STATE OF NEW YORK
________________________________________________________________________
343
2019-2020 Regular Sessions
IN SENATE(Prefiled)
January 9, 2019
___________
Introduced by Sen. AKSHAR -- read twice and ordered printed, and when
printed to be committed to the Committee on Labor
AN ACT to amend the workers' compensation law, in relation to extending
the board's authority to resolve medical bill disputes and simplify
the process
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. Section 13-b of the workers' compensation law, as amended
2 by chapter 1068 of the laws of 1960, the section heading, subdivisions 1
3 and 2 as amended by chapter 473 of the laws of 2000 and subdivision 3 as
4 amended by section 85 of part A of chapter 58 of the laws of 2010, is
5 amended to read as follows:
6 § 13-b. Authorization of [physicians] providers, medical bureaus and
7 laboratories by the chair. 1. [Upon the recommendation of the medical
8 society of the county in which the physician's office is located or of a
9 board designated by such county society or of a board representing duly
10 licensed physicians of any other school of medical practice in such
11 county, the chair may authorize physicians licensed to practice medicine
12 in the state of New York to render medical care under this chapter and
13 to perform independent medical examinations in accordance with subdivi-
14 sion four of section thirteen-a of this article. If, within sixty days
15 after the chair requests such recommendations the medical society of
16 such county or board fails to act, or if there is no such society in
17 such county, the chair shall designate a board of three outstanding
18 physicians, who shall make the requisite recommendations.
19 No such authorization shall be made in the absence of a recommendation
20 of the appropriate society or board or of a review and recommendation by
21 the medical appeals unit.] No person shall render medical care or
22 conduct independent medical examinations under this chapter without such
23 authorization by the chair[, provided, that: (a)]. As used in this
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD05172-01-9
S. 343 2
1 title, the following definitions shall have the following meanings
2 unless their context requires otherwise:
3 (a) "Acupuncturist" shall mean licensed as having completed a formal
4 course of study and having passed an examination in accordance with the
5 education law, the regulations of the commissioner of education, and the
6 requirements of the board of regents. Acupuncturists are required by the
7 education law to advise, in writing, each patient of the requirement
8 that he or she consult with a physician for the condition or conditions
9 necessitating acupuncture care, as prescribed by the education law.
10 (b) "Chair" of the board shall mean either the chair or the chair's
11 designee.
12 (c) "Chiropractor" shall mean licensed and having completed two years
13 of preprofessional college study and a four-year resident program in
14 chiropractic in accordance with the education law, and consistent with
15 the licensing requirements of the commissioner of education.
16 (d) "Dentist" shall mean licensed and having completed a four-year
17 course of study leading to a D.D.S. or D.D.M. degree, or an equivalent
18 degree, in accordance with the education law and the licensing require-
19 ments of the commissioner of education.
20 (e) "Employer" shall mean a self-insured employer or, if insured, the
21 insurance carrier.
22 (f) "Independent medical examination" shall mean an examination
23 performed by a medical provider, authorized under this section to
24 perform such examination, for the purpose of examining or evaluating
25 injury or illness pursuant to paragraph (b) of subdivision four of
26 section thirteen-a and section one hundred thirty-seven of this chapter
27 and as more fully set forth in regulation.
28 (g) "Nurse practitioner" shall mean a licensed registered professional
29 nurse certified pursuant to section sixty-nine hundred ten of the educa-
30 tion law.
31 (h) "Occupational therapist" shall mean licensed as having a bach-
32 elor's or master's degree in occupational therapy from a registered
33 program with the education department or receipt of a diploma or degree
34 resulting from completion of not less than four years of postsecondary
35 study, which includes the professional study of occupational therapy in
36 accordance with the education law and the regulations of the commission-
37 er of education.
38 (i) "Physical therapist" shall mean licensed as having completed a
39 master's degree or higher in physical therapy in accordance with the
40 education law and the licensing requirements of the commissioner of
41 education.
42 (j) "Physician" shall mean licensed with a degree of doctor of medi-
43 cine, M.D., or doctor of osteopathic medicine, D.O., or an equivalent
44 degree in accordance with the education law and the licensing require-
45 ments of the state board of medicine and the regulations of the commis-
46 sioner of education.
47 (k) "Physician assistant" shall mean a licensed provider who has grad-
48 uated from a two- to four-year state-approved physician assistant
49 program, has passed a licensing examination, and whose actions and
50 duties are within the scope of practice of the supervising physician, in
51 accordance with the education law and the regulations of the commission-
52 er of education.
53 (l) "Podiatrist" shall mean a doctor of podiatric medicine licensed as
54 having received a doctoral degree in podiatric medicine in accordance
55 with the regulations of the commissioner of education and the education
S. 343 3
1 law, and must satisfactorily meet all other requirements of the state
2 board for podiatric medicine.
3 (m) "Provider" shall mean a duly licensed acupuncturist, chiropractor,
4 independent medical examiner, nurse practitioner, physical therapist,
5 physician, physician assistant, podiatrist, psychologist, or social
6 worker authorized by the chair.
