Florida Regulations 59A-31.013
§ 59A-31.013 Petition Withdrawal.
|(1) Prior to the issuance of a determination, the petitioner may voluntarily withdraw its Petition for Resolution of Reimbursement Dispute.
(2) The withdrawal of a petition shall be in writing and must clearly indicate:
(a) The name of the health care provider or facility requesting withdrawal;
(b) The name of the carrier against whom the petition has been initiated;
(c) The date(s) of service covered by the petition; and
(d) The identity of the injured employee to whom medical services were delivered.
(3) The result of receipt by the Agency of a request for withdrawal of a petition shall be dismissal of the determination case by the Agency.
History: New 11-28-06.