation claims determines that the punitive penalty

16  should be made by the employer rather than the carrier. Any

17  additional installment of compensation paid by the carrier

18  pursuant to this section shall be paid directly to the

19  employee.

20         (8)  In addition to any other penalties provided by

21  this chapter for late payment, if any installment of

22  compensation is not paid when it becomes due, the employer,

23  carrier, or servicing agent shall pay interest thereon at the

24  rate of 12 percent per year from the date the installment

25  becomes due until it is paid, whether such installment is

26  payable without an order or under the terms of an order. The

27  interest payment shall be the greater of the amount of

28  interest due or $5.

29         (a)  Within 30 days after final payment of compensation

30  has been made, the employer, carrier, or servicing agent shall

31  send to the department division a notice, in accordance with a

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  1  format and manner form prescribed by the department division,

  2  stating that such final payment has been made and stating the

  3  total amount of compensation paid, the name of the employee

  4  and of any other person to whom compensation has been paid,

  5  the date of the injury or death, and the date to which

  6  compensation has been paid.

  7         (b)  If the employer, carrier, or servicing agent fails

  8  to so notify the department division within such time, the

  9  department division shall assess against such employer,

10  carrier, or servicing agent a civil penalty in an amount not

11  over $100.

12         (c)  In order to ensure carrier compliance under this

13  chapter and provisions of the Florida Insurance Code, the

14  department division shall monitor the performance of carriers

15  by conducting market conduct examinations, as provided in s.

16  624.3161, and conducting investigations, as provided in s.

17  624.317. The department division shall impose penalties on

18  establish by rule minimum performance standards for carriers

19  to ensure that a minimum of 90 percent of all compensation

20  benefits are timely paid. The division shall fine a carrier as

21  provided in s. 440.13(11)(b) up to $50 for each late payment

22  of compensation pursuant to s. 624.4211 that is below the

23  minimum 90 percent performance standard. This paragraph does

24  not affect the imposition of any penalties or interest due to

25  the claimant. If a carrier contracts with a servicing agent to

26  fulfill its administrative responsibilities under this

27  chapter, the payment practices of the servicing agent are

28  deemed the payment practices of the carrier for the purpose of

29  assessing penalties against the carrier.

30         (9)  The department division may upon its own

31  initiative at any time in a case in which payments are being

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  1  made without an award investigate same and shall, in any case

  2  in which the right to compensation is controverted, or in

  3  which payments of compensation have been stopped or suspended,

  4  upon receipt of notice from any person entitled to

  5  compensation or from the employer that the right to

  6  compensation is controverted or that payments of compensation

  7  have been stopped or suspended, make such investigations,

  8  cause such medical examination to be made, or hold such

  9  hearings, and take such further action as it considers will

10  properly protect the rights of all parties.

11         (10)  Whenever the department division deems it

12  advisable, it may require any employer to make a deposit with

13  the Treasurer to secure the prompt and convenient payments of

14  such compensation; and payments therefrom upon any awards

15  shall be made upon order of the department division or judge

16  of compensation claims.

17         (11)(a)  When a claimant is not represented by counsel,

18  upon joint petition of all interested parties, a lump-sum

19  payment in exchange for the employer's or carrier's release

20  from liability for future medical expenses, as well as future

21  payments of compensation expenses and any other benefits

22  provided under this chapter, shall be allowed at any time in

23  any case in which the employer or carrier has filed a written

24  notice of denial within 120 days after the employer receives

25  notice of the injury, and the judge of compensation claims at

26  a hearing to consider the settlement proposal finds a

27  justiciable controversy as to legal or medical compensability

28  of the claimed injury or the alleged accident.  The employer

29  or carrier may not pay any attorney's fees on behalf of the

30  claimant for any settlement under this section unless

31  expressly authorized elsewhere in this chapter. Upon the joint

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  1  petition of all interested parties and after giving due

  2  consideration to the interests of all interested parties, the

  3  judge of compensation claims may enter a compensation order

  4  approving and authorizing the discharge of the liability of

  5  the employer for compensation and remedial treatment, care,

  6  and attendance, as well as rehabilitation expenses, by the

  7  payment of a lump sum. Such a compensation order so entered

  8  upon joint petition of all interested parties is not subject

  9  to modification or review under s. 440.28. If the settlement

10  proposal together with supporting evidence is not approved by

11  the judge of compensation claims, it shall be considered void.

12  Upon approval of a lump-sum settlement under this subsection,

13  the judge of compensation claims shall send a report to the

14  Chief Judge of the amount of the settlement and a statement of

15  the nature of the controversy. The Chief Judge shall keep a

16  record of all such reports filed by each judge of compensation

17  claims and shall submit to the Legislature a summary of all

18  such reports filed under this subsection annually by September

19  15.

20         (b)  When a claimant is not represented by counsel,

21  upon joint petition of all interested parties, a lump-sum

22  payment in exchange for the employer's or carrier's release

23  from liability for future medical expenses, as well as future

24  payments of compensation and rehabilitation expenses, and any

25  other benefits provided under this chapter, may be allowed at

26  any time in any case after the injured employee has attained

27  maximum medical improvement. An employer or carrier may not

28  pay any attorney's fees on behalf of the claimant for any

29  settlement, unless expressly authorized elsewhere in this

30  chapter. A compensation order so entered upon joint petition

31  of all interested parties shall not be subject to modification

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  1  or review under s. 440.28. However, a judge of compensation

  2  claims is not required to approve any award for lump-sum

  3  payment when it is determined by the judge of compensation

  4  claims that the payment being made is in excess of the value

  5  of benefits the claimant would be entitled to under this

  6  chapter. The judge of compensation claims shall make or cause

  7  to be made such investigations as she or he considers

  8  necessary, in each case in which the parties have stipulated

  9  that a proposed final settlement of liability of the employer

10  for compensation shall not be subject to modification or

11  review under s. 440.28, to determine whether such final

12  disposition will definitely aid the rehabilitation of the

13  injured worker or otherwise is clearly for the best interests

14  of the person entitled to compensation and, in her or his

15  discretion, may have an investigation made by the Department

16  of Education Rehabilitation Section of the Division of

17  Workers' Compensation. The joint petition and the report of

18  any investigation so made will be deemed a part of the

19  proceeding. An employer shall have the right to appear at any

20  hearing pursuant to this subsection which relates to the

21  discharge of such employer's liability and to present

22  testimony at such hearing. The carrier shall provide

23  reasonable notice to the employer of the time and date of any

24  such hearing and inform the employer of her or his rights to

25  appear and testify. The probability of the death of the

26  injured employee or other person entitled to compensation

27  before the expiration of the period during which such person

28  is entitled to compensation shall, in the absence of special

29  circumstances making such course improper, be determined in

30  accordance with the most recent United States Life Tables

31  published by the National Office of Vital Statistics of the

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  1  United States Department of Health and Human Services. The

  2  probability of the happening of any other contingency

  3  affecting the amount or duration of the compensation, except

  4  the possibility of the remarriage of a surviving spouse, shall

  5  be disregarded. As a condition of approving a lump-sum payment

  6  to a surviving spouse, the judge of compensation claims, in

  7  the judge of compensation claims' discretion, may require

  8  security which will ensure that, in the event of the

  9  remarriage of such surviving spouse, any unaccrued future

10  payments so paid may be recovered or recouped by the employer

11  or carrier. Such applications shall be considered and

12  determined in accordance with s. 440.25.

13         (c)  Notwithstanding s. 440.21(2), when a claimant is

14  represented by counsel, the claimant may waive all rights to

15  any and all benefits under this chapter by entering into a

16  settlement agreement releasing the employer and the carrier

17  from liability for workers' compensation benefits in exchange

18  for a lump-sum payment to the claimant. The settlement

19  agreement requires approval by the judge of compensation

20  claims only as to the attorney's fees paid to the claimant's

21  attorney by the claimant. The parties need not submit any

22  information or documentation in support of the settlement,

23  except as needed to justify the amount of the attorney's fees.

24  Neither the employer nor the carrier is responsible for any

25  attorney's fees relating to the settlement and release of

26  claims under this section. Payment of the lump-sum settlement

27  amount must be made within 14 days after the date the judge of

28  compensation claims mails the order approving the attorney's

29  fees. Any order entered by a judge of compensation claims

30  approving the attorney's fees as set out in the settlement

31  under this subsection is not considered to be an award and is

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  1  not subject to modification or review. The judge of

  2  compensation claims shall report these settlements to the

  3  Deputy Chief Judge in accordance with the requirements set

  4  forth in paragraphs (a) and (b). Settlements entered into

  5  under this subsection are valid and apply to all dates of

  6  accident.

  7         (d)1.  With respect to any lump-sum settlement under

  8  this subsection, a judge of compensation claims must consider

  9  at the time of the settlement, whether the settlement

10  allocation provides for the appropriate recovery of child

11  support arrearages.

12         2.  When reviewing any settlement of lump-sum payment

13  pursuant to this subsection, judges of compensation claims

14  shall consider the interests of the worker and the worker's

15  family when approving the settlement, which must consider and

16  provide for appropriate recovery of past due support.

17         (e)  This section applies to all claims that the

18  parties have not previously settled, regardless of the date of

19  accident.

20         (12)(a)  Liability of an employer for future payments

21  of compensation may not be discharged by advance payment

22  unless prior approval of a judge of compensation claims or the

23  department division has been obtained as hereinafter provided.

24  The approval shall not constitute an adjudication of the

25  claimant's percentage of disability.

26         (b)  When the claimant has reached maximum recovery and

27  returned to her or his former or equivalent employment with no

28  substantial reduction in wages, such approval of a reasonable

29  advance payment of a part of the compensation payable to the

30  claimant may be given informally by letter by a judge of

31

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  1  compensation claims or, by the department division director,

  2  or by the administrator of claims of the division.

  3         (c)  In the event the claimant has not returned to the

  4  same or equivalent employment with no substantial reduction in

  5  wages or has suffered a substantial loss of earning capacity

  6  or a physical impairment, actual or apparent:

  7         1.  An advance payment of compensation not in excess of

  8  $2,000 may be approved informally by letter, without hearing,

  9  by any judge of compensation claims or the Chief Judge.

10         2.  An advance payment of compensation not in excess of

11  $2,000 may be ordered by any judge of compensation claims

12  after giving the interested parties an opportunity for a

13  hearing thereon pursuant to not less than 10 days' notice by

14  mail, unless such notice is waived, and after giving due

15  consideration to the interests of the person entitled thereto.

16  When the parties have stipulated to an advance payment of

17  compensation not in excess of $2,000, such advance may be

18  approved by an order of a judge of compensation claims, with

19  or without hearing, or informally by letter by any such judge

20  of compensation claims, or by the department division

21  director, if such advance is found to be for the best

22  interests of the person entitled thereto.

23         3.  When the parties have stipulated to an advance

24  payment in excess of $2,000, subject to the approval of the

25  department division, such payment may be approved by a judge

26  of compensation claims by order if the judge finds that such

27  advance payment is for the best interests of the person

28  entitled thereto and is reasonable under the circumstances of

29  the particular case. The judge of compensation claims shall

30  make or cause to be made such investigations as she or he

31  considers necessary concerning the stipulation and, in her or

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  1  his discretion, may have an investigation of the matter made

  2  by the Department of Education Rehabilitation Section of the

  3  division. The stipulation and the report of any investigation

  4  shall be deemed a part of the record of the proceedings.

  5         (d)  When an application for an advance payment in

  6  excess of $2,000 is opposed by the employer or carrier, it

  7  shall be heard by a judge of compensation claims after giving

  8  the interested parties not less than 10 days' notice of such

  9  hearing by mail, unless such notice is waived. In her or his

10  discretion, the judge of compensation claims may have an

11  investigation of the matter made by the Department of

12  Education Rehabilitation Section of the division, in which

13  event the report and recommendation of that section will be

14  deemed a part of the record of the proceedings. If the judge

15  of compensation claims finds that such advance payment is for

16  the best interests of the person entitled to compensation,

17  will not materially prejudice the rights of the employer and

18  carrier, and is reasonable under the circumstances of the

19  case, she or he may order the same paid. However, in no event

20  may any such advance payment under this paragraph be granted

21  in excess of $7,500 or 26 weeks of benefits in any 48-month

22  period, whichever is greater, from the date of the last

23  advance payment.

24         (15)(a)  The department division shall examine on an

25  ongoing basis claims files in accordance with ss. 624.3161 and

26  624.310(5) and this chapter in order to identify questionable

27  claims-handling techniques, questionable patterns or practices

28  of claims, or a pattern of repeated unreasonably controverted

29  claims by employers, carriers, as defined in s. 440.02,

30  self-insurers, health care providers, health care facilities,

31  training and education providers, or any others providing

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  1  services to employees pursuant to this chapter and may certify

  2  its findings to the Department of Insurance. If the department

  3  finds such questionable techniques, patterns, or repeated

  4  unreasonably controverted claims as constitute a general

  5  business practice of a carrier, as defined in s. 440.02 in the

  6  judgment of the division shall be certified in its findings by

  7  the division to the Department of Insurance or such other

  8  appropriate licensing agency. Such certification by the

  9  division is exempt from the provisions of chapter 120. Upon

10  receipt of any such certification, the department of Insurance

11  shall take appropriate action so as to bring such general

12  business practices to a halt pursuant to s. 440.38(3)(a) or

13  may impose penalties pursuant to s. 624.4211. The department

14  division may initiate investigations of questionable

15  techniques, patterns, practices, or repeated unreasonably

16  controverted claims. The department division may by rule

17  establish forms and procedures for corrective action plans and

18  for auditing carriers.