7 (n) "Psychologist" shall mean licensed as having received a doctoral
8 degree in psychology from a program of psychology registered with the
9 state education department or the substantial equivalent thereof in
10 accordance with the education law, the requirements of the state board
11 for psychology, and the regulations of the commissioner of education.
12 (o) "Social worker" shall mean a licensed clinical social worker. A
13 licensed clinical social worker has completed a master's degree of
14 social work that includes completion of a core curriculum of at least
15 twelve credit hours of clinical courses or the equivalent post-graduate
16 clinical coursework, in accordance with the education law and the regu-
17 lations of the commissioner of education.
18 2. Any [physician] provider licensed [to practice medicine] pursuant
19 to the education law to provide medical care and treatment in the state
20 of New York may render emergency [medical] care and treatment in an
21 emergency hospital or urgent care setting providing emergency treatment
22 under this chapter without authorization by the chair under this
23 section; [and
24 (b)] (a) Such licensed [physician] provider as identified in this
25 subdivision who is [a member of a constituted medical staff of any
26 hospital] on staff at any hospital or urgent care center providing emer-
27 gency treatment may [render] continue such medical care under this chap-
28 ter while an injured employee remains a patient in such hospital or
29 urgent care setting; and
30 [(c)] (b) Under the [active and personal] direct supervision of an
31 authorized [physician] provider, medical care may be rendered by a
32 registered nurse or other person trained in laboratory or diagnostic
33 techniques within the scope of such person's specialized training and
34 qualifications. This supervision shall be evidenced by signed records of
35 instructions for treatment and signed records of the patient's condition
36 and progress. Reports of such treatment and supervision shall be made by
37 such [physician] provider to the chair [on such forms and] in the format
38 prescribed by the chair at such times as the chair may require.
39 [(d) Upon the referral which may be directive as to treatment of an
40 authorized physician physical therapy care may be rendered by a duly
41 licensed physical therapist. Where physical therapy care is rendered
42 records of the patient's condition and progress, together with records
43 of instruction for treatment, if any, shall be maintained by the phys-
44 ical therapist and physician. Said records shall be submitted to the
45 chair on such forms and at such times as the chair may require.
46 (e) Upon the prescription or referral of an authorized physician occu-
47 pational therapy care may be rendered by a duly licensed occupational
48 therapist. Where occupational therapy care is rendered records of the
49 patient's condition and progress, together with records of instruction
50 for treatment, if any shall be maintained by the occupational therapist
51 and physician. Said records shall be submitted to the chair on forms and
52 at such times as the chair may require.
53 (f)] (c) Where it would place an unreasonable burden upon the employer
54 or carrier to arrange for, or for the claimant to attend, an independent
55 medical examination by an authorized [physician] provider, the employer
56 or carrier shall arrange for such examination to be performed by a qual-
S. 343 4
1 ified [physician] provider in a medical facility convenient to the
2 claimant.
3 [2.] (d) Upon the prescription or referral of an authorized physician,
4 or nurse practitioner acting within the scope of his or her practice,
5 care or treatment may be rendered to an injured employee by an author-
6 ized physical therapist, occupational therapist or acupuncturist
7 provided the conditions and the treatment performed are among the condi-
8 tions that the physical therapist, occupational therapist or acupunctu-
9 rist is authorized to treat pursuant to the education law or the regu-
10 lations of the commissioner of education. Where any such care or
11 treatment is rendered, records of the patient's condition and progress,
12 together with records of instruction for treatment, if any, shall be
13 maintained by the physical therapist, occupational therapist or acupunc-
14 turist rendering treatment and by the referring physician or nurse prac-
15 titioner. Said records shall be submitted to the chair on forms and at
16 such times as the chair may require.
17 (e) A record, report or opinion of a physical therapist, occupational
18 therapist, acupuncturist or physician assistant shall not be considered
19 as evidence of the causal relationship of any condition to a work
20 related accident or occupational disease under this chapter. Nor may a
21 record, report or opinion of a physical therapist, occupational thera-
22 pist or acupuncturist be considered evidence of disability. Nor may a
23 record, report or opinion of a physician assistant be considered
24 evidence of the presence of a permanent or initial disability or the
25 degree thereof. Nor may a physical therapist, occupational therapist,
26 acupuncturist or physician assistant perform an independent medical
27 examination concerning a claim under this chapter.
28 (f) A nurse practitioner, or licensed certified social worker, may
29 perform an independent medical examination on behalf of an employer only
30 to the extent that the examination concerns treatment rendered by an
31 identical provider type, but may not perform an independent medical
32 examination on behalf of the employer concerning (1) the causal
33 relationship of any condition to a work related accident or occupational
34 disease under this chapter or (2) the presence of a disability or the
35 degree thereof.
