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A07455 Summary:

BILL NOA07455
 
SAME ASNo Same As
 
SPONSORTitone
 
COSPNSRZebrowski, Stirpe, Gunther, Jaffee, Cook, Montesano, Benedetto, Magnarelli
 
MLTSPNSRAbbate, Crouch, Hikind, Hooper, McLaughlin
 
Amd 13, 13-k, 13-l & 13-m, Work Comp L
 
Relates to the establishment of rates of payment and delivery of health care services; directs the chair of the workers' compensation board to biennially prepare and establish a schedule of fees.
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A07455 Actions:

BILL NOA07455
 
04/26/2017referred to labor
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A07455 Memo:

NEW YORK STATE ASSEMBLY
MEMORANDUM IN SUPPORT OF LEGISLATION
submitted in accordance with Assembly Rule III, Sec 1(f)
 
BILL NUMBER: A7455
 
SPONSOR: Titone (MS)
  TITLE OF BILL: An act to amend the workers' compensation law, in relation to the establishment of rates of payment and delivery of health care services   PURPOSE OR GENERAL IDEA OF BILL: To require the Workers' Compensation Board to biennially prepare and establish a rate schedule for health care rendered under workers compen- sation system.   SUMMARY OF PROVISIONS: Section 1 through 4 of the bill require the Workers' Compensation Board to biennially prepare and establish a rate schedule for health care rendered under the workers' compensation system. Section 5 requires the Workers' Compensation Board to publish a revision to the existing fee schedules one year from the effective date. Section 6 is the effective date.   DIFFERENCE BETWEEN ORIGINAL AND AMENDED VERSION (IF APPLICABLE): N/A   JUSTIFICATION: The Workers' Compensation Board has not adjusted rates of payment for health care providers for over 10 years. Today, New York's rates are the lowest or near the lowest in the country for many health care services. Payments for health care services rendered pursuant to the workers' compensation system do not reflect the current cost health care, includ- ing labor, property and energy costs. As a result, many providers no longer participate in the workers' compensation system, and those that do struggle to maintain quality services in light of the low payment levels. The bill would require the Workers' Compensation Board to under- take the process of examining the appropriateness of rates of payment annually, something the board is currently required to do.   PRIOR LEGISLATIVE HISTORY: 2011-2012- A7356 Referred to labor 2013-2014- A7661 Referred to labor 2015-2016- A3158 Referred to labor   FISCAL IMPLICATIONS FOR STATE AND LOCAL GOVERNMENTS: None   EFFECTIVE DATE: Immediate
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A07455 Text:



 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                          7455
 
                               2017-2018 Regular Sessions
 
                   IN ASSEMBLY
 
                                     April 26, 2017
                                       ___________
 
        Introduced by M. of A. TITONE, ZEBROWSKI, STIRPE, GUNTHER, JAFFEE, COOK,
          MONTESANO,  BENEDETTO,  MAGNARELLI  --  Multi-Sponsored by -- M. of A.
          ABBATE, CROUCH, HIKIND, HOOPER, McLAUGHLIN -- read once  and  referred
          to the Committee on Labor
 
        AN ACT to amend the workers' compensation law, in relation to the estab-
          lishment of rates of payment and delivery of health care services
 
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
 
     1    Section 1. The closing paragraph of subdivision (a) of section  13  of
     2  the  workers'  compensation  law, as amended by chapter 6 of the laws of
     3  2007, is amended to read as follows:
     4    The chair, in consultation with the board's  medical  director,  shall
     5  biennially  prepare and establish a schedule for the state, or schedules
     6  limited to defined localities, of charges  and  fees  for  such  medical
     7  treatment and care, and including all medical, dental, surgical, optome-
     8  tric or other attendance or treatment, nurse and hospital service, medi-
     9  cine,  optometric  services, crutches, eye-glasses, false teeth, artifi-
    10  cial eyes,  orthotics,  prosthetic  devices,  functional  assistive  and
    11  adaptive  devices  and apparatus in accordance with and to be subject to
    12  change pursuant to rules promulgated by the chair. Before preparing such
    13  schedule for the state or schedules for  limited  localities  the  chair
    14  shall  request  the president of the medical society of the state of New
    15  York and the president of the New York state osteopathic medical society
    16  to submit to him or her a report on the amount of remuneration deemed by
    17  such society to be fair and adequate for the types of medical care to be
    18  rendered under this chapter, but consideration shall  be  given  to  the
    19  view  of  other interested parties. In the case of physical therapy fees
    20  schedules the chair shall request the president of [a recognized profes-
    21  sional association representing physical therapists in the state of  New
    22  York]  the New York physical therapy association to submit to him or her
    23  a report on the amount of remuneration deemed by such association to  be
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD11041-01-7

