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S02360 Summary:

Add S13-p, Work Comp L
Authorizes the mental health care and treatment of injured employees by licensed clinical social workers under the workers' compensation program.
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S02360 Text:

                STATE OF NEW YORK
                               2013-2014 Regular Sessions
                    IN SENATE
                                    January 16, 2013
        Introduced  by  Sens.  KLEIN, HASSELL-THOMPSON -- read twice and ordered
          printed, and when printed to be committed to the Committee on Labor --
          reported favorably from said committee and committed to the  Committee
          on Finance -- committee discharged, bill amended, ordered reprinted as
          amended  and  recommitted  to  said  committee  --  recommitted to the

          Committee on Labor in  accordance  with  Senate  Rule  6,  sec.  8  --
          reported  favorably from said committee and committed to the Committee
          on Finance -- committee discharged, bill amended, ordered reprinted as
          amended and recommitted to said committee
        AN ACT to amend the workers' compensation law, in relation to  the  care
          and treatment of injured employees by certain licensed clinical social
          The  People of the State of New York, represented in Senate and Assem-
        bly, do enact as follows:
     1    Section 1. Short title.  This act shall be known and may be  cited  as
     2  the "injured workers assistance act".
     3    §  2. The workers' compensation law is amended by adding a new section
     4  13-p to read as follows:
     5    § 13-p. Care and treatment of injured employees  by  certain  licensed

     6  clinical  social  workers. 1. Where the term "clinical social worker" is
     7  used in this section, such term shall mean a person who is duly licensed
     8  and registered as a licensed clinical social worker pursuant to  article
     9  one hundred fifty-four of the education law.
    10    2.  (a)  An  injured  employee, injured under circumstances which make
    11  such an injury compensable under this article, may lawfully be  treated,
    12  upon  the  referral  of  an authorized physician, by a licensed clinical
    13  social worker authorized by the chair to render social work care  pursu-
    14  ant to this section. Such services shall be within the scope of licensed
    15  clinical  social  work as defined in subdivision two of section seventy-

    16  seven hundred one of the education law. Clinical social workers  author-
    17  ized  by  the  chair to provide services pursuant to this section, shall
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.

        S. 2360--B                          2
     1  not be authorized to perform independent  medical  examinations,  except
     2  for  independent  medical  exams related to the need for clinical social
     3  work services.
     4    (b)  Medical  bureaus,  medical  centers jointly operated by labor and
     5  management representatives, hospitals and health  maintenance  organiza-

     6  tions, authorized to provide medical care pursuant to section thirteen-c
     7  of  this  article,  may  provide  clinical  social  work  services  when
     8  required, upon the referral of an authorized  physician,  provided  such
     9  care  is rendered by a duly registered, licensed and authorized clinical
    10  social worker as required by this section.
    11    (c) A licensed clinical social worker rendering  service  pursuant  to
    12  this section shall maintain records of the patient's condition and clin-
    13  ical social work treatment, and such records or reports shall be submit-
    14  ted  to  the  chair  on  such  forms  and at such times as the chair may
    15  require.
    16    3. A licensed clinical social worker who is desirous of being  author-

    17  ized  to  render  clinical social work services under this section shall
    18  file an application for authorization under this section with the  clin-
    19  ical  social  work  practice  committee.  The  applicant  shall agree to
    20  refrain from  subsequently  treating  for  remuneration,  as  a  private
    21  patient, any person seeking clinical social work services, in connection
    22  with,  or  as a result of, any injury compensable under this chapter, if
    23  he or she has been removed from the  list  of  clinical  social  workers
    24  authorized  to  render services under this chapter. This agreement shall
    25  run to the benefit of the injured person so treated, and shall be avail-
    26  able as a defense in any action  by  such  clinical  social  worker  for

    27  payment  for  treatment  rendered  by  such clinical social worker after
    28  being removed from the list of clinical  social  workers  authorized  to
    29  render  clinical  social  work services under this section. The clinical
    30  social work practice committee,  if  it  deems  such  licensed  clinical
    31  social  worker  duly  qualified,  shall recommend to the chair that such
    32  person be authorized to render clinical social work services under  this
    33  section.  Such  recommendations  shall be only advisory to the chair and
    34  shall not be binding or conclusive. The chair shall prepare  and  estab-
    35  lish a schedule for the state or schedules limited to defined localities
    36  of  charges  and fees for clinical social work treatment and care, to be

    37  determined in accordance with and be subject to change pursuant to rules
    38  promulgated by the chair. Before preparing such schedule for  the  state
    39  or schedules for limited localities the chair shall request the clinical
    40  social  work  practice committee to submit to such chair a report on the
    41  amount of remuneration deemed by such committee to be fair and  adequate
    42  for the types of clinical social work services to be rendered under this
    43  chapter,  but  consideration  shall be given to the view of other inter-
    44  ested parties. The amounts payable by the employer  for  such  treatment
    45  and services shall be the fees and charges established by such schedule.
    46    4.    No  claim  for  clinical social work services shall be valid and