36 3. A [physician licensed to practice medicine in the state of New York
37 who is] provider properly licensed or certified pursuant to the regu-
38 lations of the commissioner of education and the requirements of the
39 education law desirous of being authorized to render medical care under
40 this chapter and/or to conduct independent medical examinations in
41 accordance with paragraph (b) of subdivision four of section thirteen-a
42 and section one hundred thirty-seven of this chapter shall file an
43 application for authorization under this chapter with the [medical soci-
44 ety in the county in which his or her office is located, or with a board
45 designated by such society, or with a board designated by the chair as
46 provided in this section. In such application the applicant shall state
47 his or her training and qualifications, and shall agree to limit his or
48 her professional activities under this chapter to such medical care and
49 independent medical examinations, as his or her experience and training
50 qualify him or her to render. The applicant shall further agree to
51 refrain] chair or chair's designee. Prior to receiving authorization, a
52 physician must, together with submission of an application to the chair,
53 submit such application to the medical society of the county in which
54 the physician's office is located or of a board designated by such coun-
55 ty society or of a board representing duly licensed physicians of any
56 other school of medical practice in such county, and submit the recom-
S. 343 5
1 mendation to the board. In the event such county society or board fails
2 to take action upon a physician's application within forty-five days,
3 the chair may complete review of the application without such approval.
4 Upon approval of the application by the chair or the chair's designee,
5 the applicant shall further agree to refrain from subsequently treating
6 for remuneration, as a private patient, any person seeking medical
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 [physicians]
10 providers authorized to render medical care or to conduct independent
11 medical examinations under this chapter, or if the person seeking such
12 treatment, or submitting to an independent medical examination, has been
13 transferred from his or her care in accordance with the provisions of
14 this chapter. This agreement shall run to the benefit of the injured
15 person so treated or examined, and shall be available to him or her as a
16 defense in any action by such [physician] provider for payment for
17 treatment rendered by a [physician] provider after he or she has been
18 removed from the list of [physicians] providers authorized to render
19 medical care or to conduct independent medical examinations under this
20 chapter, or after the injured person was transferred from his or her
21 care in accordance with the provisions of this chapter. [The medical
22 society or the board designated by it, or the board as otherwise
23 provided under this section, if it deems such licensed physician duly
24 qualified, shall recommend to the chair that such physician be author-
25 ized to render medical care and/or conduct independent medical examina-
26 tions under this chapter, and such recommendation and authorization
27 shall specify the character of the medical care or independent medical
28 examination which such physician is qualified and authorized to render
29 under this chapter. Such recommendations shall be advisory to the chair
30 only and shall not be binding or conclusive upon him or her. The
31 licensed physician may present to the medical society or board,
32 evidences of additional qualifications at any time subsequent to his or
33 her original application. If the medical society or board fails to
34 recommend to the chair that a physician be authorized to render medical
35 care and/or to conduct independent medical examinations under this chap-
36 ter, the physician may appeal to the medical appeals unit. The medical
37 society or the board designated by it, or the board as otherwise
38 provided under this section, may upon its own initiative, or shall upon
39 request of the chair, review at any time the qualifications of any
40 physician as to the character of the medical care or independent medical
41 examinations which such physician has theretofore been authorized to
42 render under this chapter and may recommend to the chair that such
43 physician be authorized to render medical care or to conduct independent
44 medical examinations thereafter of the character which such physician is
45 then qualified to render. On such advisory recommendation the chair may
46 review and after reasonable investigation may revise the authorization
47 of a physician in respect to the character of medical care and/or to
48 conduct independent medical examinations which he or she is authorized
49 to render. If the medical society or board recommends to the chair that
50 a physician be authorized to render medical care and/or to conduct inde-
51 pendent medical examinations under this chapter of a character different
52 from the character of medical care or independent medical examinations
53 he or she has been theretofore authorized to render, such physician may
54 appeal from such recommendation to the medical appeals unit.
55 3.] 4. Laboratories and bureaus engaged in x-ray diagnosis or treat-
56 ment or in physiotherapy or other therapeutic procedures and which
S. 343 6
1 participate in the diagnosis or treatment of injured [workmen] workers
2 under this chapter shall be operated or supervised by [qualified physi-
3 cians duly] providers authorized under this chapter and shall be subject
4 to the provisions of section thirteen-c of this article. The person in
5 charge of diagnostic clinical laboratories duly authorized under this
6 chapter shall possess the qualifications established by the public
7 health and health planning council for approval by the state commission-
8 er of health or, in the city of New York, the qualifications approved by
9 the board of health of said city and shall maintain the standards of
10 work required for such approval.
11 § 2. Section 13-g of the workers' compensation law, as added by chap-
12 ter 258 of the laws of 1935, subdivision 1 as amended by chapter 674 of
13 the laws of 1994, subdivisions 2 and 3 as amended by section 4 of part
14 GG of chapter 57 of the laws of 2013, subdivision 4 as amended by
15 section 3 of part D of chapter 55 of the laws of 2015, subdivision 5 as
16 amended by chapter 578 of the laws of 1959 and subdivision 6 as amended
17 by chapter 639 of the laws of 1996, is amended to read as follows:
18 § 13-g. Payment of bills for medical care. (1) Within forty-five days
19 after a bill for medical care or supplies delivered pursuant to section
20 thirteen of this article has been rendered to the employer [by the
21 hospital, physician or self-employed physical or occupational therapist
22 who has rendered treatment pursuant to a referral from the injured
23 employee's authorized physician or authorized podiatrist for treatment
24 to the injured employee], such employer must pay the bill or notify the
25 [hospital, physician or self-employed physical or occupational therapist
26 in writing] medical care provider or supplier in the format prescribed
27 by the chair that the bill is not being paid and explain the reasons for
28 non-payment. In the event that the employer fails to make payment or
29 notify the [hospital, physician or self-employed physical or occupa-
30 tional therapist] medical care provider or supplier within such forty-
31 five day period that payment is not being made, the [hospital, physi-
32 cian, self-employed physical therapist or self-employed occupational
33 therapist] medical care provider or supplier may notify the board in the
34 format prescribed by the chair [in writing] that the bill has not been
35 paid and request that the board make an award for payment of such bill.