        A. 7455                             2
 
     1  fair  and  reasonable for the type of physical therapy services rendered
     2  under this chapter, but consideration shall be given  to  the  views  of
     3  other  interested parties.  The chair shall also prepare and establish a
     4  schedule  for  the state, or schedules limited to defined localities, of
     5  charges and fees for outpatient hospital services not covered under  the
     6  medical  fee  schedule previously referred to in this subdivision, to be
     7  determined in accordance with and to be subject to  change  pursuant  to
     8  rules  promulgated  by the chair. Before preparing such schedule for the
     9  state or schedules for limited localities the chair  shall  request  the
    10  president of the hospital association of New York state to submit to him
    11  or her a report on the amount of remuneration deemed by such association
    12  to  be fair and adequate for the types of hospital outpatient care to be
    13  rendered under this chapter, but consideration shall  be  given  to  the
    14  views  of  other interested parties. In the case of occupational therapy
    15  fees schedules the chair shall request the  president  of  a  recognized
    16  professional  association  representing  occupational  therapists in the
    17  state of New York to submit to him or her a  report  on  the  amount  of
    18  remuneration  deemed  by  such association to be fair and reasonable for
    19  the type of occupational therapy services rendered under  this  chapter,
    20  but  consideration  shall  be  given  to  the  views of other interested
    21  parties. The amounts payable by the  employer  for  such  treatment  and
    22  services  shall  be  the  fees and charges established by such schedule.
    23  Nothing in this schedule, however, shall prevent  voluntary  payment  of
    24  amounts  higher or lower than the fees and charges fixed therein, but no
    25  physician rendering medical treatment or care, and no physical or  occu-
    26  pational  therapist  rendering their respective physical or occupational
    27  therapy services may receive payment in any higher  amount  unless  such
    28  increased  amount has been authorized by the employer, or by decision as
    29  provided in section thirteen-g of this article. Nothing in this  section
    30  shall  be  construed  as  preventing the employment of a duly authorized
    31  physician on a salary basis by an authorized compensation medical bureau
    32  or laboratory.
    33    § 2. Subdivision 2 of section 13-k of the workers'  compensation  law,
    34  as  amended  by  chapter  473 of the laws of 2000, is amended to read as
    35  follows:
    36    2. An employee injured under  circumstances  which  make  such  injury
    37  compensable  under  this article, when care is required for an injury to
    38  the foot which injury or resultant condition therefrom may  lawfully  be
    39  treated by a duly registered and licensed podiatrist of the state of New
    40  York,  may  select  to treat him or her any podiatrist authorized by the
    41  chair to render podiatry care, as hereinafter provided. If the injury or
    42  condition is one which is without the limits prescribed by the education
    43  law for podiatry care and treatment, or  the  injuries  involved  affect
    44  other  parts  of  the  body in addition to the foot, the said podiatrist
    45  must so advise the said injured employee and  instruct  him  or  her  to
    46  consult  a  physician of said employee's choice for appropriate care and
    47  treatment. Such physician shall thenceforth have overall supervision  of
    48  the  treatment  of  said  patient  including  the future treatment to be
    49  administered to the patient by the podiatrist. If for any reason  during
    50  the  period  when  podiatry treatment and care is required, the employee
    51  wishes to transfer his or her treatment and care to  another  authorized
    52  podiatrist  he  or she may do so, in accordance with rules prescribed by
    53  the chair, provided however that the employer shall be  liable  for  the
    54  proper  fees of the original podiatrist for the care and treatment he or
    55  she shall have rendered. A podiatrist licensed and registered  to  prac-
    56  tice  podiatry in the state of New York who is desirous of being author-