19         (b)  As to any examination, investigation, or hearing

20  being conducted under this chapter, the Insurance Commissioner

21  or his or her Secretary of Labor and Employment Security or

22  the secretary's designee:

23         1.  May administer oaths, examine and cross-examine

24  witnesses, receive oral and documentary evidence; and

25         2.  Shall have the power to subpoena witnesses, compel

26  their attendance and testimony, and require by subpoena the

27  production of books, papers, records, files, correspondence,

28  documents, or other evidence which is relevant to the inquiry.

29         (c)  If any person refuses to comply with any such

30  subpoena or to testify as to any matter concerning which she

31  or he may be lawfully interrogated, the Circuit Court of Leon

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  1  County or of the county wherein such examination,

  2  investigation, or hearing is being conducted, or of the county

  3  wherein such person resides, may, on the application of the

  4  department, issue an order requiring such person to comply

  5  with the subpoena and to testify.

  6         (d)  Subpoenas shall be served, and proof of such

  7  service made, in the same manner as if issued by a circuit

  8  court. Witness fees, costs, and reasonable travel expenses, if

  9  claimed, shall be allowed the same as for testimony in a

10  circuit court.

11         (e)  The department division shall publish annually a

12  report which indicates the promptness of first payment of

13  compensation records of each carrier or self-insurer so as to

14  focus attention on those carriers or self-insurers with poor

15  payment records for the preceding year. A copy of such report

16  shall be certified to The department of Insurance which shall

17  take appropriate steps so as to cause such poor carrier

18  payment practices to halt pursuant to s. 440.38(3)(a). In

19  addition, the department division shall take appropriate

20  action so as to halt such poor payment practices of

21  self-insurers. "Poor payment practice" means a practice of

22  late payment sufficient to constitute a general business

23  practice.

24         (f)  The department division shall promulgate rules

25  providing guidelines to carriers, as defined in s. 440.02,

26  self-insurers, and employers to indicate behavior that may be

27  construed as questionable claims-handling techniques,

28  questionable patterns of claims, repeated unreasonably

29  controverted claims, or poor payment practices.

30         (16)  No penalty assessed under this section may be

31  recouped by any carrier or self-insurer in the rate base, the

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  1  premium, or any rate filing. In the case of carriers, The

  2  Department of Insurance shall enforce this subsection; and in

  3  the case of self-insurers, the  division shall enforce this

  4  subsection.

  5         (17)  The department division may by rule establish

  6  audit procedures and set standards for the Automated Carrier

  7  Performance System.

  8         Section 33.  Subsections (1) and (2) of section

  9  440.207, Florida Statutes, are amended to read:

10         440.207  Workers' compensation system guide.--

11         (1)  The department Division of Workers' Compensation

12  of the Department of Labor and Employment Security shall

13  educate all persons providing or receiving benefits pursuant

14  to this chapter as to their rights and responsibilities under

15  this chapter.

16         (2)  The department division shall publish an

17  understandable guide to the workers' compensation system which

18  shall contain an explanation of benefits provided; services

19  provided by the Employee Assistance and Ombudsman Office;

20  procedures regarding mediation, the hearing process, and civil

21  and criminal penalties; relevant rules of the department

22  division; and such other information as the department

23  division believes will inform employees, employers, carriers,

24  and those providing services pursuant to this chapter of their

25  rights and responsibilities under this chapter and the rules

26  of the department division. For the purposes of this

27  subsection, a guide is understandable if the text of the guide

28  is written at a level of readability not exceeding the eighth

29  grade level, as determined by a recognized readability test.

30         Section 34.  Subsection (1) of section 440.211, Florida

31  Statutes, is amended to read:

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  1         440.211  Authorization of collective bargaining

  2  agreement.--

  3         (1)  Subject to the limitation stated in subsection

  4  (2), a provision that is mutually agreed upon in any

  5  collective bargaining agreement filed with the department

  6  division between an individually self-insured employer or

  7  other employer upon consent of the employer's carrier and a

  8  recognized or certified exclusive bargaining representative

  9  establishing any of the following shall be valid and binding:

10         (a)  An alternative dispute resolution system to

11  supplement, modify, or replace the provisions of this chapter

12  which may include, but is not limited to, conciliation,

13  mediation, and arbitration. Arbitration held pursuant to this

14  section shall be binding on the parties.

15         (b)  The use of an agreed-upon list of certified health

16  care providers of medical treatment which may be the exclusive

17  source of all medical treatment under this chapter.

18         (c)  The use of a limited list of physicians to conduct

19  independent medical examinations which the parties may agree

20  shall be the exclusive source of independent medical examiners

21  pursuant to this chapter.

22         (d)  A light-duty, modified-job, or return-to-work

23  program.

24         (e)  A vocational rehabilitation or retraining program.

25         Section 35.  Subsections (1), (2), and (3) of section

26  440.24, Florida Statutes, are amended to read:

27         440.24  Enforcement of compensation orders;

28  penalties.--

29         (1)  In case of default by the employer or carrier in

30  the payment of compensation due under any compensation order

31  of a judge of compensation claims or other failure by the

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  1  employer or carrier to comply with such order within 10 days

  2  after the order becomes final, any circuit court of this state

  3  within the jurisdiction of which the employer or carrier

  4  resides or transacts business shall, upon application by the

  5  department division or any beneficiary under such order, have

  6  jurisdiction to issue a rule nisi directing such employer or

  7  carrier to show cause why a writ of execution, or such other

  8  process as may be necessary to enforce the terms of such

  9  order, shall not be issued, and, unless such cause is shown,

10  the court shall have jurisdiction to issue a writ of execution

11  or such other process or final order as may be necessary to

12  enforce the terms of such order of the judge of compensation

13  claims.

14         (2)  In any case where the employer is insured and the

15  carrier fails to comply with any compensation order of a judge

16  of compensation claims or court within 10 days after such

17  order becomes final, the division shall notify the department

18  of Insurance of such failure, and the Department of Insurance

19  shall thereupon suspend the license of such carrier to do an

20  insurance business in this state, until such carrier has

21  complied with such order.

22         (3)  In any case where the employer is a self-insurer

23  and fails to comply with any compensation order of a judge of

24  compensation claims or court within 10 days after such order

25  becomes final, the department division may suspend or revoke

26  any authorization previously given to the employer to become a

27  self-insurer, and the department division may sell such of the

28  securities deposited by such self-insurer with the department

29  division as may be necessary to satisfy such order.

30         Section 36.  Subsections (5) and (7) of section 440.25,

31  Florida Statutes, are amended to read:

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  1         440.25  Procedures for mediation and hearings.--

  2         (5)(a)  Procedures with respect to appeals from orders

  3  of judges of compensation claims shall be governed by rules

  4  adopted by the Supreme Court. Such an order shall become final

  5  30 days after mailing of copies of such order to the parties,

  6  unless appealed pursuant to such rules.

  7         (b)  An appellant may be relieved of any necessary

  8  filing fee by filing a verified petition of indigency for

  9  approval as provided in s. 57.081(1) and may be relieved in

10  whole or in part from the costs for preparation of the record

11  on appeal if, within 15 days after the date notice of the

12  estimated costs for the preparation is served, the appellant

13  files with the judge of compensation claims a copy of the

14  designation of the record on appeal, and a verified petition

15  to be relieved of costs. A verified petition filed prior to

16  the date of service of the notice of the estimated costs shall

17  be deemed not timely filed. The verified petition relating to

18  record costs shall contain a sworn statement that the

19  appellant is insolvent and a complete, detailed, and sworn

20  financial affidavit showing all the appellant's assets,

21  liabilities, and income. Failure to state in the affidavit all

22  assets and income, including marital assets and income, shall

23  be grounds for denying the petition with prejudice. The Office

24  of the Judges of Compensation Claims shall adopt rules as may

25  be required pursuant to this subsection, including forms for

26  use in all petitions brought under this subsection. The

27  appellant's attorney, or the appellant if she or he is not

28  represented by an attorney, shall include as a part of the

29  verified petition relating to record costs an affidavit or

30  affirmation that, in her or his opinion, the notice of appeal

31  was filed in good faith and that there is a probable basis for

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  1  the District Court of Appeal, First District, to find

  2  reversible error, and shall state with particularity the

  3  specific legal and factual grounds for the opinion. Failure to

  4  so affirm shall be grounds for denying the petition. A copy of

  5  the verified petition relating to record costs shall be served

  6  upon all interested parties. The judge of compensation claims

  7  shall promptly conduct a hearing on the verified petition

  8  relating to record costs, giving at least 15 days' notice to

  9  the appellant, the department division, and all other

10  interested parties, all of whom shall be parties to the

11  proceedings. The judge of compensation claims may enter an

12  order without such hearing if no objection is filed by an

13  interested party within 20 days from the service date of the

14  verified petition relating to record costs. Such proceedings

15  shall be conducted in accordance with the provisions of this

16  section and with the workers' compensation rules of procedure,

17  to the extent applicable. In the event an insolvency petition

18  is granted, the judge of compensation claims shall direct the

19  department division to pay record costs and filing fees from

20  the Workers' Compensation Administrative Trust Fund pending

21  final disposition of the costs of appeal. The department

22  division may transcribe or arrange for the transcription of

23  the record in any proceeding for which it is ordered to pay

24  the cost of the record.

25         (c)  As a condition of filing a notice of appeal to the

26  District Court of Appeal, First District, an employer who has

27  not secured the payment of compensation under this chapter in

28  compliance with s. 440.38 shall file with the notice of appeal

29  a good and sufficient bond, as provided in s. 59.13,

30  conditioned to pay the amount of the demand and any interest

31  and costs payable under the terms of the order if the appeal

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  1  is dismissed, or if the District Court of Appeal, First

  2  District, affirms the award in any amount. Upon the failure of

  3  such employer to file such bond with the judge of compensation

  4  claims or the District Court of Appeal, First District, along

  5  with the notice of appeal, the District Court of Appeal, First

  6  District, shall dismiss the notice of appeal.

  7         (7)  An injured employee claiming or entitled to

  8  compensation shall submit to such physical examination by a

  9  certified expert medical advisor approved by the department

10  division or the judge of compensation claims as the department

11  division or the judge of compensation claims may require. The

12  place or places shall be reasonably convenient for the

13  employee. Such physician or physicians as the employee,

14  employer, or carrier may select and pay for may participate in

15  an examination if the employee, employer, or carrier so

16  requests. Proceedings shall be suspended and no compensation

17  shall be payable for any period during which the employee may

18  refuse to submit to examination. Any interested party shall

19  have the right in any case of death to require an autopsy, the

20  cost thereof to be borne by the party requesting it; and the

21  judge of compensation claims shall have authority to order and

22  require an autopsy and may, in her or his discretion, withhold

23  her or his findings and award until an autopsy is held.

24         Section 37.  Section 440.271, Florida Statutes, is

25  amended to read:

26         440.271  Appeal of order of judge of compensation

27  claims.--Review of any order of a judge of compensation claims

28  entered pursuant to this chapter shall be by appeal to the

29  District Court of Appeal, First District.  Appeals shall be

30  filed in accordance with rules of procedure prescribed by the

31  Supreme Court for review of such orders. The department

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  1  division shall be given notice of any proceedings pertaining

  2  to s. 440.25, regarding indigency, or s. 440.49, regarding the

  3  Special Disability Trust Fund, and shall have the right to

  4  intervene in any proceedings.

  5         Section 38.  Section 440.345, Florida Statutes, is

  6  amended to read:

  7         440.345  Reporting of attorney's fees.--All fees paid

  8  to attorneys for services rendered under this chapter shall be

  9  reported to the Office of the Judges of Compensation Claims as

10  the Division of Administrative Hearings Office of the Judges

11  of Compensation Claims requires by rule. The Office of the

12  Judges of Compensation Claims shall annually summarize such

13  data in a report to the Workers' Compensation Oversight Board.

14         Section 39.  Section 440.35, Florida Statutes, is

15  amended to read:

16         440.35  Record of injury or death.--Every employer

17  shall keep a record in respect of any injury to an employee.

18  Such record shall contain such information of disability or

19  death in respect of such injury as the department division may

20  by regulation require, and shall be available to inspection by

21  the department division or by any state authority at such time

22  and under such conditions as the department division may by

23  regulation prescribe.

24         Section 40.  Subsections (1), (2), and (3) of section

25  440.38, Florida Statutes, are amended to read:

26         440.38  Security for compensation; insurance carriers

27  and self-insurers.--

28         (1)  Every employer shall secure the payment of

29  compensation under this chapter:

30         (a)  By insuring and keeping insured the payment of

31  such compensation with any stock company or mutual company or

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  1  association or exchange, authorized to do business in the

  2  state;

  3         (b)  By furnishing satisfactory proof to the department

  4  division of its financial ability to pay such compensation

  5  individually and on behalf of its subsidiary and affiliated

  6  companies with employees in this state and receiving an

  7  authorization from the department division to pay such

  8  compensation directly in accordance with the following

  9  provisions:

10         1.  The department division may require an employer to

11  deposit with the department division a qualifying security

12  deposit. The department division shall determine the type and

13  amount of the qualifying security deposit and shall prescribe

14  conditions for the qualifying security deposit, which shall

15  include authorization for the department division to call the

16  qualifying security deposit in the case of default. In

17  addition, the department division shall require, as a

18  condition to authorization to self-insure, proof that the

19  employer has provided for competent personnel with whom to

20  deliver benefits and to provide a safe working environment.

21  Further, the department division shall require such employer

22  to carry reinsurance at levels that will ensure the actuarial

23  soundness of such employer in accordance with rules adopted

24  promulgated by the department division.  The department

25  division may by rule require that, in the event of an

26  individual self-insurer's insolvency, such qualifying security

27  deposits and reinsurance policies are payable to the Florida

28  Self-Insurers Guaranty Association, Incorporated, created

29  pursuant to s. 440.385.  Any employer securing compensation in

30  accordance with the provisions of this paragraph shall be

31

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  1  known as a self-insurer and shall be classed as a carrier of

  2  her or his own insurance.