    47  enforceable as against the employer or employees  unless  within  forty-
    48  eight  hours  following  the  first treatment the clinical social worker
    49  giving such care or treatment furnishes to the employer and directly  to
    50  the  chair a preliminary notice of such injury and treatment, and within
    51  fifteen days thereafter a more complete report  and  subsequent  thereto
    52  progress  reports  as requested in writing by the chair, board, employer
    53  or insurance carrier, at intervals of not less than three weeks apart or
    54  at less frequent intervals if  requested  on  forms  prescribed  by  the
    55  chair.  The board may excuse the failure to give such notices within the

        S. 2360--B                          3

     1  designated periods when it finds it to be in the interest of justice  to
     2  do so.
     3    5.  Fees  for clinical social work services shall be payable only to a
     4  duly licensed clinical social worker as licensed in article one  hundred
     5  fifty-four  of  the education law, or to the agent, executor or adminis-
     6  trator of the  estate  of  such  licensed  clinical  social  worker.  No
     7  licensed  clinical  social  worker rendering treatment to a compensation
     8  claimant shall collect or receive a fee from such claimant  within  this
     9  state,  but shall have recourse for payment of services rendered only to
    10  the employer under the provisions of this section.
    11    6. Whenever his or her  attendance  at  a  hearing  is  required,  the

    12  licensed  clinical  social worker of the injured employee shall be enti-
    13  tled to receive a fee from the employer in an amount to be fixed by  the
    14  board,  in  addition to any fee payable under section eight thousand one
    15  of the civil practice law and rules.
    16    7. (a) Unless within thirty days after a bill has been rendered to the
    17  employer by the licensed clinical  social  worker  who  has  treated  an
    18  injured  employee,  such employer shall have notified the chair and such
    19  clinical social worker in writing that such employer demands  an  impar-
    20  tial  examination of the fairness of the amount claimed by such clinical
    21  social worker for his or her services, the right to  such  an  impartial

    22  examination  shall be deemed to be waived and the amount claimed by such
    23  clinical social worker shall be deemed to  be  the  fair  value  of  the
    24  services  rendered.   If the parties fail to agree as to the social work
    25  care rendered under this chapter to a  claimant,  such  value  shall  be
    26  decided  by the social work practice committee and the majority decision
    27  of such committee shall be conclusive upon the parties as to  the  value
    28  of  the services rendered. The board may make an award for any such bill
    29  or part thereof which remains unpaid in the same manner as an award  for
    30  bills rendered under subdivisions one and three of section thirteen-g of
    31  this article, and such award may be collected in like manner as an award

    32  of compensation. The chair shall assess the sum of fifty dollars against
    33  the  employer  for each such award made by the board, which sum shall be
    34  paid into the state treasury.
    35    (b) Where a licensed clinical social worker's bill has been determined
    36  to be due and owing in accordance with the provisions of  this  section,
    37  the board may impose a penalty of not more than one and one-half percent
    38  interest  per  month  payable  to the licensed clinical social worker in
    39  accordance with the rules and regulations promulgated by the board.
    40    (c) The parties to such proceeding shall each pay to the chair  a  sum
    41  equal  to  five  per  centum of the amount payable under the decision of
    42  such committee or a minimum of five dollars, whichever is  greater.  The

    43  sums  so  collected  shall be transferred to the state treasury to reim-
    44  burse it on account of the expense of administering this section.
    45    8. Within the limits prescribed by  the  education  law  for  licensed
    46  clinical  social work services, the report or testimony of an authorized
    47  clinical social worker concerning the condition of an  injured  employee
    48  and treatment thereof shall be deemed competent evidence and the profes-
    49  sional  opinion  of  the  licensed  clinical  social worker as to causal
    50  relation and as to required treatment  shall  be  deemed  competent  but
    51  shall  not  be  controlling.  Nothing in this section shall be deemed to
    52  deprive any employer or insurance carrier of  any  right  to  a  medical

    53  examination or presentation of medical testimony now conferred by law.
    54    9.  The  chair  shall  promulgate  rules governing the procedure to be
    55  followed by those rendering clinical social  work  services  under  this
    56  section,  which  rules  so far as practicable shall conform to the rules

        S. 2360--B                          4
     1  presently in effect with reference to medical care furnished  to  claim-
     2  ants  in  workers'  compensation. In connection with the promulgation of
     3  such rules the chair may  consult  the  clinical  social  work  practice
     4  committee  and  may take into consideration the view of other interested
     5  parties.
     6    10. The chair shall appoint for and with jurisdiction  in  the  entire

