STATE OF NEW YORK
________________________________________________________________________
7151
2013-2014 Regular Sessions
IN ASSEMBLY
May 2, 2013
___________
Introduced by M. of A. HEASTIE -- (at request of the State Insurance
Fund) -- read once and referred to the Committee on Labor
AN ACT to amend the workers' compensation law, in relation to the estab-
lishment of a fee schedule covering the costs of ambulance services
provided to injured employees
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Subdivision (a) of section 13 of the workers' compensation
2 law, as amended by chapter 6 of the laws of 2007, is amended to read as
3 follows:
4 (a) The employer shall promptly provide for an injured employee such
5 medical, dental, surgical, optometric or other attendance or treatment,
6 nurse and hospital service, medicine, optometric services, crutches,
7 eye-glasses, false teeth, artificial eyes, orthotics, prosthetic
8 devices, functional assistive and adaptive devices and apparatus for
9 such period as the nature of the injury or the process of recovery may
10 require. The employer shall be liable for the payment of the expenses of
11 medical, dental, surgical, optometric or other attendance or treatment,
12 ambulance services including air transport, nurse and hospital service,
13 medicine, optometric services, crutches, eye-glasses, false teeth, arti-
14 ficial eyes, orthotics, prosthetic devices, functional assistive and
15 adaptive devices and apparatus, as well as artificial members of the
16 body or other devices or appliances necessary in the first instance to
17 replace, support or relieve a portion or part of the body resulting from
18 and necessitated by the injury of an employee, for such period as the
19 nature of the injury or the process of recovery may require, and the
20 employer shall also be liable for replacements or repairs of such arti-
21 ficial members of the body or such other devices, eye-glasses, false
22 teeth, artificial eyes, orthotics, prosthetic devices, functional assis-
23 tive and adaptive devices or appliances necessitated by ordinary wear or
24 loss or damage to a prosthesis, with or without bodily injury to the
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD08921-01-3
A. 7151 2
1 employee. Damage to or loss of a prosthetic device shall be deemed an
2 injury except that no disability benefits shall be payable with respect
3 to such injury under section fifteen of this article. Such a replacement
4 or repair of artificial members of the body or such other devices, eye-
5 glasses, false teeth, artificial eyes, orthotics, prosthetic devices,
6 functional assistive and adaptive devices or appliances or the providing
7 of medical treatment and care as defined herein shall not constitute the
8 payment of compensation under section twenty-five-a of this article. All
9 fees and other charges for such treatment and services shall be limited
10 to such charges as prevail in the same community for similar treatment
11 of injured persons of a like standard of living.
12 The chair shall prepare and establish a schedule for the state, or
13 schedules limited to defined localities, of charges and fees for such
14 medical treatment and care, and including all medical, dental, surgical,
15 optometric or other attendance or treatment, nurse and hospital service,
16 medicine, optometric services, crutches, eye-glasses, false teeth, arti-
17 ficial eyes, orthotics, prosthetic devices, functional assistive and
18 adaptive devices and apparatus and ambulance services including trans-
19 port by air in accordance with and to be subject to change pursuant to
20 rules promulgated by the chair. Before preparing such schedule for the
21 state or schedules for limited localities the chair shall request the
22 president of the medical society of the state of New York and the presi-
23 dent of the New York state osteopathic medical society to submit to him
24 or her a report on the amount of remuneration deemed by such society to
25 be fair and adequate for the types of medical care to be rendered under
26 this chapter, but consideration shall be given to the view of other
27 interested parties. In the case of physical therapy fees schedules the
28 chair shall request the president of a recognized professional associ-
29 ation representing physical therapists in the state of New York to
30 submit to him or her a report on the amount of remuneration deemed by
31 such association to be fair and reasonable for the type of physical
32 therapy services rendered under this chapter, but consideration shall be
33 given to the views of other interested parties. The chair shall also
34 prepare and establish a schedule for the state, or schedules limited to
35 defined localities, of charges and fees for outpatient hospital services
36 not covered under the medical fee schedule previously referred to in
37 this subdivision, to be determined in accordance with and to be subject
38 to change pursuant to rules promulgated by the chair. Before preparing
39 such schedule for the state or schedules for limited localities the
40 chair shall request the president of the hospital association of New
41 York state to submit to him or her a report on the amount of remunera-
42 tion deemed by such association to be fair and adequate for the types of
43 hospital outpatient care to be rendered under this chapter, but consid-
44 eration shall be given to the views of other interested parties. In the
45 case of occupational therapy fees schedules the chair shall request the
46 president of a recognized professional association representing occupa-
47 tional therapists in the state of New York to submit to him or her a
48 report on the amount of remuneration deemed by such association to be
49 fair and reasonable for the type of occupational therapy services
50 rendered under this chapter, but consideration shall be given to the
51 views of other interested parties. The amounts payable by the employer
52 for such treatment and services shall be the fees and charges estab-
53 lished by such schedule. Nothing in this schedule, however, shall
54 prevent voluntary payment of amounts higher or lower than the fees and
55 charges fixed therein, but no physician rendering medical treatment or
56 care, and no physical or occupational therapist rendering their respec-
A. 7151 3
1 tive physical or occupational therapy services may receive payment in
2 any higher amount unless such increased amount has been authorized by
3 the employer, or by decision as provided in section thirteen-g of this
4 article. Nothing in this section shall be construed as preventing the
5 employment of a duly authorized physician on a salary basis by an
6 authorized compensation medical bureau or laboratory.
7 § 2. This act shall take effect on the one hundred eightieth day after
8 it shall have become a law.