  3         2.  If the employer fails to maintain the foregoing

  4  requirements, the department division shall revoke the

  5  employer's authority to self-insure, unless the employer

  6  provides to the department division the certified opinion of

  7  an independent actuary who is a member of the American Academy

  8  Society of Actuaries as to the actuarial present value of the

  9  employer's determined and estimated future compensation

10  payments based on cash reserves, using a 4-percent discount

11  rate, and a qualifying security deposit equal to 1.5 times the

12  value so certified. The employer shall thereafter annually

13  provide such a certified opinion until such time as the

14  employer meets the requirements of subparagraph 1.  The

15  qualifying security deposit shall be adjusted at the time of

16  each such annual report.  Upon the failure of the employer to

17  timely provide such opinion or to timely provide a security

18  deposit in an amount equal to 1.5 times the value certified in

19  the latest opinion, the department division shall then revoke

20  such employer's authorization to self-insure, and such failure

21  shall be deemed to constitute an immediate serious danger to

22  the public health, safety, or welfare sufficient to justify

23  the summary suspension of the employer's authorization to

24  self-insure pursuant to s. 120.68.

25         3.  Upon the suspension or revocation of the employer's

26  authorization to self-insure, the employer shall provide to

27  the department division and to the Florida Self-Insurers

28  Guaranty Association, Incorporated, created pursuant to s.

29  440.385 the certified opinion of an independent actuary who is

30  a member of the American Academy Society of Actuaries of the

31  actuarial present value of the determined and estimated future

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  1  compensation payments of the employer for claims incurred

  2  while the member exercised the privilege of self-insurance,

  3  using a discount rate of 4 percent. The employer shall provide

  4  such an opinion at 6-month intervals thereafter until such

  5  time as the latest opinion shows no remaining value of claims.

  6  With each such opinion, the employer shall deposit with the

  7  department division a qualifying security deposit in an amount

  8  equal to the value certified by the actuary.  The association

  9  has a cause of action against an employer, and against any

10  successor of the employer, who fails to timely provide such

11  opinion or who fails to timely maintain the required security

12  deposit with the department division. The association shall

13  recover a judgment in the amount of the actuarial present

14  value of the determined and estimated future compensation

15  payments of the employer for claims incurred while the

16  employer exercised the privilege of self-insurance, together

17  with attorney's fees.  For purposes of this section, the

18  successor of an employer means any person, business entity, or

19  group of persons or business entities, which holds or acquires

20  legal or beneficial title to the majority of the assets or the

21  majority of the shares of the employer.

22         4.  A qualifying security deposit shall consist, at the

23  option of the employer, of:

24         a.  Surety bonds, in a form and containing such terms

25  as prescribed by the department division, issued by a

26  corporation surety authorized to transact surety business by

27  the Department of Insurance, and whose policyholders' and

28  financial ratings, as reported in A.M. Best's Insurance

29  Reports, Property-Liability, are not less than "A" and "V",

30  respectively.

31

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  1         b.  Irrevocable letters of credit in favor of the

  2  department division issued by financial institutions located

  3  within this state, the deposits of which are insured through

  4  the Federal Deposit Insurance Corporation.

  5         5.  The qualifying security deposit shall be held by

  6  the department division exclusively for the benefit of

  7  workers' compensation claimants. The security shall not be

  8  subject to assignment, execution, attachment, or any legal

  9  process whatsoever, except as necessary to guarantee the

10  payment of compensation under this chapter.  No surety bond

11  may be terminated, and no letter of credit may be allowed to

12  expire, without 90 days' prior notice to the department

13  division and deposit by the self-insuring employer of some

14  other qualifying security deposit of equal value within 10

15  business days after such notice. Failure to provide such

16  notice or failure to timely provide qualifying replacement

17  security after such notice shall constitute grounds for the

18  department division to call or sue upon the surety bond or to

19  exercise its rights under a letter of credit. Current

20  self-insured employers must comply with this section on or

21  before December 31, 2001, or upon the maturity of existing

22  security deposits, whichever occurs later. The department

23  division may specify by rule the amount of the qualifying

24  security deposit required prior to authorizing an employer to

25  self-insure and the amount of net worth required for an

26  employer to qualify for authorization to self-insure;

27         (c)  By entering into a contract with a public utility

28  under an approved utility-provided self-insurance program as

29  set forth in s. 624.46225 in effect as of July 1, 1983.  The

30  department division shall adopt rules to implement this

31  paragraph;

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  1         (d)  By entering into an interlocal agreement with

  2  other local governmental entities to create a local government

  3  pool pursuant to s. 624.4622;

  4         (e)  In accordance with s. 440.135, an employer, other

  5  than a local government unit, may elect coverage under the

  6  Workers' Compensation Law and retain the benefit of the

  7  exclusiveness of liability provided in s. 440.11 by obtaining

  8  a 24-hour health insurance policy from an authorized property

  9  and casualty insurance carrier or an authorized life and

10  health insurance carrier, or by participating in a fully or

11  partially self-insured 24-hour health plan that is established

12  or maintained by or for two or more employers, so long as the

13  law of this state is not preempted by the Employee Retirement

14  Income Security Act of 1974, Pub. L. No. 93-406, or any

15  amendment to that law, which policy or plan must provide, for

16  at least occupational injuries and illnesses, medical benefits

17  that are comparable to those required by this chapter. A local

18  government unit, as a single employer, in accordance with s.

19  440.135, may participate in the 24-hour health insurance

20  coverage plan referenced in this paragraph. Disputes and

21  remedies arising under policies issued under this section are

22  governed by the terms and conditions of the policies and under

23  the applicable provisions of the Florida Insurance Code and

24  rules adopted under the insurance code and other applicable

25  laws of this state. The 24-hour health insurance policy may

26  provide for health care by a health maintenance organization

27  or a preferred provider organization. The premium for such

28  24-hour health insurance policy shall be paid entirely by the

29  employer. The 24-hour health insurance policy may use

30  deductibles and coinsurance provisions that require the

31  employee to pay a portion of the actual medical care received

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  1  by the employee. If an employer obtains a 24-hour health

  2  insurance policy or self-insured plan to secure payment of

  3  compensation as to medical benefits, the employer must also

  4  obtain an insurance policy or policies that provide indemnity

  5  benefits as follows:

  6         1.  If indemnity benefits are provided only for

  7  occupational-related disability, such benefits must be

  8  comparable to those required by this chapter.

  9         2.  If indemnity benefits are provided for both

10  occupational-related and nonoccupational-related disability,

11  such benefits must be comparable to those required by this

12  chapter, except that they must be based on 60 percent of the

13  average weekly wages.

14         3.  The employer shall provide for each of its

15  employees life insurance with a death benefit of $100,000.

16         4.  Policies providing coverage under this subsection

17  must use prescribed and acceptable underwriting standards,

18  forms, and policies approved by the Department of Insurance.

19  If any insurance policy that provides coverage under this

20  section is canceled, terminated, or nonrenewed for any reason,

21  the cancellation, termination, or nonrenewal is ineffective

22  until the self-insured employer or insurance carrier or

23  carriers notify the division and the Department of Insurance

24  of the cancellation, termination, or nonrenewal, and until the

25  department division has actually received the notification.

26  The division must be notified of replacement coverage under a

27  workers' compensation and employer's liability insurance

28  policy or plan by the employer prior to the effective date of

29  the cancellation, termination, or nonrenewal; or

30         (f)  By entering into a contract with an individual

31  self-insurer under an approved individual

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  1  self-insurer-provided self-insurance program as set forth in

  2  s. 624.46225.  The department division may adopt rules to

  3  administer this subsection.

  4         (2)(a)  The department division shall adopt rules by

  5  which businesses may become qualified to provide underwriting

  6  claims-adjusting, loss control, and safety engineering

  7  services to self-insurers.

  8         (b)  The department division shall adopt rules

  9  requiring self-insurers to file any reports necessary to

10  fulfill the requirements of this chapter.  Any self-insurer

11  who fails to file any report as prescribed by the rules

12  adopted by the department division shall be subject to a civil

13  penalty not to exceed $100 for each such failure.

14         (3)(a)  The license of any stock company or mutual

15  company or association or exchange authorized to do insurance

16  business in the state shall for good cause, upon

17  recommendation of the division, be suspended or revoked by the

18  Department of Insurance.  No suspension or revocation shall

19  affect the liability of any carrier already incurred.

20         (b)  The department division shall suspend or revoke

21  any authorization to a self-insurer for good cause, as defined

22  by rule of the department division. No suspension or

23  revocation shall affect the liability of any self-insurer

24  already incurred.

25         (c)  Violation of s. 440.381 by a self-insurance fund

26  shall result in the imposition of a fine not to exceed $1,000

27  per audit if the self-insurance fund fails to act on said

28  audits by correcting errors in employee classification or

29  accepted applications for coverage where it knew employee

30  classifications were incorrect.  Such fines shall be levied by

31

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  1  the department division and deposited into the Workers'

  2  Compensation Administration Trust Fund.

  3         Section 41.  Subsections (3) and (7) of section

  4  440.381, Florida Statutes, are amended to read:

  5         440.381  Application for coverage; reporting payroll;

  6  payroll audit procedures; penalties.--

  7         (3)  The department of Insurance and the Department of

  8  Labor and Employment Security shall establish by rule minimum

  9  requirements for audits of payroll and classifications in

10  order to ensure that the appropriate premium is charged for

11  workers' compensation coverage. The rules shall ensure that

12  audits performed by both carriers and employers are adequate

13  to provide that all sources of payments to employees,

14  subcontractors, and independent contractors have been reviewed

15  and that the accuracy of classification of employees has been

16  verified. The rules shall provide that employers in all

17  classes other than the construction class be audited not less

18  frequently than biennially and may provide for more frequent

19  audits of employers in specified classifications based on

20  factors such as amount of premium, type of business, loss

21  ratios, or other relevant factors. In no event shall employers

22  in the construction class, generating more than the amount of

23  premium required to be experience rated, be audited less than

24  annually. The annual audits required for construction classes

25  shall consist of physical onsite audits. Payroll verification

26  audit rules must include, but need not be limited to, the use

27  of state and federal reports of employee income, payroll and

28  other accounting records, certificates of insurance maintained

29  by subcontractors, and duties of employees.

30         (7)  If an employee suffering a compensable injury was

31  not reported as earning wages on the last quarterly earnings

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  1  report filed with the Division of Unemployment Compensation

  2  before the accident, the employer shall indemnify the carrier

  3  for all workers' compensation benefits paid to or on behalf of

  4  the employee unless the employer establishes that the employee

  5  was hired after the filing of the quarterly report, in which

  6  case the employer and employee shall attest to the fact that

  7  the employee was employed by the employer at the time of the

  8  injury. It shall be the responsibility of the Division of

  9  Workers' Compensation to collect all necessary data so as to

10  enable it to notify the carrier of the name of an injured

11  worker who was not reported as earning wages on the last

12  quarterly earnings report. The division is hereby authorized

13  to release such records to the carrier which will enable the

14  carrier to seek reimbursement as provided under this

15  subsection. Failure of the employer to indemnify the insurer

16  within 21 days after demand by the insurer shall constitute

17  grounds for the insurer to immediately cancel coverage.  Any

18  action for indemnification brought by the carrier shall be

19  cognizable in the circuit court having jurisdiction where the

20  employer or carrier resides or transacts business.  The

21  insurer shall be entitled to a reasonable attorney's fee if it

22  recovers any portion of the benefits paid in such action.

23         Section 42.  Subsections (1), (2), (3), (4), (5), (6),

24  (8), (9), and (10) of section 440.385, Florida Statutes, are

25  amended to read:

26         440.385  Florida Self-Insurers Guaranty Association,

27  Incorporated.--

28         (1)  CREATION OF ASSOCIATION.--

29         (a)  There is created a nonprofit corporation to be

30  known as the "Florida Self-Insurers Guaranty Association,

31  Incorporated," hereinafter referred to as "the association."

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  1  Upon incorporation of the association, all individual

  2  self-insurers as defined in ss. 440.02(23)(a) and

  3  440.38(1)(b), other than individual self-insurers which are

  4  public utilities or governmental entities, shall be members of

  5  the association as a condition of their authority to

  6  individually self-insure in this state.  The association shall

  7  perform its functions under a plan of operation as established

  8  and approved under subsection (5) and shall exercise its

  9  powers and duties through a board of directors as established

10  under subsection (2). The corporation shall have those powers

11  granted or permitted corporations not for profit, as provided

12  in chapter 617.

13         (b)  A member may voluntarily withdraw from the

14  association when the member voluntarily terminates the

15  self-insurance privilege and pays all assessments due to the

16  date of such termination.  However, the withdrawing member

17  shall continue to be bound by the provisions of this section

18  relating to the period of his or her membership and any claims

19  charged pursuant thereto.  The withdrawing member who is a

20  member on or after January 1, 1991, shall also be required to

21  provide to the department division upon withdrawal, and at

22  12-month intervals thereafter, satisfactory proof that it

23  continues to meet the standards of s. 440.38(1)(b)1. in

24  relation to claims incurred while the withdrawing member

25  exercised the privilege of self-insurance. Such reporting

26  shall continue until the withdrawing member satisfies the

27  department division that there is no remaining value to claims

28  incurred while the withdrawing member was self-insured.  If

29  during this reporting period the withdrawing member fails to

30  meet the standards of s. 440.38(1)(b)1., the withdrawing

31  member who is a member on or after January 1, 1991, shall

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  1  thereupon, and at 6-month intervals thereafter, provide to the

  2  department division and the association the certified opinion

  3  of an independent actuary who is a member of the American

  4  Academy Society of Actuaries of the actuarial present value of

  5  the determined and estimated future compensation payments of

  6  the member for claims incurred while the member was a

  7  self-insurer, using a discount rate of 4 percent.  With each

  8  such opinion, the withdrawing member shall deposit with the

  9  department division security in an amount equal to the value

10  certified by the actuary and of a type that is acceptable for

11  qualifying security deposits under s. 440.38(1)(b).  The

12  withdrawing member shall continue to provide such opinions and

13  to provide such security until such time as the latest opinion

14  shows no remaining value of claims.  The association has a

15  cause of action against a withdrawing member, and against any

16  successor of a withdrawing member, who fails to timely provide

17  the required opinion or who fails to maintain the required

18  deposit with the department division.  The association shall

19  be entitled to recover a judgment in the amount of the

20  actuarial present value of the determined and estimated future

21  compensation payments of the withdrawing member for claims

22  incurred during the time that the withdrawing member exercised

23  the privilege of self-insurance, together with reasonable

24  attorney's fees.  For purposes of this section, the successor

25  of a withdrawing member means any person, business entity, or

26  group of persons or business entities, which holds or acquires

27  legal or beneficial title to the majority of the assets or the

28  majority of the shares of the withdrawing member.

