HB 5603

1	A bill to be entitled
2	An act relating to the Department of Financial Services;
3	amending s. 20.121, F.S.; revising duties of the Division
4	of Consumer Services; amending ss. 284.01 and 284.36,
5	F.S.; revising criteria for premiums charged to agencies
6	and departments for purposes of the State Risk Management
7	Trust Fund; amending s. 284.42, F.S.; revising reporting
8	requirements on the state insurance program; requiring the
9	Division of Risk Management to analyze and report on
10	certain agency return-to-work programs and activities;
11	amending s. 284.50, F.S.; requiring certain agencies to
12	establish and maintain return-to-work programs for certain
13	employees; providing program goals; requiring the Division
14	of Risk Management to evaluate agency risk management
15	programs; requiring reports; requiring agencies to respond
16	to the division's evaluation and recommendations;
17	requiring the division to submit the evaluation report to
18	the legislative appropriations committees; amending s.
19	440.13, F.S.; revising requirements for determining the
20	amount of a reimbursement for repackaged or relabeled
21	prescription medication; providing limitations; amending
22	s. 440.50, F.S.; providing for reversion of certain
23	unencumbered and undisbursed funds to the Workers'
24	Compensation Administration Trust Fund; providing an
25	effective date.
26
27	Be It Enacted by the Legislature of the State of Florida:
28
29	Section 1.  Paragraph (h) of subsection (2) of section
30	20.121, Florida Statutes, is amended to read:
31	20.121  Department of Financial Services.-There is created
32	a Department of Financial Services.
33	(2)  DIVISIONS.-The Department of Financial Services shall
34	consist of the following divisions:
35	(h)  The Division of Consumer Services.
36	1.  The Division of Consumer Services shall perform the
37	following functions concerning products or services regulated by
38	the department of Financial Services or by either office of the
39	Office of Insurance Regulation Financial Services Commission:
40	a.  Receive inquiries and complaints from consumers.
41	b.  Prepare and disseminate such information as the
42	department deems appropriate to inform or assist consumers.
43	c.  Provide direct assistance and advocacy for consumers
44	who request such assistance or advocacy.
45	d.  With respect to apparent or potential violations of law
46	or applicable rules by a person or entity licensed by the
47	department or office by either office of the commission, report
48	such apparent or potential violations violation to the office or
49	the appropriate division of the department or office of the
50	commission, which may take such further action as it deems
51	appropriate.
52	e.  Designate an employee of the division as primary
53	contact for consumers on issues relating to sinkholes.
54	2.  Any person licensed or issued a certificate of
55	authority by the department or by the Office of Insurance
56	Regulation shall respond, in writing, to the Division of
57	Consumer Services within 20 days after receipt of a written
58	request for information from the division concerning a consumer
59	complaint. The response must address the issues and allegations
60	raised in the this complaint. The division may, in its
61	discretion, impose an administrative penalty for failure to
62	comply with this subparagraph of in an amount up to $2,500 per
63	violation upon any entity licensed by the department or the
64	office of Insurance Regulation and $250 for the first violation,
65	$500 for the second violation, and up to $1,000 per violation
66	thereafter upon any individual licensed by the department or the
67	office of Insurance Regulation.
68	3.  The department may adopt rules to administer implement
69	the provisions of this paragraph.
70	4.  The powers, duties, and responsibilities expressed or
71	granted in this paragraph do shall not limit the powers, duties,
72	and responsibilities of the Department of Financial Services,
73	the Financial Services Commission, the Office of Insurance
74	Regulation, or the Office of Financial Regulation set forth
75	elsewhere in the Florida Statutes.
76	Section 2.  Subsection (5) of section 284.01, Florida
77	Statutes, is amended to read:
78	284.01  State Risk Management Trust Fund; coverages to be
79	provided.-
80	(5)  Premiums charged to agencies for coverage shall be
81	adopted promulgated on a retrospective rating arrangement based
82	upon actual losses accruing to the fund and loss prevention
83	results, taking into account reasonable expectations,
84	maintenance, and stability of the fund and cost of reinsurance.
85	Section 3.  Section 284.36, Florida Statutes, is amended to
86	read:
87	284.36  Appropriation deposits; premium payment.-Premiums
88	for coverage by the State Risk Management Trust Fund as
89	calculated on all coverages shall be billed and charged to each
90	state agency according to coverages obtained by the fund for
91	their benefit, and such obligations shall be paid promptly by
92	each agency from its operating budget upon presentation of a
93	bill therefor. After the first year of operation, premiums to be
94	charged to all departments of the state are to be computed on a
95	retrospective rating arrangement based upon actual losses
96	accruing to the fund and loss prevention results, taking into
97	account reasonable expectations, the maintenance and stability
98	of the fund, and the cost of insurance.
99	Section 4.  Subsection (1) of section 284.42, Florida
100	Statutes, is amended to read:
101	284.42  Reports on state insurance program.-
102	(1)(a)  The Department of Financial Services, with the
103	Department of Management Services, shall conduct make an
104	analysis of the state insurance program each year and submit the
105	results on or before January 1 in a report to the Governor, the
106	President of the Senate, and the Speaker of the House of
107	Representatives annually, which shall include:
108	1.(a)  Complete underwriting information as to the nature
109	of the risks accepted for self-insurance and those risks that
110	are transferred to the insurance market.