36 The board or the chair may make an award not in excess of the estab-
37 lished fee schedules for any such bill or part thereof which remains
38 unpaid after said forty-five day period or thirty days after all other
39 questions duly and timely raised in accordance with the provisions of
40 this chapter, relating to the employer's liability for the payment of
41 such amount, shall have been finally determined adversely to the employ-
42 er, whichever is later, in accordance with rules promulgated by the
43 chair, and such award may be collected in like manner as an award of
44 compensation. The chair shall assess the sum of fifty dollars against
45 the employer for each such award made by the board, which sum shall be
46 paid into the state treasury.
47 In the event that the employer has provided an explanation in writing
48 why the bill has not been paid, in part or in full, within the aforesaid
49 time period, and the parties can not agree as to the value of medical
50 aid rendered under this chapter, such value shall be decided by arbi-
51 tration [if requested by the hospital, physician or self-employed phys-
52 ical or occupational therapist, in accordance with the provisions of
53 subdivision two or subdivision three of this section, as appropriate,
54 and] as set forth in rules and regulations promulgated by the chair.
55 Where a [physician, physical or occupational therapist] bill for
56 medical care or supplies has been determined to be due and owing in
S. 343 7
1 accordance with the provisions of this section the board shall include
2 in the amount of the award interest of not more than one and one-half
3 [per cent] percent (1 1/2%) per month payable to the [physician, phys-
4 ical or occupational therapist] medical care provider or supplier, in
5 accordance with the rules and regulations promulgated by the board.
6 Interest shall be calculated from the forty-fifth day after the bill was
7 rendered or from the thirtieth day after all other questions duly and
8 timely raised in accordance with the provisions of this chapter, relat-
9 ing to the employer's liability for the payment of such amount, shall
10 have been finally determined adversely to the employer, whichever is
11 later, in accordance with rules promulgated by the chair.
12 (2) (a) If the parties fail to agree to the value of medical aid
13 rendered under this chapter and the amount of the disputed bill is one
14 thousand dollars or less, or if the amount of the disputed medical bill
15 exceeds one thousand dollars and the [health] medical care provider or
16 supplier expressly so requests, such value shall be decided by a single
17 arbitrator process, pursuant to rules promulgated by the chair. [The
18 chair shall appoint a physician who is a member in good standing of the
19 medical society of the state of New York to determine the value of such
20 disputed medical bill. Where the physician whose charges are being
21 arbitrated is a member in good standing of the New York osteopathic
22 society, the value of such disputed bill shall be determined by a member
23 in good standing of the New York osteopathic society appointed by the
24 chair. Where the physician whose charges are being arbitrated is a
25 member in good standing of the New York homeopathic society, the value
26 of such disputed bill shall be determined by a member in good standing
27 of the New York homeopathic society appointed by the chair. Where the
28 value of physical therapy services or occupational therapy services is
29 at issue, such value shall be determined by a member in good standing of
30 a recognized professional association representing its respective
31 profession in the state of New York appointed by the chair.] Decisions
32 rendered under the single arbitrator process shall be conclusive upon
33 the parties as to the value of the services in dispute.
34 (b) If the parties fail to agree as to the value of medical aid
35 rendered under this chapter and the amount of the disputed bill exceeds
36 one thousand dollars, such value shall be decided by an arbitration
37 committee unless the [health] medical care provider or supplier express-
38 ly requests a single arbitrator process in accordance with paragraph (a)
39 of this subdivision. The arbitration committee shall [consist of one
40 physician designated by the president of the medical society of the
41 county in which the medical services were rendered, one physician who is
42 a member of the medical society of the state of New York, appointed by
43 the employer or carrier, and one physician, also a member of the medical
44 society of the state of New York, appointed by the chair of the workers'
45 compensation board. If the physician whose charges are being arbitrated
46 is a member in good standing of the New York osteopathic society or the
47 New York homeopathic society, the members of such arbitration committee
48 shall be physicians of such organization, one to be appointed by the
49 president of that organization, one by the employer or carrier and the
50 third by the chair of the workers' compensation board. Where the value
51 of physical therapy services is at issue and the amount of the disputed
52 bill exceeds one thousand dollars, the arbitration committee shall
53 consist of a member in good standing of a recognized professional asso-
54 ciation representing physical therapists in the state of New York
55 appointed by the president of such organization, a physician designated
56 by the employer or carrier and a physician designated by the chair of
S. 343 8
1 the workers' compensation board provided however, that the chair finds
2 that there are a sufficient number of physical therapy arbitrations in a
3 geographical area comprised of one or more counties to warrant a commit-
4 tee so comprised. In all other cases where the value of physical therapy
5 services is at issue and the amount of the disputed bill exceeds one
6 thousand dollars, the arbitration committee shall be similarly selected
7 and identical in composition, provided that the physical therapist
8 member shall serve without remuneration, and provided further that in
9 the event a physical therapist is not available, the committee shall be
10 comprised of three physicians designated in the same manner as in cases
11 where the value of medical aid is at issue.