29         (2)  BOARD OF DIRECTORS.--The board of directors of the

30  association shall consist of nine persons and shall be

31  organized as established in the plan of operation.  With

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  1  respect to initial appointments, the Secretary of Labor and

  2  Employment Security shall, by July 15, 1982, approve and

  3  appoint to the board persons who are experienced with

  4  self-insurance in this state and who are recommended by the

  5  individual self-insurers in this state required to become

  6  members of the association pursuant to the provisions of

  7  paragraph (1)(a). In the event the secretary finds that any

  8  person so recommended does not have the necessary

  9  qualifications for service on the board and a majority of the

10  board has been appointed, the secretary shall request the

11  directors thus far approved and appointed to recommend another

12  person for appointment to the board.  Each director shall

13  serve for a 4-year term and may be reappointed.  Appointments

14  after June 30, 2002, other than initial appointments shall be

15  made by the Insurance Commissioner Secretary of Labor and

16  Employment Security upon recommendation of members of the

17  association.  Any vacancy on the board shall be filled for the

18  remaining period of the term in the same manner as

19  appointments other than initial appointments are made. Each

20  director shall be reimbursed for expenses incurred in carrying

21  out the duties of the board on behalf of the association.

22         (3)  POWERS AND DUTIES.--

23         (a)  Upon creation of the Insolvency Fund pursuant to

24  the provisions of subsection (4), the association is obligated

25  for payment of compensation under this chapter to insolvent

26  members' employees resulting from incidents and injuries

27  existing prior to the member becoming an insolvent member and

28  from incidents and injuries occurring within 30 days after the

29  member has become an insolvent member, provided the incidents

30  giving rise to claims for compensation under this chapter

31  occur during the year in which such insolvent member is a

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  1  member of the guaranty fund and was assessable pursuant to the

  2  plan of operation, and provided the employee makes timely

  3  claim for such payments according to procedures set forth by a

  4  court of competent jurisdiction over the delinquency or

  5  bankruptcy proceedings of the insolvent member. Such

  6  obligation includes only that amount due the injured worker or

  7  workers of the insolvent member under this chapter.  In no

  8  event is the association obligated to a claimant in an amount

  9  in excess of the obligation of the insolvent member.  The

10  association shall be deemed the insolvent employer for

11  purposes of this chapter to the extent of its obligation on

12  the covered claims and, to such extent, shall have all rights,

13  duties, and obligations of the insolvent employer as if the

14  employer had not become insolvent. However, in no event shall

15  the association be liable for any penalties or interest.

16         (b)  The association may:

17         1.  Employ or retain such persons as are necessary to

18  handle claims and perform other duties of the association.

19         2.  Borrow funds necessary to effect the purposes of

20  this section in accord with the plan of operation.

21         3.  Sue or be sued.

22         4.  Negotiate and become a party to such contracts as

23  are necessary to carry out the purposes of this section.

24         5.  Purchase such reinsurance as is determined

25  necessary pursuant to the plan of operation.

26         6.  Review all applicants for membership in the

27  association.  Prior to a final determination by the department

28  Division of Workers' Compensation as to whether or not to

29  approve any applicant for membership in the association, the

30  association may issue opinions to the department division

31

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  1  concerning any applicant, which opinions shall be considered

  2  by the department division prior to any final determination.

  3         7.  Charge fees to any member of the association to

  4  cover the actual costs of examining the financial and safety

  5  conditions of that member.

  6         8.  Charge an applicant for membership in the

  7  association a fee sufficient to cover the actual costs of

  8  examining the financial condition of the applicant.

  9         (c)1.  To the extent necessary to secure funds for the

10  payment of covered claims and also to pay the reasonable costs

11  to administer them, the department of Labor and Employment

12  Security, upon certification of the board of directors, shall

13  levy assessments based on the annual normal premium each

14  employer would have paid had the employer not been

15  self-insured.  Every assessment shall be made as a uniform

16  percentage of the figure applicable to all individual

17  self-insurers, provided that the assessment levied against any

18  self-insurer in any one year shall not exceed 1 percent of the

19  annual normal premium during the calendar year preceding the

20  date of the assessment. Assessments shall be remitted to and

21  administered by the board of directors in the manner specified

22  by the approved plan.  Each employer so assessed shall have at

23  least 30 days' written notice as to the date the assessment is

24  due and payable.  The association shall levy assessments

25  against any newly admitted member of the association so that

26  the basis of contribution of any newly admitted member is the

27  same as previously admitted members, provision for which shall

28  be contained in the plan of operation.

29         2.  If, in any one year, funds available from such

30  assessments, together with funds previously raised, are not

31  sufficient to make all the payments or reimbursements then

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  1  owing, the funds available shall be prorated, and the unpaid

  2  portion shall be paid as soon thereafter as sufficient

  3  additional funds become available.

  4         3.  No state funds of any kind shall be allocated or

  5  paid to the association or any of its accounts except those

  6  state funds accruing to the association by and through the

  7  assignment of rights of an insolvent employer.

  8         (4)  INSOLVENCY FUND.--Upon the adoption of a plan of

  9  operation or the adoption of rules by the department of Labor

10  and Employment Security pursuant to subsection (5), there

11  shall be created an Insolvency Fund to be managed by the

12  association.

13         (a)  The Insolvency Fund is created for purposes of

14  meeting the obligations of insolvent members incurred while

15  members of the association and after the exhaustion of any

16  bond, as required under this chapter.  However, if such bond,

17  surety, or reinsurance policy is payable to the Florida

18  Self-Insurers Guaranty Association, the association shall

19  commence to provide benefits out of the Insolvency Fund and be

20  reimbursed from the bond, surety, or reinsurance policy.  The

21  method of operation of the Insolvency Fund shall be defined in

22  the plan of operation as provided in subsection (5).

23         (b)  The department shall have the authority to audit

24  the financial soundness of the Insolvency Fund annually.

25         (c)  The department may offer certain amendments to the

26  plan of operation to the board of directors of the association

27  for purposes of assuring the ongoing financial soundness of

28  the Insolvency Fund and its ability to meet the obligations of

29  this section.

30         (d)  The department actuary may make certain

31  recommendations to improve the orderly payment of claims.

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  1         (5)  PLAN OF OPERATION.--The association shall operate

  2  pursuant to a plan of operation approved by the board of

  3  directors. The plan of operation in effect on June 30, 2002,

  4  and approved by the Department of Labor and Employment

  5  Security shall remain in effect until it is subsequently

  6  revised by amendments approved by the Department of Insurance.

  7  By September 15, 1982, the board of directors shall submit to

  8  the Department of Labor and Employment Security a proposed

  9  plan of operation for the administration of the association

10  and the Insolvency Fund.

11         (a)  The purpose of the plan of operation shall be to

12  provide the association and the board of directors with the

13  authority and responsibility to establish the necessary

14  programs and to take the necessary actions to protect against

15  the insolvency of a member of the association.  In addition,

16  the plan shall provide that the members of the association

17  shall be responsible for maintaining an adequate Insolvency

18  Fund to meet the obligations of insolvent members provided for

19  under this act and shall authorize the board of directors to

20  contract and employ those persons with the necessary expertise

21  to carry out this stated purpose.

22         (b)  The plan of operation, and any amendments thereto,

23  shall take effect upon approval in writing by the department.

24  If the board of directors fails to submit a plan by September

25  15, 1982, or fails to make required amendments to the plan

26  within 30 days thereafter, the department shall promulgate

27  such rules as are necessary to effectuate the provisions of

28  this subsection.  Such rules shall continue in force until

29  modified by the department or superseded by a plan submitted

30  by the board of directors and approved by the department.

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  1         (b)(c)  All member employers shall comply with the plan

  2  of operation.

  3         (c)(d)  The plan of operation shall:

  4         1.  Establish the procedures whereby all the powers and

  5  duties of the association under subsection (3) will be

  6  performed.

  7         2.  Establish procedures for handling assets of the

  8  association.

  9         3.  Establish the amount and method of reimbursing

10  members of the board of directors under subsection (2).

11         4.  Establish procedures by which claims may be filed

12  with the association and establish acceptable forms of proof

13  of covered claims.  Notice of claims to the receiver or

14  liquidator of the insolvent employer shall be deemed notice to

15  the association or its agent, and a list of such claims shall

16  be submitted periodically to the association or similar

17  organization in another state by the receiver or liquidator.

18         5.  Establish regular places and times for meetings of

19  the board of directors.

20         6.  Establish procedures for records to be kept of all

21  financial transactions of the association and its agents and

22  the board of directors.

23         7.  Provide that any member employer aggrieved by any

24  final action or decision of the association may appeal to the

25  department within 30 days after the action or decision.

26         8.  Establish the procedures whereby recommendations of

27  candidates for the board of directors shall be submitted to

28  the department.

29         9.  Contain additional provisions necessary or proper

30  for the execution of the powers and duties of the association.

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  1         (d)(e)  The plan of operation may provide that any or

  2  all of the powers and duties of the association, except those

  3  specified under subparagraphs (d)1. and 2., be delegated to a

  4  corporation, association, or other organization which performs

  5  or will perform functions similar to those of this association

  6  or its equivalent in two or more states.  Such a corporation,

  7  association, or organization shall be reimbursed as a

  8  servicing facility would be reimbursed and shall be paid for

  9  its performance of any other functions of the association.  A

10  delegation of powers or duties under this subsection shall

11  take effect only with the approval of both the board of

12  directors and the department and may be made only to a

13  corporation, association, or organization which extends

14  protection which is not substantially less favorable and

15  effective than the protection provided by this section.

16         (6)  POWERS AND DUTIES OF DEPARTMENT OF INSURANCE LABOR

17  AND EMPLOYMENT SECURITY.--

18         (a)  The department shall:

19         1.  Notify the association of the existence of an

20  insolvent employer not later than 3 days after it receives

21  notice of the determination of insolvency.

22         2.  Upon request of the board of directors, provide the

23  association with a statement of the annual normal premiums of

24  each member employer.

25         (b)  The department may:

26         1.  Require that the association notify the member

27  employers and any other interested parties of the

28  determination of insolvency and of their rights under this

29  section.  Such notification shall be by mail at the last known

30  address thereof when available; but, if sufficient information

31  for notification by mail is not available, notice by

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  1  publication in a newspaper of general circulation shall be

  2  sufficient.

  3         2.  Suspend or revoke the authority of any member

  4  employer failing to pay an assessment when due or failing to

  5  comply with the plan of operation to self-insure in this

  6  state. As an alternative, the department may levy a fine on

  7  any member employer failing to pay an assessment when due.

  8  Such fine shall not exceed 5 percent of the unpaid assessment

  9  per month, except that no fine shall be less than $100 per

10  month.

11         3.  Revoke the designation of any servicing facility if

12  the department finds that claims are being handled

13  unsatisfactorily.

14         (8)  PREVENTION OF INSOLVENCIES.--To aid in the

15  detection and prevention of employer insolvencies:

16         (a)  Upon determination by majority vote that any

17  member employer may be insolvent or in a financial condition

18  hazardous to the employees thereof or to the public, it shall

19  be the duty of the board of directors to notify the department

20  of Labor and Employment Security of any information indicating

21  such condition.

22         (b)  The board of directors may, upon majority vote,

23  request that the department determine the condition of any

24  member employer which the board in good faith believes may no

25  longer be qualified to be a member of the association.  Within

26  30 days of the receipt of such request or, for good cause

27  shown, within a reasonable time thereafter, the department

28  shall make such determination and shall forthwith advise the

29  board of its findings. Each request for a determination shall

30  be kept on file by the department, but the request shall not

31

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  1  be open to public inspection prior to the release of the

  2  determination to the public.

  3         (c)  It shall also be the duty of the department to

  4  report to the board of directors when it has reasonable cause

  5  to believe that a member employer may be in such a financial

  6  condition as to be no longer qualified to be a member of the

  7  association.

  8         (d)  The board of directors may, upon majority vote,

  9  make reports and recommendations to the department upon any

10  matter which is germane to the solvency, liquidation,

11  rehabilitation, or conservation of any member employer. Such

12  reports and recommendations shall not be considered public

13  documents.

14         (e)  The board of directors may, upon majority vote,

15  make recommendations to the department for the detection and

16  prevention of employer insolvencies.

17         (f)  The board of directors shall, at the conclusion of

18  any member's insolvency in which the association was obligated

19  to pay covered claims, prepare a report on the history and

20  cause of such insolvency, based on the information available

21  to the association, and shall submit such report to the

22  department.

23         (9)  EXAMINATION OF THE ASSOCIATION.--The association

24  shall be subject to examination and regulation by the

25  department of Labor and Employment Security.  No later than

26  March 30 of each year, the board of directors shall submit a

27  financial report for the preceding calendar year in a form

28  approved by the department.

29         (10)  IMMUNITY.--There shall be no liability on the

30  part of, and no cause of action of any nature shall arise

31  against, any member employer, the association or its agents or

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  1  employees, the board of directors, or the department of Labor

  2  and Employment Security or its representatives for any action

  3  taken by them in the performance of their powers and duties

  4  under this section.