111	2.(b)  The funds allocated to the Florida Casualty Risk
112	Management Trust Fund and premiums paid for insurance through
113	the market.
114	3.(c)  The method of handling legal matters and the cost
115	allocated.
116	4.(d)  The method and cost of handling inspection and
117	engineering of risks.
118	5.(e)  The cost of risk management service purchased.
119	6.(f)  The cost of managing the State Insurance Program by
120	the Department of Financial Services and the Department of
121	Management Services.
122	(b)  Beginning January 1, 2012, the Division of Risk
123	Management shall include in its annual report an analysis of
124	agency return-to-work efforts, including, but not limited to,
125	agency return-to-work program performance metrics and a status
126	report on participating return-to-work programs. The report
127	shall specify benchmarks, including, but not limited to, the
128	average lost-time claims per year, per agency; the total number
129	of lost claims; and specific agency measurable outcomes
130	indicating the change in performance from year to year.
131	Section 5.  Subsections (4) and (5) are added to section
132	284.50, Florida Statutes, to read:
133	284.50  Loss prevention program; safety coordinators;
134	Interagency Advisory Council on Loss Prevention; employee
135	recognition program.-
136	(4)  All agencies that are provided workers' compensation
137	insurance coverage by the State Risk Management Trust Fund that
138	employ more than 6,000 full-time employees shall establish and
139	maintain return-to-work programs for employees who are receiving
140	workers' compensation benefits. Such programs shall have the
141	primary goal of enabling injured workers to remain at work or
142	return to work to perform job duties within the physical or
143	mental functional limitations and restrictions established by
144	the workers' treating physicians. If no such limitations or
145	restrictions are established in writing by a worker's treating
146	physician, the worker shall be deemed to be able to fully
147	perform the same work duties he or she performed prior to the
148	injury.
149	(5)  The Division of Risk Management shall evaluate each
150	agency's risk management programs, including, but not limited
151	to, return-to-work, safety, and loss prevention programs, at
152	least once every 5 years. Reports, including, but not limited
153	to, any recommended corrective action, resulting from such
154	evaluations shall be provided to the head of the agency being
155	evaluated, the Chief Financial Officer, and the Director of the
156	Division of Risk Management. The agency head must provide to the
157	Division of Risk Management a response to all report
158	recommendations within 45 days and a plan to implement any
159	corrective action to be taken as part of the response. If the
160	agency disagrees with any final report recommendations,
161	including, but not limited to, any recommended corrective
162	action, or if the agency fails to implement any recommended
163	corrective action within a reasonable time, the division shall
164	submit the evaluation report to the legislative appropriations
165	committees.
166	Section 6.  Paragraph (c) of subsection (12) of section
167	440.13, Florida Statutes, is amended to read:
168	440.13  Medical services and supplies; penalty for
169	violations; limitations.-
170	(12)  CREATION OF THREE-MEMBER PANEL; GUIDES OF MAXIMUM
171	REIMBURSEMENT ALLOWANCES.-
172	(c)  As to reimbursement for a prescription medication,
173	regardless of the location or provider from which the claimant
174	receives the prescription medication, the reimbursement amount
175	for a prescription shall be the average wholesale price plus
176	$4.18 for the dispensing fee, except when where the carrier has
177	contracted for a lower amount. The reimbursement amount for a
178	drug that has been repackaged or relabeled shall be calculated
179	by multiplying the number of units dispensed times the per-unit
180	average wholesale price set by the original manufacturer of the
181	underlying drug, which shall not be the manufacturer of the
182	repackaged or relabeled drug, plus a $4.18 dispensing fee,
183	except when the carrier has contracted for a lower amount. In no
184	case shall the repackaged or relabeled drug price exceed the
185	amount otherwise payable had the drug not been repackaged or
186	relabeled. Fees for pharmaceuticals and pharmaceutical services
187	shall be reimbursable at the applicable fee schedule amount.
188	Where the employer or carrier has contracted for such services
189	and the employee elects to obtain them through a provider not a
190	party to the contract, the carrier shall reimburse at the
191	schedule, negotiated, or contract price, whichever is lower. No
192	such contract shall rely on a provider that is not reasonably
193	accessible to the employee.
194	Section 7.  Subsection (5) is added to section 440.50,
195	Florida Statutes, to read:
196	440.50  Workers' Compensation Administration Trust Fund.-
197	(5)  Funds appropriated by operating appropriation or
198	nonoperating transfer from the Workers' Compensation
199	Administration Trust Fund to the Department of Education, the
200	Agency for Health Care Administration, the Department of
201	Business and Professional Regulation, the Department of
202	Management Services, the First District Court of Appeal, and the
203	Justice Administrative Commission remaining unencumbered as of
204	June 30 or undisbursed as of September 30 each year shall revert
205	to the Workers' Compensation Administration Trust Fund.
206	Section 8.  This act shall take effect July 1, 2010.

CODING: Words stricken are deletions; words underlined are additions.