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A05299 Summary:

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A05299 Floor Votes:

A05299 Text:

 
                STATE OF NEW YORK
        ________________________________________________________________________
 
                                         5299--B
 
                               2013-2014 Regular Sessions
 
                   IN ASSEMBLY
 
                                    February 22, 2013
                                       ___________
 
        Introduced  by  M.  of  A.  PRETLOW, BRONSON, ROSENTHAL -- read once and
          referred to the Committee  on  Labor  --  committee  discharged,  bill
          amended,  ordered reprinted as amended and recommitted to said commit-
          tee -- recommitted to the Committee on Labor in accordance with Assem-
          bly Rule 3, sec. 2 -- reported and referred to the Committee on  Codes

          -- reported and referred to the Committee on Ways and Means -- commit-
          tee  discharged, bill amended, ordered reprinted as amended and recom-
          mitted 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
          workers
 
          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
    18  not be authorized to perform independent  medical  examinations,  except
 
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD06715-04-4
        A. 5299--B                          2
 
     1  for  independent  medical  exams related to the need for clinical social
     2  work services.
     3    (b)  Medical  bureaus,  medical  centers jointly operated by labor and
     4  management representatives, hospitals and health  maintenance  organiza-
     5  tions, authorized to provide medical care pursuant to section thirteen-c

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

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

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

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

    47  eight  hours  following  the  first treatment the clinical social worker
    48  giving such care or treatment furnishes to the employer and directly  to
    49  the  chair a preliminary notice of such injury and treatment, and within
    50  fifteen days thereafter a more complete report  and  subsequent  thereto
    51  progress  reports  as requested in writing by the chair, board, employer
    52  or insurance carrier, at intervals of not less than three weeks apart or
    53  at less frequent intervals if  requested  on  forms  prescribed  by  the
    54  chair.  The board may excuse the failure to give such notices within the
    55  designated periods when it finds it to be in the interest of justice  to
    56  do so.
        A. 5299--B                          3
 

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

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

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

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

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

    52    9.  The  chair  shall  promulgate  rules governing the procedure to be
    53  followed by those rendering clinical social  work  services  under  this
    54  section,  which  rules  so far as practicable shall conform to the rules
    55  presently in effect with reference to medical care furnished  to  claim-
    56  ants  in  workers'  compensation. In connection with the promulgation of
        A. 5299--B                          4
 
     1  such rules the chair may  consult  the  clinical  social  work  practice
     2  committee  and  may take into consideration the view of other interested
     3  parties.
     4    10.  The  chair  shall appoint for and with jurisdiction in the entire
     5  state of New York a  single  clinical  social  work  practice  committee

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

    16  to a workers' compensation claim or  otherwise.  The  attorney  general,
    17  upon request, shall advise and assist such committee.
    18    11.  The  clinical  social  work practice committee shall investigate,
    19  hear and make findings with respect to all charges as to professional or
    20  other misconduct of any authorized clinical social worker as provided in
    21  this section under rules and procedures to be prescribed  by  the  chair
    22  and  shall  report  evidence of such misconduct, with their findings and
    23  recommendations with respect thereto, to the chair.  The findings, deci-
    24  sion and recommendation of such clinical social work practice  committee
    25  shall be advisory to the chair only, and shall not be binding or conclu-

    26  sive  upon  him or her. The chair shall remove from the list of licensed
    27  clinical social  workers  authorized  to  render  clinical  social  work
    28  services  under  this chapter the name of any clinical social worker who
    29  he or she shall find  after  reasonable  investigation  is  disqualified
    30  because such clinical social worker:
    31    (a) has been guilty of professional or other misconduct or incompeten-
    32  cy in connection with the rendering of clinical social work services,
    33    (b)  has  exceeded the limits of his or her professional competence in
    34  rendering clinical social work services under the law, or has made false
    35  statements regarding qualifications  in  the  application  for  authori-
    36  zation,

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

    48  officer of the state, any legal question or produce any relevant book or
    49  paper concerning conduct under an authorization granted under law, or
    50    (g)  has directly or indirectly requested, received or participated in
    51  the division, transference, assignment, rebating, splitting or refunding
    52  of a fee for, or has directly or indirectly requested, received or prof-
    53  ited by means of a credit  or  otherwise  valuable  consideration  as  a
    54  commission,  discount  or gratuity in connection with the treatment of a
    55  workers' compensation claimant.
        A. 5299--B                          5
 
     1    12. Any person who violates or attempts to violate, and any person who
     2  aids another to violate or attempts to induce him or her to violate  the

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

    14  workers  who practice as partners, in groups or as a professional corpo-
    15  ration from pooling fees and moneys received, either by the partnership,
    16  professional corporation or group or by the individual members  thereof,
    17  for  professional  services  furnished  by  any  individual professional
    18  member, or employee of such partnership, corporation or group, nor shall
    19  the professionals constituting the partnerships, corporations, or groups
    20  be prohibited from sharing, dividing or apportioning the fees and moneys
    21  received by them or by the partnership, corporation or group in  accord-
    22  ance with a partnership or other agreement.
    23    § 3. This act shall take effect on the one hundred eightieth day after
    24  it  shall have become a law. Effective immediately, the addition, amend-

    25  ment and/or repeal of any rules and regulations necessary  to  implement
    26  the  provisions  of  this act on its effective date are authorized to be
    27  made on or before such effective date.