Florida Regulations 69L-24.0222

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§ 69L-24.0222 Re-Audit and Certification for Noncompliance.

(1) Any carrier, self-insurer or servicing agent who fails to achieve at least 90 percent compliance on any initial audit shall be audited again within twelve (12) months of the date of the initial audit. During the re-audit, the Division shall examine the entity's performance based on the deficiencies identified in the initial audit report and the specific action proposed for eliminating the deficiencies in the entity�s Statement of Objectives. Once the entity has been re-audited and determined not to satisfy the 90 percent compliance rate, that entity shall be subject to the following sanctions:

(a) If the entity�s performance is below 90 percent compliance due to its failure to carry out the specific action proposed, it shall be certified to the Department of Financial Services or this Division, as applicable, under Section 440.20(15)(a), Florida Statutes, in addition to any penalty or fine authorized under Rule 69L- 24.0221, F.A.C.

(b) All carriers, self-insurers, or servicing agents failing to submit a Statement of Objectives and who do not achieve at least 90 percent compliance on re-audit shall be certified to the licensing authority, in addition to any penalty or fine authorized under Rule 69L- 24.0221, F.A.C.

(2) Any carrier, self-insurer or servicing agent whose initial audit indicates a failure to achieve at least 50 percent compliance, shall be certified to the Department of Financial Services or this Division, as applicable, under Section 440.20(15)(a), Florida Statutes.

(3) Upon conclusion of any on-site audit, the Division�s personnel conducting the audit shall review the preliminary findings of such audit with the claims manager or the individual in charge of the office being audited or his designee. Carriers that will be sanctioned under subsection (2) of this rule may request that Division personnel hold, or cause to be held, a workshop which shall include, but not be limited to, the areas of deficiency identified in the audit.

(4) The Division shall not re-audit a carrier, self-insurer, or servicing agent for failure to achieve 90 percent compliance with the Automated Carrier Performance System indicators set forth in paragraphs 69L- 24.0221(1)(a)-(f), F.A.C.

Specific Authority 440.13(11)(b), 440.20(15)(f), 440.591 FS. Law Implemented 440.20 FS. History-New 8-29-94, Amended 5-14-95, Formerly 38F-24.0222, 4L-24.0222.