1. STATE APPELLATE DECISIONS
    1. FLORIDA
  • ABC Capital Markets etc., and Enrique Aubert Vetencourt, etc., v. Provincial De Reaseguros C.A., etc., (Fla. 3rd DCA). Jurisdiction/forum non conveniens. Suit filed in Florida by Venezuelan reinsurance company against foreign entity incorporated in the British Virgin Islands regarding repayment of bonds and off-shore investments. Defendant moved to dismiss case asserting forum non conveniens. Appeals court held that remand is not required where order denying motion to dismiss did not set forth the trial court's analysis of Kinney factors. Record on appeal showed that the parties’ position on the Kinney factors were made clear during the hearings and were considered by the trial court. Appeals court held that trial court properly found defendant failed to establish the balance of private interests favors dismissal.
  • Avery v. City of Coral Gables and Johns Eastern (Fla. 1st DCA). Workers’ compensation/deauthorization of treating physicians. Order denying claimant’s motion for rehearing reversed and case remanded. Deauthorization of medical treatment under section 440.13(2)(d), Fla. Stat. is inapplicable where a claimant has reached maximum medical improvement and is receiving only palliative treatment with no expected additional improvement. A claimant who has reached maximum medical improvement cannot be in “recuperation” as a matter of law, where the treatment being provided is not curative. When an employer/carrier has concerns of overutilization, the proper remedy is to obtain a determination of overutilization under section 440.13, Fla. Stat. 
  • Amica Mutual Insurance Company, etc. v. Pulte Home Corporation a/k/a Pulte, etc., et al., (Fla. 5th DCA). Appeals/certiorari. Order denying motion for leave to file second amended complaint to name proper defendant after statute of limitations had run did not create irreparable harm irremediable on appeal. If the trial court erred or relied on an inadequate factual record in denying leave to amend, that error is correctable on appeal. Certiorari review denied.
  1. GEORGIA
  • Aimwell, Inc. v. McClendon Enterprises, Inc. (A12A1415, November 7, 2012); McClendon Enterprises Inc. v. Aimwell, Inc. (A12A1416, November 7, 2012). Workers’ compensation/liability apportionment. Superior court did not err in affirming Appellate Division’s finding that joint employer that solely paid injured employee’s wages was required to bear 100% of employees compensation claim, pursuant to O.C.G.A. § 34-9-224. Plain language of O.C.G.A. § 34-9-224 states that in the case of joint employment, each employer is required to contribute to compensation to an injured employee in proportion to its responsibility for paying the employee’s wages. The term “wage” in O.C.G.A. § 34-9-260 has been interpreted to mean “any payment by the employer to the employee for services rendered in the course of employment that constitutes a net economic gain to the employee.”
  • Arby’s Restaurant Group, Inc., et al. v. McRae, (S12G0714, Nov. 5, 2012). Workers’ compensation/health information. Court of Appeals decision reversed and case remanded. An employer may seek relevant protected health information informally by communicating orally with an employee’s treating physician. O.C.G.A. § 34-9-207(a) does not expressly prohibit ex parte communications and HIPAA’s privacy provisions do not preempt Georgia law on the subject of ex parte communications because HIPAA exempts from its requirements disclosures made in accordance with state workers’ compensation laws. O.C.G.A § 34-9-207(a) does not demand that physicians agree to be interviewed ex parte. Physicians may agree to be interviewed only on the condition that their own counsel, or the employee or his/her counsel, is present, may request that the interview be audio or video recorded, and may share the substance of the interview with the employee and his/her counsel.
  1. FEDERAL APPELLATE DECISIONS
  • No Florida or Georgia decisions reported.
  1. ADMINISTRATIVE LAW/AGENCY DECISIONS
  1. NOTICES OF ADMINISTRATIVE RULEMAKING PROCEEDINGS
    1. FLORIDA
  • No Florida rulemaking proceedings published.
  1. GEORGIA
  • Proposed Rule and Regulation Chapter 120-2-101 – Child Only Individual Health Coverage. The Office of the Commissioner of lnsurance proposes to add a new Rule and Regulation Chapter entitled "Child Only Individual Health Coverage." The purpose of proposed Rule and Regulation 120-2-101 is to implement recent changes to Title 33 resulting from the passage of House Bill 1166 during the most recent session of the Georgia General Assembly. Click here for the full text of proposed Rule and Regulation 120-2-I01. A public hearing will be held on December 7, 2012, 9:00 a.m. in the Hearing Room of the Office of Commissioner of Insurance, Seventh Floor, West Tower, Floyd Building, Two Martin Luther King, Jr. Drive, Atlanta, GA.
  1. MEETING NOTICES OF INTEREST/MISCELLANEOUS
  • Florida OIR Announces Online Video Tutorials to Navigate CHOICES Auto and Homeowners Rate Comparison System. Florida OIR announced the addition of two new online video tutorials for consumers to utilize as an educational resource for navigating the CHOICES Auto and Homeowners Rate Comparison System. CHOICES is an interactive program designed to give Florida residents the ability to compare automobile and/or homeowners insurance rates using sample risk scenarios created for each.
