New ASC Workers' Compensation Manual Proposed

The Florida Division of Workers’ Compensation has provided notice that it intends to update the Florida Workers’ Compensation Manual for Ambulatory Surgical Centers later this year.  

The proposed new Manual focuses on removing payments based on individual facility charges in favor of a comprehensive state-wide schedule of maximum reimbursement allowances (MRAs) for all claims.  These rates are found in Appendix A of the Manual.

FSASC has taken part in numerous meetings with the Division over the seven years since the 2015 Manual was introduced.  We have made significant recommendations to simplify the Manual and minimize the impact of the new schedule of reimbursement allowances on participating ambulatory surgical centers.  The final impact of the change will depend much on the case mix of each individual center.

Click here to view the proposed new Manual. In addition to the MRA schedule expansion, the Division is proposing to lower the reimbursement for surgical implants from 150% of cost to 130%.  They are broadening permissible implant reimbursement to include distributor billing and requiring all implants and associated disposable instrumentation to be documented with every claim (by eliminating implant certification).

The Division has not yet announced a date when the Manual will go into effect, but FSASC believes it is likely to affect ASC 2023 budgets.  Until the effective date, continue to use the 2015 Manual.