Compliance Corner
If you’re in Florida and need an expert medical adviser, would you know for whom to look and what that person could do once you found her? Thanks to Simply Research, you can, and we highlight some of it here.
Qualifications for Expert Medical Advisor Certification and Re-Certification
To be certified as an EMA, a physician shall meet the following qualifications:
(a) Must have correctly answered 95% of the EMA Tutorial review questions; and,
(b) Must hold valid licensure, issued by the Florida Department of Health, with “clear active” status; and,
(c) Must demonstrate board certification or board eligibility applicable to the specialty for which the applicant seeks certification by submitting proof of current certification or eligibility; and,
(d) Must demonstrate experience in the assignment of permanent impairment ratings to Florida’s injured employees, pursuant to Rule 69L-7.604, F.A.C., within the two-year period immediately preceding the date of application by submitting a minimum of two copies of a completed DFS-F5-DWC-25, Florida Workers’ Compensation Uniform Medical Treatment/Status Reporting Form, as incorporated in paragraph 69L-7.720(1)(d), F.A.C., assigning a permanent impairment rating; and,
(e) Must demonstrate experience in performing Independent Medical Examinations pursuant to Section 440.13(2) or 440.13(5), F.S., by submitting a minimum of two copies of a completed Independent Medical Examination report for a determination of the appropriateness of medical treatment being recommended or provided to an injured employee or for a determination of the injured employee’s disability and physical limitations, within the two-year period immediately preceding the date of application; and,
(f) Must have completed 20 hours of continuing medical education, specifically related to the physician’s field of specialty, within the two-year period immediately preceding the date of application. Proof of required CMEs must be provided at time of application. Completion of courses required for licensure by the Florida Department of Health addressing Domestic Violence, HIV-AIDS and Prevention of Medical Errors will not be applied to the medical continuing education requirements for EMA Certification.
Temporary EMAs
A physician who has performed services as a Temporary EMA for either a JCC or the Department within the two-year period immediately preceding the date of application for certification shall not be required to meet the requirements of paragraphs (d) and (e) above.
Renewals
An EMA applying for renewal prior to or no more than 90 days after the expiration of the EMA’s most current certification period shall not be required to meet the requirement of paragraph (a) above.
Disqualification
A physician who, pursuant to a final order, has been found to have engaged in certain violations, including a standard of care or billing violation, or overutilization, pursuant to Section 440.13(8), (13), or (15), F.S., shall not be certified as an EMA.
Expert Medical Advisor Responsibilities
(1) A physician shall disclose any conflict of interest upon receiving notice of selection as an EMA or Temporary EMA and shall not accept selection if a conflict of interest exists. For the purposes of this rule, “conflict of interest” means that any of the following matters may exist, potentially influencing the EMA’s opinions and decisions while fulfilling responsibilities to evaluate the medical care provided the injured employee by the examining physician:
(a) Private, business, financial or ownership interests involving potential gain or benefit based on the outcome of the case; or
(b) Prior knowledge of the injured employee.
(2) An EMA shall be responsible for notifying the Department of any change in the physician’s license or board certification status or change in address or contact information within 30 calendar days of the change. EMAs may notify the Department by updating their profiles through the DWC Medical Services Web Portal, or by emailing the Department at workers.compmedservice@myfloridacfo.com. EMAs may also forward documentation regarding such changes to the Division of Workers’ Compensation, Medical Services Section, c/o Department of Financial Services, 200 E. Gaines Street, Tallahassee, Florida, 32399-4232.
(3) When the JCC selects an EMA from the Certification List, the EMA shall complete and submit a written report to the JCC within 15 calendar days following receipt of all medical records and, when appropriate, the examination of the injured employee. The medical records to be submitted shall be within the discretion of the JCC.
(4) When the Department selects an EMA or Temporary EMA and provides the complete medical record for the treatment under review, the EMA or Temporary EMA shall complete and submit a written report to the Department within 15 calendar days following receipt of all medical records. Should an EMA find it necessary to perform an examination of the injured employee, the EMA’s written report shall be submitted to the Department within 15 calendar days following the completion of such examination.
(5) The EMA or Temporary EMA shall furnish a copy of the written report to the insurer and to the injured employee pursuant to paragraph 440.13(9)(d), F.S.