  5         Section 43.  Section 440.40, Florida Statutes, is

  6  amended to read:

  7         440.40  Compensation notice.--Every employer who has

  8  secured compensation under the provisions of this chapter

  9  shall keep posted in a conspicuous place or places in and

10  about her or his place or places of business typewritten or

11  printed notices, in accordance with a form prescribed by the

12  department division, stating that such employer has secured

13  the payment of compensation in accordance with the provisions

14  of this chapter. Such notices shall contain the name and

15  address of the carrier, if any, with whom the employer has

16  secured payment of compensation and the date of the expiration

17  of the policy. The department division may by rule prescribe

18  the form of the notices and require carriers to provide the

19  notices to policyholders.

20         Section 44.  Section 440.41, Florida Statutes, is

21  amended to read:

22         440.41  Substitution of carrier for employer.--In any

23  case where the employer is not a self-insurer, in order that

24  the liability for compensation imposed by this chapter may be

25  most effectively discharged by the employer, and in order that

26  the administration of this chapter in respect of such

27  liability may be facilitated, the department division shall by

28  regulation provide for the discharge, by the carrier for such

29  employer, of such obligations and duties of the employer in

30  respect of such liability, imposed by this chapter upon the

31

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  1  employer, as it considers proper in order to effectuate the

  2  provisions of this chapter.  For such purposes:

  3         (1)  Notice to or knowledge of an employer of the

  4  occurrence of the injury shall be notice to or knowledge of

  5  the carrier.

  6         (2)  Jurisdiction of the employer by the judges of

  7  compensation claims, the department division, or any court

  8  under this chapter shall be jurisdiction of the carrier.

  9         (3)  Any requirement by the judges of compensation

10  claims, the department division, or any court under any

11  compensation order, finding, or decision shall be binding upon

12  the carrier in the same manner and to the same extent as upon

13  the employer.

14         Section 45.  Subsection (3) of section 440.42, Florida

15  Statutes, is amended to read:

16         440.42  Insurance policies; liability.--

17         (3)  No contract or policy of insurance issued by a

18  carrier under this chapter shall expire or be canceled until

19  at least 30 days have elapsed after a notice of cancellation

20  has been sent to the department division and to the employer

21  in accordance with the provisions of s. 440.185(7).  However,

22  when duplicate or dual coverage exists by reason of two

23  different carriers having issued policies of insurance to the

24  same employer securing the same liability, it shall be

25  presumed that only that policy with the later effective date

26  shall be in force and that the earlier policy terminated upon

27  the effective date of the latter.  In the event that both

28  policies carry the same effective date, one of the policies

29  may be canceled instanter upon filing a notice of cancellation

30  with the department division and serving a copy thereof upon

31  the employer in such manner as the department division

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  1  prescribes by rule. The department division may by rule

  2  prescribe the content of the notice of retroactive

  3  cancellation and specify the time, place, and manner in which

  4  the notice of cancellation is to be served.

  5         Section 46.  Section 440.44, Florida Statutes, is

  6  amended to read:

  7         440.44  Workers' compensation; staff organization.--

  8         (1)  INTERPRETATION OF LAW.--As a guide to the

  9  interpretation of this chapter, the Legislature takes due

10  notice of federal social and labor acts and hereby creates an

11  agency to administer such acts passed for the benefit of

12  employees and employers in Florida industry, and desires to

13  meet the requirements of such federal acts wherever not

14  inconsistent with the Constitution and laws of Florida.

15         (2)  INTENT.--It is the intent of the Legislature that

16  the department, the agency, the Department of Education, and

17  the Division of Administrative Hearings assume an active and

18  forceful role in its administration of this act, so as to

19  ensure that the system operates efficiently and with maximum

20  benefit to both employers and employees.

21         (3)  EXPENDITURES.--The department, the agency, the

22  Department of Education, division and the director of the

23  Division of Administrative Hearings shall make such

24  expenditures, including expenditures for personal services and

25  rent at the seat of government and elsewhere, for law books;

26  for telephone services and WATS lines; for books of reference,

27  periodicals, equipment, and supplies; and for printing and

28  binding as may be necessary in the administration of this

29  chapter.  All expenditures in the administration of this

30  chapter shall be allowed and paid as provided in s. 440.50

31  upon the presentation of itemized vouchers therefor approved

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  1  by the department, the agency, the Department of Education,

  2  division or the director of the Division of Administrative

  3  Hearings.

  4         (4)  MERIT SYSTEM PRINCIPLE OF PERSONNEL

  5  ADMINISTRATION.--Subject to the other provisions of this

  6  chapter, the division is authorized to appoint, and prescribe

  7  the duties and powers of, bureau chiefs, attorneys,

  8  accountants, medical advisers, technical assistants,

  9  inspectors, claims examiners, and such other employees as may

10  be necessary in the performance of their its duties under this

11  chapter.

12         (5)  OFFICE.--The department, the agency, the

13  Department of Education, division and the Deputy Chief Judge

14  shall maintain and keep open during reasonable business hours

15  an office, which shall be provided in the Capitol or some

16  other suitable building in the City of Tallahassee, for the

17  transaction of business under this chapter, at which office

18  the official records and papers shall be kept.  The office

19  shall be furnished and equipped.  The department, the agency

20  division, any judge of compensation claims, or the Deputy

21  Chief Judge may hold sessions and conduct hearings at any

22  place within the state. The Office of the Judges of

23  Compensation Claims shall maintain the 17 district offices, 31

24  judges of compensation claims, and 31 mediators as they exist

25  on June 30, 2001.

26         (6)  SEAL.--The department division and the judges of

27  compensation claims shall have a seal upon which shall be

28  inscribed the words "State of Florida Department of

29  Insurance--Seal" and "Division of Administrative

30  Hearings--Seal," respectively.

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  1         (7)  DESTRUCTION OF OBSOLETE RECORDS.--The department

  2  division is expressly authorized to provide by regulation for

  3  and to destroy obsolete records of the department division.

  4  The Division of Administrative Hearings is expressly

  5  authorized to provide by regulation for and to destroy

  6  obsolete records of the Office of the Judges of Compensation

  7  Claims.

  8         (8)  PROCEDURE.--In the exercise of its duties and

  9  functions requiring administrative hearings, the department

10  and the agency division shall proceed in accordance with the

11  Administrative Procedure Act.  The authority of the department

12  and the agency division to issue orders resulting from

13  administrative hearings as provided for in this chapter shall

14  not infringe upon the jurisdiction of the judges of

15  compensation claims.

16         Section 47.  Subsection (1) of section 440.45, Florida

17  Statutes, is amended to read:

18         440.45  Office of the Judges of Compensation Claims.--

19         (1)(a)  There is created the Office of the Judges of

20  Compensation Claims within the Department of Management

21  Services. The Office of the Judges of Compensation Claims

22  shall be headed by the Deputy Chief Judge of Compensation

23  Claims. The Deputy Chief Judge shall report to the director of

24  the Division of Administrative Hearings. The Deputy Chief

25  Judge shall be appointed by the Governor for a term of 4 years

26  from a list of three names submitted by the statewide

27  nominating commission created under subsection (2). The Deputy

28  Chief Judge must demonstrate prior administrative experience

29  and possess the same qualifications for appointment as a judge

30  of compensation claims, and the procedure for reappointment of

31  the Deputy Chief Judge will be the same as for reappointment

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  1  of a judge of compensation claims. The office shall be a

  2  separate budget entity and the director of the Division of

  3  Administrative Hearings shall be its agency head for all

  4  purposes, including, but not limited to, rulemaking and

  5  establishing agency policies and procedures.  The Department

  6  of Management Services shall provide administrative support

  7  and service to the office to the extent requested by the

  8  director of the Division of Administrative Hearings but shall

  9  not direct, supervise, or control the Office of the Judges of

10  Compensation Claims in any manner, including, but not limited

11  to, personnel, purchasing, budgetary matters, or property

12  transactions. The operating budget of the Office of the Judges

13  of Compensation Claims shall be paid out of the Workers'

14  Compensation Administration Trust Fund established in s.

15  440.50.

16         (b)  The current term of the Chief Judge of

17  Compensation Claims shall expire October 1, 2001. Effective

18  October 1, 2001, the position of Deputy Chief Judge of

19  Compensation Claims is created.

20         Section 48.  Subsections (1), (2), (7), (8), (9), (10),

21  and (11) of section 440.49, Florida Statutes, are amended to

22  read:

23         440.49  Limitation of liability for subsequent injury

24  through Special Disability Trust Fund.--

25         (1)  LEGISLATIVE INTENT.--Whereas it is often difficult

26  for workers with disabilities to achieve employment or to

27  become reemployed following an injury, and it is the desire of

28  the Legislature to facilitate the return of these workers to

29  the workplace, it is the purpose of this section to encourage

30  the employment, reemployment, and accommodation of the

31  physically disabled by reducing an employer's insurance

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  1  premium for reemploying an injured worker, to decrease

  2  litigation between carriers on apportionment issues, and to

  3  protect employers from excess liability for compensation and

  4  medical expense when an injury to a physically disabled worker

  5  merges with, aggravates, or accelerates her or his preexisting

  6  permanent physical impairment to cause either a greater

  7  disability or permanent impairment, or an increase in

  8  expenditures for temporary compensation or medical benefits

  9  than would have resulted from the injury alone. The department

10  division or the administrator shall inform all employers of

11  the existence and function of the fund and shall interpret

12  eligibility requirements liberally. However, this subsection

13  shall not be construed to create or provide any benefits for

14  injured employees or their dependents not otherwise provided

15  by this chapter. The entitlement of an injured employee or her

16  or his dependents to compensation under this chapter shall be

17  determined without regard to this subsection, the provisions

18  of which shall be considered only in determining whether an

19  employer or carrier who has paid compensation under this

20  chapter is entitled to reimbursement from the Special

21  Disability Trust Fund.

22         (2)  DEFINITIONS.--As used in this section, the term:

23         (a)  "Permanent physical impairment" means and is

24  limited to the conditions listed in paragraph (6)(a).

25         (b)  "Preferred worker" means a worker who, because of

26  a permanent impairment resulting from a compensable injury or

27  occupational disease, is unable to return to the worker's

28  regular employment.

29         (c)  "Merger" describes or means that:

30

31

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  1         1.  If the permanent physical impairment had not

  2  existed, the subsequent accident or occupational disease would

  3  not have occurred;

  4         2.  The permanent disability or permanent impairment

  5  resulting from the subsequent accident or occupational disease

  6  is materially and substantially greater than that which would

  7  have resulted had the permanent physical impairment not

  8  existed, and the employer has been required to pay, and has

  9  paid, permanent total disability or permanent impairment

10  benefits for that materially and substantially greater

11  disability;

12         3.  The preexisting permanent physical impairment is

13  aggravated or accelerated as a result of the subsequent injury

14  or occupational disease, or the preexisting impairment has

15  contributed, medically and circumstantially, to the need for

16  temporary compensation, medical, or attendant care and the

17  employer has been required to pay, and has paid, temporary

18  compensation, medical, or attendant care benefits for the

19  aggravated preexisting permanent impairment; or

20         4.  Death would not have been accelerated if the

21  permanent physical impairment had not existed.

22         (d)  "Excess permanent compensation" means that

23  compensation for permanent impairment, or permanent total

24  disability or death benefits, for which the employer or

25  carrier is otherwise entitled to reimbursement from the

26  Special Disability Trust Fund.

27         (e)  "Administrator" means the entity selected by the

28  department division to review, allow, deny, compromise,

29  controvert, and litigate claims of the Special Disability

30  Trust Fund.

31

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  1  In addition to the definitions contained in this subsection,

  2  the department division may by rule prescribe definitions that

  3  are necessary for the effective administration of this

  4  section.

  5         (7)  REIMBURSEMENT OF EMPLOYER.--

  6         (a)  The right to reimbursement as provided in this

  7  section is barred unless written notice of claim of the right

  8  to such reimbursement is filed by the employer or carrier

  9  entitled to such reimbursement with the department division or

10  administrator at Tallahassee within 2 years after the date the

11  employee last reached maximum medical improvement, or within 2

12  years after the date of the first payment of compensation for

13  permanent total disability, wage loss, or death, whichever is

14  later. The notice of claim must contain such information as

15  the department division by rule requires or as established by

16  the administrator; and the employer or carrier claiming

17  reimbursement shall furnish such evidence in support of the

18  claim as the department division or administrator reasonably

19  may require.

20         (b)  For notice of claims on the Special Disability

21  Trust Fund filed on or after July 1, 1978, the Special

22  Disability Trust Fund shall, within 120 days after receipt of

23  notice that a carrier has paid, been required to pay, or

24  accepted liability for excess compensation, serve notice of

25  the acceptance of the claim for reimbursement.

26         (c)  A proof of claim must be filed on each notice of

27  claim on file as of June 30, 1997, within 1 year after July 1,

28  1997, or the right to reimbursement of the claim shall be

29  barred. A notice of claim on file on or before June 30, 1997,

30  may be withdrawn and refiled if, at the time refiled, the

31  notice of claim remains within the limitation period specified

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  1  in paragraph (a).  Such refiling shall not toll, extend, or

  2  otherwise alter in any way the limitation period applicable to

  3  the withdrawn and subsequently refiled notice of claim. Each

  4  proof of claim filed shall be accompanied by a proof-of-claim

  5  fee as provided in paragraph (9)(d). The Special Disability

  6  Trust Fund shall, within 120 days after receipt of the proof

  7  of claim, serve notice of the acceptance of the claim for

  8  reimbursement. This paragraph shall apply to all claims

  9  notwithstanding the provisions of subsection (12).