12 (c) Where the value of occupational therapy services is at issue the
13 arbitration committee shall consist of a member in good standing of a
14 recognized professional association representing occupational therapists
15 in the state of New York appointed by the president of such organiza-
16 tion; a physician designated by the employer or carrier and a physician
17 designated by the chair of the workers' compensation board provided,
18 however, that the chair finds that there are a sufficient number of
19 occupational therapy arbitrations in a geographical area comprised of
20 one or more counties to warrant a committee so comprised. In all other
21 cases where the value of occupational therapy services is at issue and
22 the amount of the disputed bill exceeds one thousand dollars, the arbi-
23 tration committee shall be similarly selected and identical in composi-
24 tion, provided that the occupational therapist member shall serve with-
25 out remuneration, and provided further that in the event an occupational
26 therapist is not available, the committee shall be comprised of three
27 physicians designated in the same manner as in cases where the value of
28 medical aid is at issue.] have three members designated by the chair in
29 consultation with the medical director's office of the workers' compen-
30 sation board. The majority decision of any such arbitration committee
31 shall be conclusive upon the parties as to the value of the services in
32 dispute.
33 (3) [(a) If an employer shall have notified the hospital in writing,
34 as provided in subdivision one of this section, why the bill has not
35 been paid, in part or in full, and the amount of the disputed bill is
36 one thousand dollars or less, or where the amount of the disputed
37 medical bill exceeds one thousand dollars and the hospital expressly so
38 requests, such value shall be decided by a single arbitrator process,
39 pursuant to rules promulgated by the chair. The chair shall appoint a
40 physician in good standing licensed to practice in New York state to
41 determine the value of such disputed bill. Decisions rendered under the
42 administrative resolution procedure shall be conclusive upon the parties
43 as to the value of the services in dispute.
44 (b) If an employer shall have notified the hospital in writing, as
45 provided in subdivision one of this section, why the bill has not been
46 paid, in part or in full, and the amount of the disputed bill exceeds
47 one thousand dollars, the value of such bill shall be determined by an
48 arbitration committee appointed by the chair for that purpose, which
49 committee shall consider all of the charges of the hospital, unless the
50 hospital expressly requests a single arbitrator process pursuant to
51 paragraph (a) of this subdivision. The committee shall consist of three
52 physicians. One member of the committee may be nominated by the chair
53 upon recommendation of the president of the hospital association of New
54 York state and one member may be nominated by the employer or insurance
55 carrier. The majority decision of any such committee shall be conclusive
56 upon the parties as to the value of the services rendered. The chair may
S. 343 9
1 make reasonable rules and regulations consistent with the provisions of
2 this section.
3 (4)] A provider or supplier initiating an arbitration, including a
4 single arbitrator process, pursuant to this section shall not pay a fee
5 to cover the costs related to the conduct of such arbitration. [Each
6 member of an arbitration committee for medical bills, and each member of
7 an arbitration committee for hospital bills shall be entitled to receive
8 and shall be paid a fee for each day's attendance at an arbitration
9 session in any one count in an amount fixed by the chair of the workers'
10 compensation board.
11 (5)] (4) In claims where the employer has failed to secure compen-
12 sation to his employees as required by section fifty of this chapter,
13 the board may make an award for the value of medical [and podiatry]
14 services, supplies or treatment rendered to such employees, in accord-
15 ance with the schedules of fees and charges prepared and established
16 under the provisions of [section thirteen, subdivision a, and section
17 thirteen-k, subdivision two, of] this chapter[, and for the reasonable
18 value of hospital care in accordance with the charges currently in force
19 in hospitals in the same community for cases coming within the
20 provisions of this chapter]. Such award shall be made to the [physician,
21 podiatrist, or hospital] medical care provider or supplier entitled
22 thereto. A default in the payment of such award may be enforced in the
23 manner provided for the enforcement of compensation awards as set forth
24 in section twenty-six of this [chapter] article.
25 In all cases coming under this subdivision the payment of the claim
26 [of the physician, podiatrist, or hospital for medical, podiatry, or
27 surgical services or treatment] for medical care or supplies shall be
28 subordinate to that of the claimant or his or her beneficiaries.
29 [(6) Notwithstanding any inconsistent provision of law, arbitration
30 regarding payments for inpatient hospital services for any patient
31 discharged on or after January first, nineteen hundred ninety-one and
32 prior to December thirty-first, nineteen hundred ninety-six shall be
33 resolved in accordance with paragraph (d) of subdivision three of
34 section twenty-eight hundred seven-c of the public health law.]
35 § 3. Subdivisions 1 and 2 and paragraph (b) of subdivision 3 of
36 section 13-k of the workers' compensation law, subdivision 1 as added by
37 chapter 787 of the laws of 1952 and subdivision 2 and paragraph (b) of
38 subdivision 3 as amended by chapter 473 of the laws of 2000, are amended
39 to read as follows:
40 1. When the term "chairman" is hereinafter used, it shall be deemed to
41 mean the [chairman] chair of the [workmen's] workers' compensation board
42 of the state of New York.