  • Florida OIR Announces Staff Change - New Director of Life and Health Product Review. Effective November 13, 2012, Jack McDermott is appointed Director of Life & Health Product Review, succeeding Suzetta Furlong, who accepted a position with the Department of Management Services Division of State Group Insurance. McDermott has 16 years of insurance regulatory experience, and a decade of management experience in various roles with the Office, most recently as the Director of Communications. In his new role he will oversee a group of nearly 20 professionals with the responsibility of handling the form and rate filings for the Office in the life and health area.
  • Agency for Health Care Administration – Medicaid Division. On November 15, 2012, 9:00 a.m. - 12:00 Noon, Agency for Health Care Administration, 2727 Mahan Drive, Building 3, Conference Room A, Tallahassee, FL. To participate by phone, please dial 1-888-670-3525, participant passcode 8074710718#. General subject matter to be discussed: Diagnosis Related Group (DRG) based reimbursement payment system for hospital inpatient services. All meeting discussion material, including an agenda, will be posted to the Medicaid Institutional Provider Cost Reimbursement Medicaid Cost Reimbursement website at http://ahca.myflorida.com/Medicaid/cost_reim/index.shtml.
  • Citizens Property Insurance Corporation – Audit Committee. On November 16, 2012, 9.00 a.m. Teleconference Only: Dial in number: 1-866-361-7525. A copy of the agenda may be obtained by contacting: Betty Veal at (904) 407-0440 or on the website: www.citizensfla.com.
  • Florida Self-Insurers Guaranty Association, Inc., Finance Committee. On November 16, 2012, 2:00 p.m., Florida Self-Insurers Guaranty Association, Inc., 1427 E. Piedmont Drive, 2nd Floor, Tallahassee, FL. Matters to be discussed: General business. A copy of the agenda may be obtained by contacting: Brian Gee, Executive Director at (850) 222-1882.
  • Agency for Health Care Administration – Medicaid Reform Technical Advisory Panel Teleconference. On November 19, 2012, 10:00 a.m. - 11:00 a.m., dial-in number: 1(877) 299-4502, passcode: 391-242-80#. A copy of the agenda may be obtained by contacting: Danielle Pigott at (850) 412-4724 or by email at Danielle.Pigott@ahca.myflorida.com.
  • Agency for Health Care Administration – Statewide Medicaid Program. On November 19, 2012, 1:30 p.m. – 4:30 p.m., Location: Agency for Health Care Administration, 2727 Mahan Drive, Bldg. 3, Conference Room A, Tallahassee, FL. A conference number will be available for those unable to attend in person. Dial In Number: 1 (888) 482-0024, Conference Code: 277-949-69. The purpose of the meeting is to address questions about the Managed Medical Assistance Data Book released on September 21, 2012. The Data Book provides relevant background information that prospective plans will find useful in the development of their response to the Invitation to Negotiate (ITN). The ITN will be released by January 1, 2013. The MMA Data Book provides three most recent years of data for Medicaid services that will be the responsibility of the MMA plans. These data include summarized regional and statewide historical fee-for-service data together with financial and encounter data for populations expected to be eligible for the SMMC MMA program. Certain adjustments have been made to historical data in the Data Book, and additional adjustments to the data are expected to be made as the negotiation of actuarially sound rates with the plans occurs. For more information about the Statewide Medicaid Managed Care program, visit: http://ahca.myflorida.com/Medicaid/statewide_mc/index.shtml If you have not previously submitted questions on the Managed Medical Assistance Data Book and would like to do so prior to the public meeting, email them to FLMedicaidManagedCare@ahca.myflorida.com by November 9, 2012. A copy of the agenda may be obtained by contacting: Erica Wilson at Erica.Wilson@ahca.myflorida.com or by calling at (850)412-4669.
  • Board of Employee Leasing Companies – Probable Cause Panel. On November 28, 2012, 8:30 a.m., Holiday Inn Resort Orlando - The Castle, 8629 International Drive, Orlando, FL. Portions of the meeting will be closed to the public. A copy of the agenda may be obtained by contacting: the Department of Business and Professional Regulation, Board of Employee Leasing Companies at 1940 North Monroe Street, Tallahassee, FL 32399-0767.
  • Agency for Agency for Health Care Administration - State Consumer Health Information and Policy Advisory Council. On November 29, 2012, 10:00 a.m. – 2:00 p.m., Agency for Health Care Administration, Conference Room “A”, 2727 Mahan Drive, Tallahassee, FL. Any person interested in participating by telephone may dial 1 (888) 670-3525, Participant Code: 3875036751#. If you have any difficulty accessing the teleconference, please call the Florida Center’s main number at (850) 412-3730. The purpose of the public meeting is to conduct a meeting of key health care stakeholders to discuss issues relating to implementing Florida Statutes mandating transparency in health care through public reporting of health care data.