10         (d)  Each notice of claim filed or refiled on or after

11  July 1, 1997, must be accompanied by a notification fee as

12  provided in paragraph (9)(d).  A proof of claim must be filed

13  within 1 year after the date the notice of claim is filed or

14  refiled, accompanied by a proof-of-claim fee as provided in

15  paragraph (9)(d), or the claim shall be barred.  The

16  notification fee shall be waived if both the notice of claim

17  and proof of claim are submitted together as a single filing.

18  The Special Disability Trust Fund shall, within 180 days after

19  receipt of the proof of claim, serve notice of the acceptance

20  of the claim for reimbursement.  This paragraph shall apply to

21  all claims notwithstanding the provisions of subsection (12).

22         (e)  For dates of accident on or after January 1, 1994,

23  the Special Disability Trust Fund shall, within 120 days of

24  receipt of notice that a carrier has been required to pay, and

25  has paid over $10,000 in benefits, serve notice of the

26  acceptance of the claim for reimbursement. Failure of the

27  Special Disability Trust Fund to serve notice of acceptance

28  shall give rise to the right to request a hearing on the claim

29  for reimbursement. If the Special Disability Trust Fund

30  through its representative denies or controverts the claim,

31  the right to such reimbursement shall be barred unless an

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  1  application for a hearing thereon is filed with the department

  2  division or administrator at Tallahassee within 60 days after

  3  notice to the employer or carrier of such denial or

  4  controversion. When such application for a hearing is timely

  5  filed, the claim shall be heard and determined in accordance

  6  with the procedure prescribed in s. 440.25, to the extent that

  7  such procedure is applicable, and in accordance with the

  8  workers' compensation rules of procedure. In such proceeding

  9  on a claim for reimbursement, the Special Disability Trust

10  Fund shall be made the party respondent, and no findings of

11  fact made with respect to the claim of the injured employee or

12  the dependents for compensation, including any finding made or

13  order entered pursuant to s. 440.20(11), shall be res

14  judicata. The Special Disability Trust Fund may not be joined

15  or made a party to any controversy or dispute between an

16  employee and the dependents and the employer or between two or

17  more employers or carriers without the written consent of the

18  fund.

19         (f)  When it has been determined that an employer or

20  carrier is entitled to reimbursement in any amount, the

21  employer or carrier shall be reimbursed annually from the

22  Special Disability Trust Fund for the compensation and medical

23  benefits paid by the employer or carrier for which the

24  employer or carrier is entitled to reimbursement, upon filing

25  request therefor and submitting evidence of such payment in

26  accordance with rules prescribed by the department division,

27  which rules may include parameters for annual audits. The

28  Special Disability Trust Fund shall pay the approved

29  reimbursement requests on a first-in, first-out basis

30  reflecting the order in which the reimbursement requests were

31  received.

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  1         (g)  The department division may by rule require

  2  specific forms and procedures for the administration and

  3  processing of claims made through the Special Disability Trust

  4  Fund.

  5         (8)  PREFERRED WORKER PROGRAM.--The Department of

  6  Education division or administrator shall issue identity cards

  7  to preferred workers upon request by qualified employees and

  8  the Department of Insurance shall reimburse an employer, from

  9  the Special Disability Trust Fund, for the cost of workers'

10  compensation premium related to the preferred workers payroll

11  for up to 3 years of continuous employment upon satisfactory

12  evidence of placement and issuance of payroll and

13  classification records and upon the employee's certification

14  of employment. The department and the Department of Education

15  division may by rule prescribe definitions, forms, and

16  procedures for the administration of the preferred worker

17  program. The Department of Education division may by rule

18  prescribe the schedule for submission of forms for

19  participation in the program.

20         (9)  SPECIAL DISABILITY TRUST FUND.--

21         (a)  There is established in the State Treasury a

22  special fund to be known as the "Special Disability Trust

23  Fund," which shall be available only for the purposes stated

24  in this section; and the assets thereof may not at any time be

25  appropriated or diverted to any other use or purpose. The

26  Treasurer shall be the custodian of such fund, and all moneys

27  and securities in such fund shall be held in trust by such

28  Treasurer and shall not be the money or property of the state.

29  The Treasurer is authorized to disburse moneys from such fund

30  only when approved by the department division or corporation

31  and upon the order of the Comptroller. The Treasurer shall

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  1  deposit any moneys paid into such fund into such depository

  2  banks as the department division may designate and is

  3  authorized to invest any portion of the fund which, in the

  4  opinion of the department division, is not needed for current

  5  requirements, in the same manner and subject to all the

  6  provisions of the law with respect to the deposits of state

  7  funds by such Treasurer. All interest earned by such portion

  8  of the fund as may be invested by the Treasurer shall be

  9  collected by her or him and placed to the credit of such fund.

10         (b)1.  The Special Disability Trust Fund shall be

11  maintained by annual assessments upon the insurance companies

12  writing compensation insurance in the state, the commercial

13  self-insurers under ss. 624.462 and 624.4621, the assessable

14  mutuals under s. 628.601, and the self-insurers under this

15  chapter, which assessments shall become due and be paid

16  quarterly at the same time and in addition to the assessments

17  provided in s. 440.51. The department division shall estimate

18  annually in advance the amount necessary for the

19  administration of this subsection and the maintenance of this

20  fund and shall make such assessment in the manner hereinafter

21  provided.

22         2.  The annual assessment shall be calculated to

23  produce during the ensuing fiscal year an amount which, when

24  combined with that part of the balance in the fund on June 30

25  of the current fiscal year which is in excess of $100,000, is

26  equal to the average of:

27         a.  The sum of disbursements from the fund during the

28  immediate past 3 calendar years, and

29         b.  Two times the disbursements of the most recent

30  calendar year.

31

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  1  Such amount shall be prorated among the insurance companies

  2  writing compensation insurance in the state and the

  3  self-insurers. Provided however, for those carriers that have

  4  excluded ceded reinsurance premiums from their assessments on

  5  or before January 1, 2000, no assessments on ceded reinsurance

  6  premiums shall be paid by those carriers until such time as

  7  the former Division of Workers' Compensation of the Department

  8  of Labor and Employment Security or the department advises

  9  each of those carriers of the impact that the inclusion of

10  ceded reinsurance premiums has on their assessment. The

11  department division may not recover any past underpayments of

12  assessments levied against any carrier that on or before

13  January 1, 2000, excluded ceded reinsurance premiums from

14  their assessment prior to the point that the former Division

15  of Workers' Compensation of the Department of Labor and

16  Employment Security or the department advises of the

17  appropriate assessment that should have been paid.

18         3.  The net premiums written by the companies for

19  workers' compensation in this state and the net premium

20  written applicable to the self-insurers in this state are the

21  basis for computing the amount to be assessed as a percentage

22  of net premiums. Such payments shall be made by each carrier

23  and self-insurer to the department division for the Special

24  Disability Trust Fund in accordance with such regulations as

25  the department division prescribes.

26         4.  The Treasurer is authorized to receive and credit

27  to such Special Disability Trust Fund any sum or sums that may

28  at any time be contributed to the state by the United States

29  under any Act of Congress, or otherwise, to which the state

30  may be or become entitled by reason of any payments made out

31  of such fund.

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  1         (c)  Notwithstanding the Special Disability Trust Fund

  2  assessment rate calculated pursuant to this section, the rate

  3  assessed shall not exceed 4.52 percent.

  4         (d)  The Special Disability Trust Fund shall be

  5  supplemented by a $250 notification fee on each notice of

  6  claim filed or refiled after July 1, 1997, and a $500 fee on

  7  each proof of claim filed in accordance with subsection (7).

  8  Revenues from the fee shall be deposited into the Special

  9  Disability Trust Fund and are exempt from the deduction

10  required by s. 215.20. The fees provided in this paragraph

11  shall not be imposed upon any insurer which is in receivership

12  with the Department of Insurance.

13         (e)  The department of Labor and Employment Security or

14  administrator shall report annually on the status of the

15  Special Disability Trust Fund.  The report shall update the

16  estimated undiscounted and discounted fund liability, as

17  determined by an independent actuary, change in the total

18  number of notices of claim on file with the fund in addition

19  to the number of newly filed notices of claim, change in the

20  number of proofs of claim processed by the fund, the fee

21  revenues refunded and revenues applied to pay down the

22  liability of the fund, the average time required to reimburse

23  accepted claims, and the average administrative costs per

24  claim.  The department or administrator shall submit its

25  report to the Governor, the President of the Senate, and the

26  Speaker of the House of Representatives by December 1 of each

27  year.

28         (10)  DEPARTMENT DIVISION ADMINISTRATION OF FUND;

29  CLAIMS; EXPENSES.--The department division or administrator

30  shall administer the Special Disability Trust Fund with

31  authority to allow, deny, compromise, controvert, and litigate

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  1  claims made against it and to designate an attorney to

  2  represent it in proceedings involving claims against the fund,

  3  including negotiation and consummation of settlements,

  4  hearings before judges of compensation claims, and judicial

  5  review. The department division or administrator or the

  6  attorney designated by it shall be given notice of all

  7  hearings and proceedings involving the rights or obligations

  8  of such fund and shall have authority to make expenditures for

  9  such medical examinations, expert witness fees, depositions,

10  transcripts of testimony, and the like as may be necessary to

11  the proper defense of any claim. All expenditures made in

12  connection with conservation of the fund, including the salary

13  of the attorney designated to represent it and necessary

14  travel expenses, shall be allowed and paid from the Special

15  Disability Trust Fund as provided in this section upon the

16  presentation of itemized vouchers therefor approved by the

17  department division.

18         (11)  EFFECTIVE DATES.--This section does not apply to

19  any case in which the accident causing the subsequent injury

20  or death or the disablement or death from a subsequent

21  occupational disease occurred prior to July 1, 1955, or on or

22  after January 1, 1998.  In no event shall the Special

23  Disability Trust Fund be liable for, or reimburse employers or

24  carriers for, any case in which the accident causing the

25  subsequent injury or death or the disablement or death from a

26  subsequent occupational disease occurred on or after January

27  1, 1998.  The Special Disability Trust Fund shall continue to

28  reimburse employers or carriers for subsequent injuries

29  occurring prior to January 1, 1998, and the department

30  division shall continue to assess for and the department

31

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  1  division or administrator shall fund reimbursements as

  2  provided in subsection (9) for this purpose.

  3         Section 49.  Paragraphs (b) through (h) of subsection

  4  (1) of section 440.491, Florida Statutes, are redesignated as

  5  paragraphs (c) through (i), respectively, a new paragraph (b)

  6  is added to said subsection, and paragraph (c) of subsection

  7  (1), paragraph (a) of subsection (3), paragraph (b) of

  8  subsection (4), paragraphs (b) and (c) of subsection (5), and

  9  subsections (6), (7), and (8) of said section are amended, to

10  read:

11         440.491  Reemployment of injured workers;

12  rehabilitation.--

13         (1)  DEFINITIONS.--As used in this section, the term:

14         (b)  "Department" means the Department of Education.

15         (d)(c)  "Qualified rehabilitation provider" means a

16  rehabilitation nurse, rehabilitation counselor, vocational

17  evaluator, rehabilitation facility, or agency approved by the

18  Department of Education division as qualified to provide

19  reemployment assessments, medical care coordination,

20  reemployment services, or vocational evaluations under this

21  chapter.

22         (3)  REEMPLOYMENT STATUS REVIEWS AND REPORTS.--

23         (a)  When an employee who has suffered an injury

24  compensable under this chapter is unemployed 60 days after the

25  date of injury and is receiving benefits for temporary total

26  disability, temporary partial disability, or wage loss, and

27  has not yet been provided medical care coordination and

28  reemployment services voluntarily by the carrier, the carrier

29  must determine whether the employee is likely to return to

30  work and must report its determination to the department

31  division. The carrier must thereafter determine the

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  1  reemployment status of the employee at 90-day intervals as

  2  long as the employee remains unemployed, is not receiving

  3  medical care coordination or reemployment services, and is

  4  receiving the benefits specified in this subsection.

  5         (4)  REEMPLOYMENT ASSESSMENTS.--

  6         (b)  The carrier shall authorize only a qualified

  7  rehabilitation provider to provide the reemployment

  8  assessment. The rehabilitation provider shall conduct its

  9  assessment and issue a report to the carrier, the employee,

10  and the department division within 30 days after the time such

11  assessment is complete.

12         (5)  MEDICAL CARE COORDINATION AND REEMPLOYMENT

13  SERVICES.--

14         (b)  If the rehabilitation provider concludes that

15  training and education are necessary to return the employee to

16  suitable gainful employment, or if the employee has not

17  returned to suitable gainful employment within 180 days after

18  referral for reemployment services or receives $2,500 in

19  reemployment services, whichever comes first, the carrier must

20  discontinue reemployment services and refer the employee to

21  the department division for a vocational evaluation.

22  Notwithstanding any provision of chapter 289 or chapter 627,

23  the cost of a reemployment assessment and the first $2,500 in

24  reemployment services to an injured employee must not be

25  treated as loss adjustment expense for workers' compensation

26  ratemaking purposes.

27         (c)  A carrier may voluntarily provide medical care

28  coordination or reemployment services to the employee at

29  intervals more frequent than those required in this section.

30  For the purpose of monitoring reemployment, the carrier or the

31  rehabilitation provider shall report to the department

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  1  division, in the manner prescribed by the department division,

  2  the date of reemployment and wages of the employee. The

  3  carrier shall report its voluntary service activity to the

  4  department division as required by rule. Voluntary services

  5  offered by the carrier for any of the following injuries must

  6  be considered benefits for purposes of ratemaking: traumatic

  7  brain injury; spinal cord injury; amputation, including loss

  8  of an eye or eyes; burns of 5 percent or greater of the total

  9  body surface.

