Division of Administrative Hearings, Florida
Filed: Jul. 28, 2015
The following are the issues presented: Whether the Division of Administrative Hearings (“DOAH”) has jurisdiction to determine the claim of Petitioners Wal-Mart, Inc. (“Wal-Mart”) and Sedgwick CMS (“Sedgwick”) to relief under section 440.13(8) and (11), Florida Statutes; If DOAH has jurisdiction, whether Petitioners have standing to raise the issue of medical overutilization; If DOAH has jurisdiction and the Petitioners have standing, whether Petitioners are estopped from seeking reimbursement of any monies paid to Intervenors Florida Institute for Neurologic Rehabilitation (“FINR”) and Fruitville Holdings - Oppidan, Inc. (“Oppidan”); If DOAH has jurisdiction and Petitioners have standing and are not estopped, whether Intervenors engaged in overutilization of medical care in their care and treatment of the injured worker, D.F.; Whether Respondent, Department of Financial Services, Division of Workers’ Compensation (the “Department), has the authority to order Intervenors to reimburse Petitioners for payments related to overutilization by Intervenors in the medical care of D.F.; and If the Department has such authority, how much money should Intervenors be ordered to reimburse Petitioners.Carrier failed to establish standing to seek administrative remedy for payments to health care provider alleged to constitute overutilization.