43 2. An employee injured under circumstances which make such injury
44 compensable under this article, when care is required for an injury to
45 the foot which injury or resultant condition therefrom may lawfully be
46 treated by a duly registered and licensed podiatrist of the state of New
47 York, may select to treat him or her any podiatrist authorized by the
48 chair to render [podiatry] podiatric medical care, as hereinafter
49 provided. If the injury or condition is one which is without the limits
50 prescribed by the education law for [podiatry] podiatric medical care
51 and treatment, or the injuries involved affect other parts of the body
52 in addition to the foot, the said podiatrist must so advise the said
53 injured employee and instruct him or her to consult a physician of said
54 employee's choice for appropriate care and treatment. Such physician
55 shall thenceforth have overall supervision of the treatment of said
56 patient including the future treatment to be administered to the patient
S. 343 10
1 by the podiatrist. If for any reason during the period when [podiatry]
2 podiatric medical treatment and care is required, the employee wishes to
3 transfer his or her treatment and care to another authorized podiatrist
4 he or she may do so, in accordance with rules prescribed by the chair,
5 provided however that the employer shall be liable for the proper fees
6 of the original podiatrist for the care and treatment he or she shall
7 have rendered. [A podiatrist licensed and registered to practice podia-
8 try in the state of New York who is desirous of being authorized to
9 render podiatry care under this section and/or to conduct independent
10 medical examinations in accordance with paragraph (b) of subdivision
11 three of this section shall file an application for authorization under
12 this section with the podiatry practice committee. In such application
13 he or she shall agree to refrain from subsequently treating for remuner-
14 ation, as a private patient, any person seeking podiatry treatment, or
15 submitting to an independent medical examination, in connection with, or
16 as a result of, any injury compensable under this chapter, if he or she
17 has been removed from the list of podiatrists authorized to render
18 podiatry care or to conduct independent medical examinations under this
19 chapter, or if the person seeking such treatment has been transferred
20 from his or her care in accordance with the provisions of this section.
21 This agreement shall run to the benefit of the injured person so treated
22 or examined, and shall be available to him or her as a defense in any
23 action by such podiatrist for payment for treatment rendered by a podia-
24 trist after he or she has been removed from the list of podiatrists
25 authorized to render podiatry care or to conduct independent medical
26 examinations under this section, or after the injured person was trans-
27 ferred from his or her care in accordance with the provisions of this
28 section. The podiatry practice committee if it deems such licensed
29 podiatrist duly qualified shall recommend to the chair that such podia-
30 trist be authorized to render podiatry care and/or to conduct independ-
31 ent medical examinations under this section. Such recommendation shall
32 be advisory to the chair only and shall not be binding or conclusive
33 upon him or her.] The chair shall prepare and establish a schedule for
34 the state, or schedules limited to defined localities, of charges and
35 fees for [podiatry] podiatric medical treatment and care, to be deter-
36 mined in accordance with and to 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 [podia-
39 try] podiatric medicine practice committee to submit to him or her a
40 report on the amount of remuneration deemed by such committee to be fair
41 and adequate for the types of [podiatry] podiatric medical care to be
42 rendered under this chapter, but consideration shall be given to the
43 view of other interested parties. The amounts payable by the employer
44 for such treatment and services shall be the fees and charges estab-
45 lished by such schedule.
46 (b) Upon receipt of the notice provided for by paragraph (a) of this
47 subdivision, the employer, the carrier and the claimant each shall be
48 entitled to have the claimant examined by a qualified podiatrist author-
49 ized by the chair in accordance with [subdivision two of this] section
50 thirteen-b and section one hundred thirty-seven of this chapter, at a
51 medical facility convenient to the claimant and in the presence of the
52 claimant's podiatrist, and refusal by the claimant to submit to such
53 independent medical examination at such time or times as may reasonably
54 be necessary in the opinion of the board shall bar the claimant from
55 recovering compensation for any period during which he or she has
56 refused to submit to such examination.
S. 343 11
1 § 4. Subdivisions 1 and 2 and paragraph (b) of subdivision 3 of
2 section 13-l of the workers' compensation law, subdivision 1 as added by
3 chapter 940 of the laws of 1973 and subdivision 2 and paragraph (b) of
4 subdivision 3 as amended by chapter 473 of the laws of 2000, are amended
5 to read as follows:
6 1. Where the term "chairman" is hereinafter used, it shall be deemed
7 to mean the [chairman] chair of the [workmen's] workers' compensation
8 board of the state of New York.
9 2. An employee injured under circumstances which make such injury
10 compensable under this article, when care is required for an injury
11 which consists solely of a condition which may lawfully be treated by a
12 chiropractor as defined in section sixty-five hundred fifty-one of the
13 education law may select to treat him or her, any duly registered and
14 licensed chiropractor of the state of New York, authorized by the chair
15 to render chiropractic care as hereinafter provided. If the injury or
16 condition is one which is outside the limits prescribed by the education
17 law for chiropractic care and treatment, the said chiropractor must so
18 advise the said injured employee and instruct him or her to consult a
19 physician of said employee's choice for appropriate care and treatment.