        A. 7455                             3
 
     1  ized to render podiatry care under this section and/or to conduct  inde-
     2  pendent  medical  examinations  in  accordance  with  paragraph  (b)  of
     3  subdivision three of this section shall file an application for authori-
     4  zation under this section with the podiatry practice committee.  In such
     5  application  he or she shall agree to refrain from subsequently treating
     6  for remuneration, as a private  patient,  any  person  seeking  podiatry
     7  treatment,  or  submitting  to  an  independent  medical examination, in
     8  connection with, or as a result of, any injury  compensable  under  this
     9  chapter,  if  he  or  she  has been removed from the list of podiatrists
    10  authorized to render podiatry care or  to  conduct  independent  medical
    11  examinations under this chapter, or if the person seeking such treatment
    12  has  been  transferred  from  his  or  her  care  in accordance with the
    13  provisions of this section. This agreement shall run to the  benefit  of
    14  the injured person so treated or examined, and shall be available to him
    15  or  her  as  a  defense in any action by such podiatrist for payment for
    16  treatment rendered by a podiatrist after he or she has been removed from
    17  the list of podiatrists authorized to render podiatry care or to conduct
    18  independent medical  examinations  under  this  section,  or  after  the
    19  injured  person  was transferred from his or her care in accordance with
    20  the provisions of this section. The podiatry practice  committee  if  it
    21  deems  such  licensed  podiatrist  duly qualified shall recommend to the
    22  chair that such podiatrist be authorized to render podiatry care  and/or
    23  to  conduct  independent  medical  examinations under this section. Such
    24  recommendation shall be advisory to the chair  only  and  shall  not  be
    25  binding  or  conclusive upon him or her. The chair, in consultation with
    26  the board's medical director, shall biennially prepare and  establish  a
    27  schedule  for  the state, or schedules limited to defined localities, of
    28  charges and fees for podiatry treatment and care, to  be  determined  in
    29  accordance with and to be subject to change pursuant to rules promulgat-
    30  ed  by the chair. Before preparing such schedule for the state or sched-
    31  ules for limited localities the chair shall request the  podiatry  prac-
    32  tice  committee  to  submit  to  him  or  her  a report on the amount of
    33  remuneration deemed by such committee to be fair and  adequate  for  the
    34  types  of podiatry care to be rendered under this chapter, but consider-
    35  ation shall be given to the view  of  other  interested  parties.    The
    36  amounts payable by the employer for such treatment and services shall be
    37  the fees and charges established by such schedule.
    38    §  3.  Subdivision 2 of section 13-l of the workers' compensation law,
    39  as amended by chapter 473 of the laws of 2000, is  amended  to  read  as
    40  follows:
    41    2.  An  employee  injured  under  circumstances which make such injury
    42  compensable under this article, when care  is  required  for  an  injury
    43  which  consists solely of a condition which may lawfully be treated by a
    44  chiropractor as defined in section sixty-five hundred fifty-one  of  the
    45  education  law  may  select to treat him or her, any duly registered and
    46  licensed chiropractor of the state of New York, authorized by the  chair
    47  to  render  chiropractic  care as hereinafter provided. If the injury or
    48  condition is one which is outside the limits prescribed by the education
    49  law for chiropractic care and treatment, the said chiropractor  must  so
    50  advise  the  said  injured employee and instruct him or her to consult a
    51  physician of said employee's choice for appropriate care and  treatment.
    52  Such  physician  shall  thenceforth have supervision of the treatment of
    53  said condition including the future treatment to be administered to  the
    54  patient  by  the chiropractor. A chiropractor licensed and registered to
    55  practice chiropractic in the state of New York, who is desirous of being
    56  authorized to render chiropractic care  under  this  section  and/or  to