10         (6)  TRAINING AND EDUCATION.--

11         (a)  Upon referral of an injured employee by the

12  carrier, or upon the request of an injured employee, the

13  department division shall conduct a training and education

14  screening to determine whether it should refer the employee

15  for a vocational evaluation and, if appropriate, approve

16  training and education or other vocational services for the

17  employee.  The department division may not approve formal

18  training and education programs unless it determines, after

19  consideration of the reemployment assessment, pertinent

20  reemployment status reviews or reports, and such other

21  relevant factors as it prescribes by rule, that the

22  reemployment plan is likely to result in return to suitable

23  gainful employment.  The department division is authorized to

24  expend moneys from the Workers' Compensation Administration

25  Trust Fund, established by s. 440.50, to secure appropriate

26  training and education or other vocational services when

27  necessary to satisfy the recommendation of a vocational

28  evaluator.  The department division shall establish training

29  and education standards pertaining to employee eligibility,

30  course curricula and duration, and associated costs.

31

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  1         (b)  When it appears that an employee who has attained

  2  maximum medical improvement requires training and education to

  3  obtain suitable gainful employment, the employer shall pay the

  4  employee additional temporary total compensation while the

  5  employee receives such training and education for a period not

  6  to exceed 26 weeks, which period may be extended for an

  7  additional 26 weeks or less, if such extended period is

  8  determined to be necessary and proper by a judge of

  9  compensation claims. However, a carrier or employer is not

10  precluded from voluntarily paying additional temporary total

11  disability compensation beyond that period. If an employee

12  requires temporary residence at or near a facility or an

13  institution providing training and education which is located

14  more than 50 miles away from the employee's customary

15  residence, the reasonable cost of board, lodging, or travel

16  must be borne by the department division from the Workers'

17  Compensation Administration Trust Fund established by s.

18  440.50. An employee who refuses to accept training and

19  education that is recommended by the vocational evaluator and

20  considered necessary by the department division is subject to

21  a 50-percent reduction in weekly compensation benefits,

22  including wage-loss benefits, as determined under s.

23  440.15(3)(b).

24         (7)  PROVIDER QUALIFICATIONS.--

25         (a)  The department division shall investigate and

26  maintain a directory of each qualified public and private

27  rehabilitation provider, facility, and agency, and shall

28  establish by rule the minimum qualifications, credentials, and

29  requirements that each rehabilitation service provider,

30  facility, and agency must satisfy to be eligible for listing

31  in the directory. These minimum qualifications and credentials

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  1  must be based on those generally accepted within the service

  2  specialty for which the provider, facility, or agency is

  3  approved.

  4         (b)  The department division shall impose a biennial

  5  application fee of $25 for each listing in the directory, and

  6  all such fees must be deposited in the Workers' Compensation

  7  Administration Trust Fund.

  8         (c)  The department division shall monitor and evaluate

  9  each rehabilitation service provider, facility, and agency

10  qualified under this subsection to ensure its compliance with

11  the minimum qualifications and credentials established by the

12  department division. The failure of a qualified rehabilitation

13  service provider, facility, or agency to provide the

14  department division with information requested or access

15  necessary for the department division to satisfy its

16  responsibilities under this subsection is grounds for

17  disqualifying the provider, facility, or agency from further

18  referrals.

19         (d)  A qualified rehabilitation service provider,

20  facility, or agency may not be authorized by an employer, a

21  carrier, or the department division to provide any services,

22  including expert testimony, under this section in this state

23  unless the provider, facility, or agency is listed or has been

24  approved for listing in the directory. This restriction does

25  not apply to services provided outside this state under this

26  section.

27         (e)  The department division, after consultation with

28  representatives of employees, employers, carriers,

29  rehabilitation providers, and qualified training and education

30  providers, shall adopt rules governing professional practices

31  and standards.

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  1         (8)  CARRIER PRACTICES.--The department division shall

  2  monitor the selection of providers and the provision of

  3  services by carriers under this section for consistency with

  4  legislative intent set forth in subsection (2).

  5         Section 50.  Section 440.50, Florida Statutes, is

  6  amended to read:

  7         440.50  Workers' Compensation Administration Trust

  8  Fund.--

  9         (1)(a)  There is established in the State Treasury a

10  special fund to be known as the "Workers' Compensation

11  Administration Trust Fund" for the purpose of providing for

12  the payment of all expenses in respect to the administration

13  of this chapter, including the vocational rehabilitation of

14  injured employees as provided in s. 440.49 and the payments

15  due under s. 440.15(1)(f), the funding of the fixed

16  administrative expenses of the plan, and the funding of the

17  Bureau of Workers' Compensation Fraud within the Department of

18  Insurance.  Such fund shall be administered by the department

19  division.

20         (b)  The department division is authorized to transfer

21  as a loan an amount not in excess of $250,000 from such

22  special fund to the Special Disability Trust Fund established

23  by s. 440.49(9), which amount shall be repaid to said special

24  fund in annual payments equal to not less than 10 percent of

25  moneys received for such Special Disability Trust Fund.

26         (2)  The Treasurer is authorized to disburse moneys

27  from such fund only when approved by the department division

28  and upon the order of the Comptroller.

29         (3)  The Treasurer shall deposit any moneys paid into

30  such fund into such depository banks as the department

31  division may designate and is authorized to invest any portion

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  1  of the fund which, in the opinion of the department division,

  2  is not needed for current requirements, in the same manner and

  3  subject to all the provisions of the law with respect to the

  4  deposit of state funds by such Treasurer.  All interest earned

  5  by such portion of the fund as may be invested by the

  6  Treasurer shall be collected by him or her and placed to the

  7  credit of such fund.

  8         (4)  All civil penalties provided in this chapter, if

  9  not voluntarily paid, may be collected by civil suit brought

10  by the department division and shall be paid into such fund.

11         Section 51.  Section 440.51, Florida Statutes, is

12  amended to read:

13         440.51  Expenses of administration.--

14         (1)  The department division shall estimate annually in

15  advance the amounts necessary for the administration of this

16  chapter, in the following manner.

17         (a)  The department division shall, by July 1 of each

18  year, notify carriers and self-insurers of the assessment

19  rate, which shall be based on the anticipated expenses of the

20  administration of this chapter for the next calendar year.

21  Such assessment rate shall take effect January 1 of the next

22  calendar year and shall be included in workers' compensation

23  rate filings approved by the Department of Insurance which

24  become effective on or after January 1 of the next calendar

25  year. Assessments shall become due and be paid quarterly.

26         (b)  The total expenses of administration shall be

27  prorated among the carriers writing compensation insurance in

28  the state and self-insurers.  The net premiums collected by

29  carriers and the amount of premiums calculated by the

30  department division for self-insured employers are the basis

31  for computing the amount to be assessed. When reporting

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  1  deductible policy premium for purposes of computing

  2  assessments levied after July 1, 2001, full policy premium

  3  value must be reported prior to application of deductible

  4  discounts or credits. This amount may be assessed as a

  5  specific amount or as a percentage of net premiums payable as

  6  the department division may direct, provided such amount so

  7  assessed shall not exceed 2.75 percent, beginning January 1,

  8  2001, except during the interim period from July 1, 2000,

  9  through December 31, 2000, such assessments shall not exceed 4

10  percent of such net premiums.  The carriers may elect to make

11  the payments required under s. 440.15(1)(f) rather than having

12  these payments made by the department division.  In that

13  event, such payments will be credited to the carriers, and the

14  amount due by the carrier under this section will be reduced

15  accordingly.

16         (2)  The department division shall provide by

17  regulation for the collection of the amounts assessed against

18  each carrier.  Such amounts shall be paid within 30 days from

19  the date that notice is served upon such carrier.  If such

20  amounts are not paid within such period, there may be assessed

21  for each 30 days the amount so assessed remains unpaid, a

22  civil penalty equal to 10 percent of the amount so unpaid,

23  which shall be collected at the same time and a part of the

24  amount assessed. For those carriers who excluded ceded

25  reinsurance premiums from their assessments prior to January

26  1, 2000, the department division shall not recover any past

27  underpayments of assessments related to ceded reinsurance

28  premiums prior to January 1, 2001, against such carriers.

29         (3)  If any carrier fails to pay the amounts assessed

30  against him or her under the provisions of this section within

31  60 days from the time such notice is served upon him or her,

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  1  the department of Insurance upon being advised by the division

  2  may suspend or revoke the authorization to insure compensation

  3  in accordance with the procedure in s. 440.38(3)(a). The

  4  department division may permit a carrier to remit any

  5  underpayment of assessments for assessments levied after

  6  January 1, 2001.

  7         (4)  All amounts collected under the provisions of this

  8  section shall be paid into the fund established in s. 440.50.

  9         (5)  Any amount so assessed against and paid by an

10  insurance carrier, self-insurer authorized pursuant to s.

11  624.4621, or commercial self-insurance fund authorized under

12  ss. 624.460-624.488 shall be allowed as a deduction against

13  the amount of any other tax levied by the state upon the

14  premiums, assessments, or deposits for workers' compensation

15  insurance on contracts or policies of said insurance carrier,

16  self-insurer, or commercial self-insurance fund. Any insurance

17  carrier claiming such a deduction against the amount of any

18  such tax shall not be required to pay any additional

19  retaliatory tax levied pursuant to s. 624.5091 as a result of

20  claiming such deduction. Because deductions under this

21  subsection are available to insurance carriers, s. 624.5091

22  does not limit such deductions in any manner.

23         (6)(a)  The department division may require from each

24  carrier, at such time and in accordance with such regulations

25  as the department division may prescribe, reports in respect

26  to all gross earned premiums and of all payments of

27  compensation made by such carrier during each prior period,

28  and may determine the amounts paid by each carrier and the

29  amounts paid by all carriers during such period.

30         (b)  The Department of Insurance may require from each

31  self-insurer, at such time and in accordance with such

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  1  regulations as the Department of Insurance prescribes, reports

  2  in respect to wages paid, the amount of premiums such

  3  self-insurer would have to pay if insured, and all payments of

  4  compensation made by such self-insurer during each prior

  5  period, and may determine the amounts paid by each

  6  self-insurer and the amounts paid by all self-insurers during

  7  such period. For the purposes of this section, the payroll

  8  records of each self-insurer shall be open to annual

  9  inspection and audit by the Department of Insurance or its

10  authorized representative, during regular business hours; and

11  if any audit of such records of a self-insurer discloses a

12  deficiency in the amounts reported to the Department of

13  Insurance or in the amounts paid to the Department of

14  Insurance by a self-insurer pursuant to this section, the

15  Department of Insurance may assess the cost of such audit

16  against the self-insurer.

17         (7)  The department division shall keep accumulated

18  cost records of all injuries occurring within the state coming

19  within the purview of this chapter on a policy and

20  calendar-year basis.  For the purpose of this chapter, a

21  "calendar year" is defined as the year in which the injury is

22  reported to the department division; "policy year" is defined

23  as that calendar year in which the policy becomes effective,

24  and the losses under such policy shall be chargeable against

25  the policy year so defined.

26         (8)  The department division shall assign an account

27  number to each employer under this chapter and an account

28  number to each insurance carrier authorized to write workers'

29  compensation insurance in the state; and it shall be the duty

30  of the department division under the account number so

31  assigned to keep the cost experience of each carrier and the

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  1  cost experience of each employer under the account number so

  2  assigned by calendar and policy year, as above defined.

  3         (9)  In addition to the above, it shall be the duty of

  4  the division to keep the accident experience, as classified by

  5  the division, by industry as follows:

  6         (a)  Cause of the injury;

  7         (b)  Nature of the injury; and

  8         (c)  Type of disability.

  9         (10)  In every case where the duration of disability

10  exceeds 30 days, the carrier shall establish a sufficient

11  reserve to pay all benefits to which the injured employee, or

12  in case of death, his or her dependents, may be entitled to

13  under the law.  In establishing the reserve, consideration

14  shall be given to the nature of the injury, the probable

15  period of disability, and the estimated cost of medical

16  benefits.

17         (11)  The department division shall furnish to any

18  employer or carrier, upon request, its individual experience.

19  The division shall furnish to the Department of Insurance,

20  upon request, the Florida experience as developed under

21  accident year or calendar year.

22         (12)  In addition to any other penalties provided by

23  this law, the failure to submit any report or other

24  information required by this law shall be just cause to

25  suspend the right of a self-insurer to operate as such, or,

26  upon certification by the division to the Department of

27  Insurance that a carrier has failed or refused to furnish such

28  reports, shall be just cause for the department of Insurance

29  to suspend or revoke the license of such carrier.

30         (13)  As used in s. 440.50 and this section, the term:

31

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  1         (a)  "Plan" means the workers' compensation joint

  2  underwriting plan provided for in s. 627.311(4).

  3         (b)  "Fixed administrative expenses" means the expenses

  4  of the plan, not to exceed $750,000, which are directly

  5  related to the plan's administration but which do not vary in

  6  direct relationship to the amount of premium written by the

  7  plan and which do not include loss adjustment premiums.

  8         (14)  Before July 1 in each year, the plan shall notify

  9  the department division of the amount of the plan's gross

10  written premiums for the preceding calendar year. Whenever the

11  plan's gross written premiums reported to the department

12  division are less than $30 million, the department division

13  shall transfer to the plan, subject to appropriation by the

14  Legislature, an amount not to exceed the plan's fixed

15  administrative expenses for the preceding calendar year.

16         Section 52.  Subsections (1) and (3) of section 440.52,

17  Florida Statutes, are amended to read:

18         440.52  Registration of insurance carriers; notice of

19  cancellation or expiration of policy; suspension or revocation

20  of authority.--

21         (1)  Each insurance carrier who desires to write such

22  compensation insurance in compliance with this chapter shall

23  be required, before writing such insurance, to register with

24  the department division and pay a registration fee of $100.

25  This shall be deposited by the department division in the fund

26  created by s. 440.50.