20 Such physician shall thenceforth have supervision of the treatment of
21 said condition including the future treatment to be administered to the
22 patient by the chiropractor. [A chiropractor licensed and registered to
23 practice chiropractic in the state of New York, who is desirous of being
24 authorized to render chiropractic care under this section and/or to
25 conduct independent medical examinations in accordance with paragraph
26 (b) of subdivision three of this section shall file an application for
27 authorization under this section with the chiropractic practice commit-
28 tee. In such application he or she shall agree to refrain from subse-
29 quently treating for remuneration, as a private patient, any person
30 seeking chiropractic treatment, or submitting to an independent medical
31 examination, in connection with, or as a result of, any injury compensa-
32 ble under this chapter, if he or she has been removed from the list of
33 chiropractors authorized to render chiropractic care or to conduct inde-
34 pendent medical examinations under this chapter, or if the person seek-
35 ing such treatment has been transferred from his or her care in accord-
36 ance with the provisions of this section. This agreement shall run to
37 the benefit of the injured person so treated, or examined, and shall be
38 available to him or her as a defense in any action by such chiropractor
39 for payment rendered by a chiropractor after he or she has been removed
40 from the list of chiropractors authorized to render chiropractic care or
41 to conduct independent medical examinations under this section, or after
42 the injured person was transferred from his or her care in accordance
43 with the provisions of this section. The chiropractic practice committee
44 if it deems such licensed chiropractor duly qualified shall recommend to
45 the chair that such be authorized to render chiropractic care and/or to
46 conduct independent medical examinations under this section. Such recom-
47 mendations shall be advisory to the chair only and shall not be binding
48 or conclusive upon him or her.] The chair shall prepare and establish a
49 schedule for the state, or schedules limited to defined localities of
50 charges and fees for chiropractic treatment and care, to be determined
51 in accordance with and to be subject to change pursuant to rules promul-
52 gated by the chair. Before preparing such schedule for the state or
53 schedules for limited localities the chair shall request the chiroprac-
54 tic practice committee to submit to him or her a report on the amount of
55 remuneration deemed by such committee to be fair and adequate for the
56 types of chiropractic care to be rendered under this chapter, but
S. 343 12
1 consideration shall be given to the view of other interested parties,
2 the amounts payable by the employer for such treatment and services
3 shall be the fees and charges established by such schedule.
4 (b) Upon receipt of the notice provided for by paragraph (a) of this
5 subdivision, the employer, the carrier, and the claimant each shall be
6 entitled to have the claimant examined by a qualified chiropractor
7 authorized by the chair in accordance with [subdivision two of this]
8 section thirteen-b and section one hundred thirty-seven of this chapter
9 at a medical facility convenient to the claimant and in the presence of
10 the claimant's chiropractor, and refusal by the claimant to submit to
11 such independent medical examination at such time or times as may
12 reasonably be necessary in the opinion of the board shall bar the claim-
13 ant from recovering compensation, for any period during which he or she
14 has refused to submit to such examination.
15 § 5. Subdivisions 1, 2 and 3 and paragraph (b) of subdivision 4 of
16 section 13-m of the workers' compensation law, subdivisions 1 and 2 as
17 added by chapter 589 of the laws of 1989 and subdivision 3 and paragraph
18 (b) of subdivision 4 as amended by chapter 473 of the laws of 2000, are
19 amended to read as follows:
20 1. Where the term "chairman" is hereinafter used, it shall be deemed
21 to mean the [chairman] chair of the workers' compensation board of the
22 state of New York.
23 2. (a) An injured employee, injured under circumstances which make
24 such injury compensable under this article, may lawfully be treated[,
25 upon the referral of an authorized physician,] by a psychologist, duly
26 registered and licensed by the state of New York, authorized by the
27 [chairman] chair to render psychological care pursuant to [this] section
28 thirteen-b of this article. Such services shall be within the scope of
29 such psychologist's specialized training and qualifications as defined
30 in article one hundred fifty-three of the education law.
31 (b) Medical bureaus, medical centers jointly operated by labor and
32 management representatives, hospitals and health maintenance organiza-
33 tions, authorized to provide medical care pursuant to section thirteen-c
34 of this [chapter] article, may provide psychological services when
35 required[, upon the referral of an authorized physician, provided such
36 care is rendered by a duly registered, licensed and authorized psychol-
37 ogist, as required by this section].
38 (c) A psychologist rendering service pursuant to this section shall
39 maintain records of the patient's psychological condition and treatment,
40 and such records or reports shall be submitted to the [chairman] chair
41 on such forms and at such times as the [chairman] chair may require.
