Disability Law

Claimant's Medical Co-Payments Go to the Employer/Carrier

By David A. McCranie, Esq.

Section 440.13(14)(c) says that an injured worker must make a $10.00 co-payment for most medical treatment rendered after he reaches maximum medical improvement.  So who gets the co-payment? The doctor? The employer/carrier?

Under proposed Fla. Admin. Code R. 69L-7.020, which would adopt the 2008 Edition of the Florida Workers' Compensation Health Care Provider Reimbursement Manual (aka the "fee schedule"), the employer/carrier is the beneficiary.  The new fee schedule specifies that "while health care providers are entitled to collect a $10.00 co-payment from injured workers who have reached maximum medical improvement, such co-payments are not in addition to any maximum reimbursement allowance or fee agreement, and that the amount of reimbursement otherwise payable by the insurer shall be reduced by the amount of the co-payment." 

 A hearing on the proposed rule is scheduled for September 9.

Full post as published by Florida Workers’ Compensation Law Blog on August 14, 2008 (boomark / email).