27         (3)  If the department division finds, after due notice

28  and a hearing at which the insurance carrier is entitled to be

29  heard in person or by counsel and present evidence, that the

30  insurance carrier has repeatedly failed to comply with its

31  obligations under this chapter, the department division may

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  1  request the Department of Insurance to suspend or revoke the

  2  authorization of such insurance carrier to write workers'

  3  compensation insurance under this chapter.  Such suspension or

  4  revocation shall not affect the liability of any such

  5  insurance carrier under policies in force prior to the

  6  suspension or revocation.

  7         Section 53.  Section 440.525, Florida Statutes, is

  8  amended to read:

  9         440.525  Examination of carriers.--Beginning July 1,

10  1994, The Division of Workers' Compensation of the department

11  of Labor and Employment Security may examine each carrier as

12  often as is warranted to ensure that carriers are fulfilling

13  their obligations under the law, and shall examine each

14  carrier not less frequently than once every 3 years. The

15  examination must cover the preceding 3 fiscal years of the

16  carrier's operations and must commence within 12 months after

17  the end of the most recent fiscal year being covered by the

18  examination. The examination may cover any period of the

19  carrier's operations since the last previous examination.

20         Section 54.  Section 440.572, Florida Statutes, is

21  amended to read:

22         440.572  Authorization for individual self-insurer to

23  provide coverage.--An individual self-insurer having a net

24  worth of not less than $250 million as authorized by s.

25  440.38(1)(f) may assume by contract the liabilities under this

26  chapter of contractors and subcontractors, or each of them,

27  employed by or on behalf of such individual self-insurer when

28  performing work on or adjacent to property owned or used by

29  the individual self-insurer by the department division. The

30  net worth of the individual self-insurer shall include the

31  assets of the self-insurer's parent company and its

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  1  subsidiaries, sister companies, affiliated companies, and

  2  other related entities, located within the geographic

  3  boundaries of the state.

  4         Section 55.  Section 440.59, Florida Statutes, is

  5  amended to read:

  6         440.59  Reporting requirements.--

  7         (1)  The department shall annually prepare a report of

  8  the administration of this chapter for the preceding calendar

  9  year, including a detailed statement of the receipts of and

10  expenditures from the fund established in s. 440.50 and a

11  statement of the causes of the accidents leading to the

12  injuries for which the awards were made, together with such

13  recommendations as the department considers advisable. On or

14  before September 15 of each year, the department shall submit

15  a copy of the report to the Governor, the President of the

16  Senate, the Speaker of the House of Representatives, the

17  Democratic and Republican Leaders of the Senate and the House

18  of Representatives, and the chairs of the legislative

19  committees having jurisdiction over workers' compensation.

20         (2)  The division shall annually prepare a closed claim

21  report for all claims for which the employee lost more than 7

22  days from work and shall submit a copy of the report to the

23  Governor, the President of the Senate, the Speaker of the

24  House of Representatives, the Democratic and Republican

25  Leaders of the Senate and the House of Representatives, and

26  the chairs of the legislative committees having jurisdiction

27  over workers' compensation on or before September 15 of each

28  year. The closed claim report shall include, but not be

29  limited to, an analysis of all claims closed during the

30  preceding year as to the date of accident, age of the injured

31  employee, occupation of the injured employee, type of injury,

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  1  body part affected, type and duration of indemnity benefits

  2  paid, permanent impairment rating, medical benefits identified

  3  by type of health care provider, and type and cost of any

  4  rehabilitation benefits provided.

  5         (3)  The division shall prepare an annual report for

  6  all claims for which the employee lost more than 7 days from

  7  work and shall submit a copy of the report to the Governor,

  8  the President of the Senate, the Speaker of the House of

  9  Representatives, the Democratic and Republican Leaders of the

10  Senate and the House of Representatives, and the chairs of the

11  legislative committees having jurisdiction over workers'

12  compensation, on or before September 15 of each year. The

13  annual report shall include a status report on all cases

14  involving work-related injuries in the previous 10 years. The

15  annual report shall include, but not be limited to, the number

16  of open and closed cases, the number of cases receiving

17  various types of benefits, and the cash and medical benefits

18  paid between the date of injury and the evaluation date in

19  each case.

20         Section 56.  Section 440.591, Florida Statutes, is

21  amended to read:

22         440.591  Administrative procedure; rulemaking

23  authority.--The department, the agency, and the Department of

24  Education may division has authority to adopt rules pursuant

25  to ss. 120.536(1) and 120.54 to implement the provisions of

26  this chapter conferring duties upon it.

27         Section 57.  Section 440.593, Florida Statutes, is

28  amended to read:

29         440.593  Electronic reporting.--

30         (1)  The department division may establish an

31  electronic reporting system requiring or authorizing an

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  1  employer or carrier to submit required forms, reports, or

  2  other information electronically rather than by other means.

  3  The department division may establish different deadlines for

  4  submitting forms, reports, or information to the department

  5  division, or to its authorized agent, via the electronic

  6  reporting system than are otherwise required when reporting

  7  information by other means.

  8         (2)  The department division may require any carrier to

  9  submit data electronically, either directly or through a

10  third-party vendor, and may require any carrier or vendor

11  submitting data to the department division electronically to

12  be certified by the department division.  The department

13  division may specify performance requirements for any carrier

14  or vendor submitting data electronically.

15         (3)  The department division may revoke the

16  certification of any carrier or vendor determined by the

17  department division to be in noncompliance with performance

18  standards prescribed by rule for electronic submissions.

19         (4)  The department division may assess a civil

20  penalty, not to exceed $500 for each violation, as prescribed

21  by rule.

22         (5)  The department may division is authorized to adopt

23  rules to administer this section.

24         Section 58.  Subsections (1), (4), and (5) of section

25  443.012, Florida Statutes, are amended to read:

26         443.012  Unemployment Appeals Commission.--

27         (1)  There is created within the Agency for Workforce

28  Innovation Department of Labor and Employment Security an

29  Unemployment Appeals Commission, hereinafter referred to as

30  the "commission."  The commission shall consist of a chair and

31  two other members to be appointed by the Governor, subject to

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  1  confirmation by the Senate.  Not more than one appointee must

  2  be a person who, on account of previous vocation, employment,

  3  or affiliation, is classified as a representative of

  4  employers; and not more than one such appointee must be a

  5  person who, on account of previous vocation, employment, or

  6  affiliation, is classified as a representative of employees.

  7         (a)  The chair shall devote his or her entire time to

  8  commission duties and shall be responsible for the

  9  administrative functions of the commission.

10         (b)  The chair shall have the authority to appoint a

11  general counsel and such other personnel as may be necessary

12  to carry out the duties and responsibilities of the

13  commission.

14         (c)  The chair shall have the qualifications required

15  by law for a judge of the circuit court and shall not engage

16  in any other business vocation or employment. Notwithstanding

17  any other provisions of existing law, the chair shall be paid

18  a salary equal to that paid under state law to a judge of the

19  circuit court.

20         (d)  The remaining members shall be paid a stipend of

21  $100 for each day they are engaged in the work of the

22  commission.  The chair and other members shall also be

23  reimbursed for travel expenses, as provided in s. 112.061.

24         (e)  The total salary and travel expenses of each

25  member of the commission shall be paid from the Employment

26  Security Administration Trust Fund.

27         (4)  The property, personnel, and appropriations

28  relating to the specified authority, powers, duties, and

29  responsibilities of the commission shall be provided to the

30  commission by the Agency for Workforce Innovation Department

31  of Labor and Employment Security.

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  1         (5)  The commission shall not be subject to control,

  2  supervision, or direction by the Agency for Workforce

  3  Innovation Department of Labor and Employment Security in the

  4  performance of its powers and duties under this chapter.

  5         Section 59.  Subsection (12) of section 443.036,

  6  Florida Statutes, is amended to read:

  7         443.036  Definitions.--As used in this chapter, unless

  8  the context clearly requires otherwise:

  9         (12)  COMMISSION.--"Commission" means the Unemployment

10  Appeals Commission of the Department of Labor and Employment

11  Security.

12         Section 60.  Subsection (3) of section 447.02, Florida

13  Statutes, is amended to read:

14         447.02  Definitions.--The following terms, when used in

15  this chapter, shall have the meanings ascribed to them in this

16  section:

17         (3)  The term "department" means the Department of

18  Business and Professional Regulation Labor and Employment

19  Security.

20         Section 61.  Subsection (4) of section 447.305, Florida

21  Statutes, is amended to read:

22         447.305  Registration of employee organization.--

23         (4)  Notification of registrations and renewals of

24  registration shall be furnished at regular intervals by the

25  commission to the Department of Business and Professional

26  Regulation Labor and Employment Security.

27         Section 62.  Subsection (4) of section 450.012, Florida

28  Statutes, is amended to read:

29         450.012  Definitions.--For the purpose of this chapter,

30  the word, phrase, or term:

31

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  1         (4)  "Department" means the Department of Business and

  2  Professional Regulation Labor and Employment Security.

  3         Section 63.  Paragraph (j) of subsection (1) of section

  4  450.191, Florida Statutes, is amended to read:

  5         450.191  Executive Office of the Governor; powers and

  6  duties.--

  7         (1)  The Executive Office of the Governor is authorized

  8  and directed to:

  9         (j)  Cooperate with the farm labor office of the

10  Department of Business and Professional Regulation Labor and

11  Employment Security in the recruitment and referral of migrant

12  laborers and other persons for the planting, cultivation, and

13  harvesting of agricultural crops in Florida.

14         Section 64.  Subsection (2) of section 450.28, Florida

15  Statutes, is amended to read:

16         450.28  Definitions.--

17         (2)  "Department" means the Department of Business and

18  Professional Regulation Labor and Employment Security.

19         Section 65.  Subsections (1) and (5) of section

20  624.3161, Florida Statutes, are amended to read:

21         624.3161  Market conduct examinations.--

22         (1)  As often as it deems necessary, the department

23  shall examine each licensed rating organization, each advisory

24  organization, each group, association, carrier, as defined in

25  s. 440.02, or other organization of insurers which engages in

26  joint underwriting or joint reinsurance, and each authorized

27  insurer transacting in this state any class of insurance to

28  which the provisions of chapter 627 are applicable.  The

29  examination shall be for the purpose of ascertaining

30  compliance by the person examined with the applicable

31  provisions of chapters 440, 624, 626, 627, and 635.

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  1         (5)  Such examinations shall also be subject to the

  2  applicable provisions of chapter 440 and ss. 624.318, 624.319,

  3  624.321, and 624.322.

  4         Section 66.  Paragraph (m) of subsection (1) of section

  5  626.88, Florida Statutes, is amended to read:

  6         626.88  Definitions of "administrator" and "insurer".--

  7         (1)  For the purposes of this part, an "administrator"

  8  is any person who directly or indirectly solicits or effects

  9  coverage of, collects charges or premiums from, or adjusts or

10  settles claims on residents of this state in connection with

11  authorized commercial self-insurance funds or with insured or

12  self-insured programs which provide life or health insurance

13  coverage or coverage of any other expenses described in s.

14  624.33(1), other than any of the following persons:

15         (m)  A person approved by the Division of Workers'

16  Compensation of the Department of Insurance Labor and

17  Employment Security who administers only self-insured workers'

18  compensation plans.

19         Section 67.  Subsection (9) of section 626.989, Florida

20  Statutes, is amended to read:

21         626.989  Investigation by department or Division of

22  Insurance Fraud; compliance; immunity; confidential

23  information; reports to division; division investigator's

24  power of arrest.--

25         (9)  In recognition of the complementary roles of

26  investigating instances of workers' compensation fraud and

27  enforcing compliance with the workers' compensation coverage

28  requirements under chapter 440, the Division of Insurance

29  Fraud of the Department of Insurance is and the Division of

30  Workers' Compensation of the Department of Labor and

31  Employment Security are directed to prepare and submit a joint

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  1  performance report to the President of the Senate and the

  2  Speaker of the House of Representatives by November 1, 2003 of

  3  each year for each of the next 2 years, and then by November 1

  4  every 3 years thereafter, describing the results obtained in

  5  achieving compliance with the workers' compensation coverage

  6  requirements and reducing the incidence of workers'

  7  compensation fraud.

  8         Section 68.  Section 627.0915, Florida Statutes, is

  9  amended to read:

10         627.0915  Rate filings; workers' compensation,

11  drug-free workplace, and safe employers.--The Department of

12  Insurance shall approve rating plans for workers' compensation

13  insurance that give specific identifiable consideration in the

14  setting of rates to employers that either implement a

15  drug-free workplace program pursuant to rules adopted by the

16  Division of Workers' Compensation of the Department of

17  Insurance Labor and Employment Security or implement a safety

18  program pursuant to provisions of the rating plan or implement

19  both a drug-free workplace program and a safety program. The

20  plans must be actuarially sound and must state the savings

21  anticipated to result from such drug-testing and safety

22  programs.

23         Section 69.  Subsection (3) of section 627.914, Florida

24  Statutes, is amended to read:

25         627.914  Reports of information by workers'

26  compensation insurers required.--

27         (3)  Individual self-insurers as defined in s. 440.02

28  shall report only Florida data as prescribed in paragraphs

29  (2)(a)-(e) to the Division of Workers' Compensation of the

30  department of Labor and Employment Security.

31

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  1         (a)  The department Division of Workers' Compensation

  2  shall publish the dates and forms necessary to enable

  3  individual self-insurers to comply with this section.

  4         (b)  A statistical or rating organization may be used

  5  by individual self-insurers for the purposes of reporting the

  6  data required by this section and calculating experience

  7  ratings.

  8         Section 70.  Sections 20.171 and 440.4416, Florida

  9  Statutes, are repealed.

10         Section 71.  If any provision of this act or its

11  application to any person or circumstance is held invalid, the

12  invalidity does not affect other provisions or applications of

13  the act which can be given effect without the invalid

14  provision or application, and to this end the provisions of

15  this act are severable.

16         Section 72.  Except as otherwise provided herein, this

17  act shall take effect July 1, 2002.

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