        A. 7455                             4

     1  conduct  independent  medical  examinations in accordance with paragraph
     2  (b) of subdivision three of this section shall file an  application  for
     3  authorization  under this section with the chiropractic practice commit-
     4  tee.  In  such  application he or she shall agree to refrain from subse-
     5  quently treating for remuneration, as  a  private  patient,  any  person
     6  seeking  chiropractic treatment, or submitting to an independent medical
     7  examination, in connection with, or as a result of, any injury compensa-
     8  ble under this chapter, if he or she has been removed from the  list  of
     9  chiropractors authorized to render chiropractic care or to conduct inde-
    10  pendent  medical examinations under this chapter, or if the person seek-
    11  ing such treatment has been transferred from his or her care in  accord-
    12  ance  with  the  provisions of this section. This agreement shall run to
    13  the benefit of the injured person so treated, or examined, and shall  be
    14  available  to him or her as a defense in any action by such chiropractor
    15  for payment rendered by a chiropractor after he or she has been  removed
    16  from the list of chiropractors authorized to render chiropractic care or
    17  to conduct independent medical examinations under this section, or after
    18  the  injured  person  was transferred from his or her care in accordance
    19  with the provisions of this section. The chiropractic practice committee
    20  if it deems such licensed chiropractor duly qualified shall recommend to
    21  the chair that such be authorized to render chiropractic care and/or  to
    22  conduct independent medical examinations under this section. Such recom-
    23  mendations  shall be advisory to the chair only and shall not be binding
    24  or conclusive upon him or her.  The  chair,  in  consultation  with  the
    25  board's medical director, shall biennially prepare and establish a sche-
    26  dule for the state, or schedules limited to defined localities of charg-
    27  es  and  fees  for  chiropractic treatment and care, to be determined in
    28  accordance with and to be subject to change pursuant to rules promulgat-
    29  ed by the chair.  Before preparing such schedule for the state or sched-
    30  ules for limited localities the chair  shall  request  the  chiropractic
    31  practice  committee  to  submit  to him or her a report on the amount of
    32  remuneration deemed by such committee to be fair and  adequate  for  the
    33  types  of  chiropractic  care  to  be  rendered  under this chapter, but
    34  consideration shall be given to the view of  other  interested  parties,
    35  the  amounts  payable  by  the  employer for such treatment and services
    36  shall be the fees and charges established by such schedule.
    37    § 4. Subdivision 3 of section 13-m of the workers'  compensation  law,
    38  as  amended  by  chapter  473 of the laws of 2000, is amended to read as
    39  follows:
    40    3. A psychologist, licensed and registered to practice  psychology  in
    41  the  state  of  New  York, who is desirous of being authorized to render
    42  psychological care under this  section  and/or  to  conduct  independent
    43  medical  examinations  in  accordance  with paragraph (b) of subdivision
    44  four of this section shall file an application for  authorization  under
    45  this section with the psychology practice committee. The applicant shall
    46  agree  to  refrain  from  subsequently  treating  for remuneration, as a
    47  private patient, any person seeking psychological treatment, or  submit-
    48  ting  to an independent medical examination, in connection with, or as a
    49  result of, any injury compensable under this chapter, if he or  she  has
    50  been removed from the list of psychologists authorized to render psycho-
    51  logical care under this chapter. This agreement shall run to the benefit
    52  of the injured person so treated, and shall be available as a defense in
    53  any  action  by  such psychologist for payment for treatment rendered by
    54  such psychologist after being removed from  the  list  of  psychologists
    55  authorized  to  render  psychological  care  or  to  conduct independent
    56  medical examinations under this section. The psychology practice commit-

        A. 7455                             5
 
     1  tee if it deems such licensed psychologist duly qualified  shall  recom-
     2  mend to the chair that such person be authorized to render psychological
     3  care  and/or  to  conduct  independent  medical  examinations under this
     4  section.  Such  recommendations  shall be only advisory to the chair and
     5  shall not be binding or conclusive. The chair, in consultation with  the
     6  board's medical director, shall biennially prepare and establish a sche-
     7  dule for the state or schedules limited to defined localities of charges
     8  and  fees  for  psychological  treatment  and  care, to be determined in
     9  accordance with and be subject to change pursuant to  rules  promulgated
    10  by  the chair. Before preparing such schedule for the state or schedules
    11  for limited localities the chair shall request the  psychology  practice
    12  committee to submit to such chair a report on the amount of remuneration
    13  deemed  by  such  committee  to  be  fair  and adequate for the types of
    14  psychological care to be rendered under this chapter, but  consideration
    15  shall  be  given  to  the  view of other interested parties. The amounts
    16  payable by the employer for such treatment and  services  shall  be  the
    17  fees and charges established by such schedule.
    18    §  5.  Notwithstanding the provisions of section one of this act or of
    19  any other law, rule or regulation to the contrary, a revision to the fee
    20  schedules established pursuant to sections 13, 13-k, 13-l  and  13-m  of
    21  the  workers' compensation law existing as of the effective date of this
    22  act shall be published by the chair of the workers'  compensation  board
    23  on  behalf  of such board no later than one year following the effective
    24  date of this act. Subsequent biennial schedules shall  be  published  in
    25  final  form  on  January  fifteenth  every  other  year. Nothing in this
    26  section shall limit the authority of the chair of the  workers'  compen-
    27  sation  board  to make adjustments in the fee schedule other than at the
    28  biennial publication.
    29    § 6. This act shall take effect immediately.
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