42 3. [A psychologist, licensed and registered to practice psychology in
43 the state of New York, who is desirous of being authorized to render
44 psychological care under this section and/or to conduct independent
45 medical examinations in accordance with paragraph (b) of subdivision
46 four of this section shall file an application for authorization under
47 this section with the psychology practice committee. The applicant shall
48 agree to refrain from subsequently treating for remuneration, as a
49 private patient, any person seeking psychological treatment, or submit-
50 ting to an independent medical examination, in connection with, or as a
51 result of, any injury compensable under this chapter, if he or she has
52 been removed from the list of psychologists authorized to render psycho-
53 logical care under this chapter. This agreement shall run to the benefit
54 of the injured person so treated, and shall be available as a defense in
55 any action by such psychologist for payment for treatment rendered by
56 such psychologist after being removed from the list of psychologists
S. 343 13
1 authorized to render psychological care or to conduct independent
2 medical examinations under this section. The psychology practice commit-
3 tee if it deems such licensed psychologist duly qualified shall recom-
4 mend to the chair that such person be authorized to render psychological
5 care and/or to conduct independent medical examinations under this
6 section. Such recommendations shall be only advisory to the chair and
7 shall not be binding or conclusive.] The chair shall prepare and estab-
8 lish a schedule for the state or schedules limited to defined localities
9 of charges and fees for psychological treatment and care, to be deter-
10 mined in accordance with and be subject to change pursuant to rules
11 promulgated by the chair. Before preparing such schedule for the state
12 or schedules for limited localities the chair shall request the psychol-
13 ogy practice committee to submit to such chair a report on the amount of
14 remuneration deemed by such committee to be fair and adequate for the
15 types of psychological care to be rendered under this chapter, but
16 consideration shall be given to the view of other interested parties.
17 The amounts payable by the employer for such treatment and services
18 shall be the fees and charges established by such schedule.
19 (b) Upon receipt of the notice provided for by paragraph (a) of this
20 subdivision, the employer, the carrier, and the claimant each shall be
21 entitled to have the claimant examined by a qualified psychologist,
22 authorized by the chair in accordance with [subdivision three of this]
23 section thirteen-b and section one hundred thirty-seven of this chapter,
24 at a medical facility convenient to the claimant and in the presence of
25 the claimant's psychologist, and refusal by the claimant to submit to
26 such independent medical examination at such time or times as may
27 reasonably be necessary in the opinion of the board shall bar the claim-
28 ant from recovering compensation, for any period during which he or she
29 has refused to submit to such examination.
30 § 6. Section 54-b of the workers' compensation law, as amended by
31 chapter 6 of the laws of 2007, is amended to read as follows:
32 § 54-b. Enforcement on failure to pay award or judgment. In case of
33 default by a carrier or self-insured employer in the payment of any
34 compensation due under an award for the period of thirty days after
35 payment is due and payable, or in the case of failure by a carrier or
36 self-insured employer to make full payment of an award for medical care
37 or supplies issued by the board or the chair pursuant to section thir-
38 teen-g of this chapter, the chair in any such case or on the chair's
39 consent any party to an award may file with the county clerk for the
40 county in which the injury occurred or the county in which the carrier
41 or self-insured employer has his or her principal place of business, (1)
42 a certified copy of the decision of the board awarding compensation or
43 ending, diminishing or increasing compensation previously awarded, from
44 which no appeal has been taken within the time allowed therefor, or if
45 an appeal has been taken by a carrier or self-insured employer who has
46 not complied with the provisions of section fifty of this article, where
47 he or she fails to deposit with the chair the amount of the award as
48 security for its payment within ten days after the same is due and paya-
49 ble, or (2) a certified copy of the award for medical care or supplies
50 issued pursuant to section thirteen-g of this chapter, and thereupon
51 judgment must be entered in the supreme court by the clerk of such coun-
52 ty in conformity therewith immediately upon such filing. If the payment
53 in default be an installment, the board may declare the entire award due
54 and judgment may be entered in accordance with the provisions of this
55 section. Such judgment shall be entered in the same manner, have the
56 same effect and be subject to the same proceedings as though rendered in
S. 343 14
1 a suit duly heard and determined by the supreme court, except that no
2 appeal may be taken therefrom. The court shall vacate or modify such
3 judgment to conform to any later award or decision of the board upon
4 presentation of a certified copy of such award or decision. The award
5 may be so compromised by the board as in the discretion of the board may
6 best serve the interest of the persons entitled to receive the compen-
7 sation or benefits. Where an award has been made against a carrier or
8 self-insured employer in accordance with the provisions of subdivision
9 nine of section fifteen, or of section twenty-five-a of this chapter,
10 such an award may be similarly compromised by the board, upon notice to
11 a representative of the fund to which the award is payable, but if there
12 be no representative of any such fund, notice shall be given to such
13 representative as may be designated by the chair of the board; and
14 notwithstanding any other provision of law, such compromise shall be
15 effective without the necessity of any approval by the state comp-
16 troller. Neither the chair nor any party in interest shall be required
17 to pay any fee to any public officer for filing or recording any paper
18 or instrument or for issuing a transcript of any judgment executed in
19 pursuance of this section. The carrier or self-insured employer shall be
20 liable for all costs and attorneys fees necessary to enforce the award.
21 For the purposes of this section, the term "carrier" shall include the
22 state insurance fund and any stock corporation, mutual corporation or
23 reciprocal insurer authorized to transact the business of workers'
24 compensation insurance in this state.
25 § 7. This act shall take effect on the ninetieth day after it shall
26 have become a law.