     7  state  of  New  York  a  single  clinical social work practice committee
     8  composed of two clinical licensed social workers, and one duly  licensed
     9  physician  of the state of New York. Each member of such committee shall
    10  receive compensation either on an annual basis or on a per diem basis to
    11  be fixed by the chair within amounts appropriated therefor. One of  such
    12  licensed  clinical  social workers shall be designated by the chair as a
    13  chair of such clinical social work practice committee. No member of such
    14  committee shall render clinical social work services under this  section
    15  nor  be  an employer or accept or participate in any fee from any insur-
    16  ance company authorized to write workers' compensation insurance in this

    17  state or from any self-insurer, whether such employment or  fee  relates
    18  to  a  workers'  compensation  claim or otherwise. The attorney general,
    19  upon request, shall advise and assist such committee.
    20    11. The clinical social work  practice  committee  shall  investigate,
    21  hear and make findings with respect to all charges as to professional or
    22  other misconduct of any authorized clinical social worker as provided in
    23  this  section  under  rules and procedures to be prescribed by the chair
    24  and shall report evidence of such misconduct, with  their  findings  and
    25  recommendations with respect thereto, to the chair.  The findings, deci-
    26  sion  and recommendation of such clinical social work practice committee

    27  shall be advisory to the chair only, and shall not be binding or conclu-
    28  sive upon him or her. The chair shall remove from the list  of  licensed
    29  clinical  social  workers  authorized  to  render  clinical  social work
    30  services under this chapter the name of any clinical social  worker  who
    31  he  or  she  shall  find  after reasonable investigation is disqualified
    32  because such clinical social worker:
    33    (a) has been guilty of professional or other misconduct or incompeten-
    34  cy in connection with the rendering of clinical social work services,
    35    (b) has exceeded the limits of his or her professional  competence  in
    36  rendering clinical social work services under the law, or has made false

    37  statements  regarding  qualifications  in  the  application for authori-
    38  zation,
    39    (c) has failed to submit timely, full  and  truthful  clinical  social
    40  work  evaluation  and  treatment reports of all findings to the employer
    41  and directly to the chair of the board within the time  limits  provided
    42  in this section,
    43    (d)  has  rendered  clinical social worker services under this chapter
    44  for a fee less than that fixed in the fee schedule,
    45    (e)  has  solicited  or  has   employed   another   to   solicit   for
    46  himself/herself  or  for  another professional treatment, examination or
    47  care of an injured employee with any claim under this chapter,
    48    (f) has refused to appear before or answer upon request of the  chair,

    49  board,  clinical  social  work practice committee or any duly authorized
    50  officer of the state, any legal question or produce any relevant book or
    51  paper concerning conduct under an authorization granted under law, or
    52    (g) has directly or indirectly requested, received or participated  in
    53  the division, transference, assignment, rebating, splitting or refunding
    54  of a fee for, or has directly or indirectly requested, received or prof-
    55  ited  by  means  of  a  credit  or otherwise valuable consideration as a

        S. 2360--B                          5
     1  commission, discount or gratuity in connection with the treatment  of  a
     2  workers' compensation claimant.
     3    12. Any person who violates or attempts to violate, and any person who

     4  aids  another to violate or attempts to induce him or her to violate the
     5  provisions of paragraph (g) of subdivision eleven of this section  shall
     6  be guilty of a misdemeanor.
     7    13.  Nothing  in  this  section  shall be construed as limiting in any
     8  respect the power or duty of  the  chair  to  investigate  instances  of
     9  misconduct,  either before or after investigation by the clinical social
    10  work practice committee, or to temporarily suspend the authorization  of
    11  any  licensed  clinical  social  worker  believed  to  be guilty of such
    12  misconduct. The provisions of subdivision one of section  thirteen-d  of
    13  this  article  which  are  not  inconsistent with the provisions of this
    14  section shall be applicable as if fully set forth in this section.

    15    14. Nothing contained in this section shall prohibit  clinical  social
    16  workers  who practice as partners, in groups or as a professional corpo-
    17  ration from pooling fees and moneys received, either by the partnership,
    18  professional corporation or group or by the individual members  thereof,
    19  for  professional  services  furnished  by  any  individual professional
    20  member, or employee of such partnership, corporation or group, nor shall
    21  the professionals constituting the partnerships, corporations, or groups
    22  be prohibited from sharing, dividing or apportioning the fees and moneys
    23  received by them or by the partnership, corporation or group in  accord-
    24  ance with a partnership or other agreement.

    25    § 3. This act shall take effect on the one hundred eightieth day after
    26  it  shall have become a law. Effective immediately, the addition, amend-
    27  ment and/or repeal of any rules and regulations necessary  to  implement
    28  the  provisions  of  this act on its effective date are authorized to be
    29  made on or before such effective date.
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