S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  1114

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                               (PREFILED)

                             January 9, 2013
                               ___________

Introduced  by  Sen. MAZIARZ -- 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  authoriz-
  ing certain care and treatment to injured employees

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Subdivision (a) of section 13 of the workers'  compensation
law,  as amended by chapter 6 of the laws of 2007, is amended to read as
follows:
  (a) The employer shall promptly provide for an injured  employee  such
medical,  dental, surgical, optometric or other attendance or treatment,
nurse and hospital service,  medicine,  optometric  services,  crutches,
eye-glasses,   false   teeth,  artificial  eyes,  orthotics,  prosthetic
devices, functional assistive and adaptive  devices  and  apparatus  for
such  period  as the nature of the injury or the process of recovery may
require. The employer shall be liable for the payment of the expenses of
medical, dental, surgical, optometric or other attendance or  treatment,
nurse  and  hospital  service,  medicine, optometric services, crutches,
eye-glasses,  false  teeth,  artificial  eyes,   orthotics,   prosthetic
devices,  functional  assistive  and  adaptive devices and apparatus, as
well as artificial members of the body or other  devices  or  appliances
necessary in the first instance to replace, support or relieve a portion
or  part of the body resulting from and necessitated by the injury of an
employee, for such period as the nature of the injury or the process  of
recovery may require, and the employer shall also be liable for replace-
ments  or  repairs  of such artificial members of the body or such other
devices, eye-glasses, false teeth, artificial eyes, orthotics, prosthet-
ic devices, functional assistive  and  adaptive  devices  or  appliances
necessitated by ordinary wear or loss or damage to a prosthesis, with or
without bodily injury to the employee. Damage to or loss of a prosthetic

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
              

                                                           LBD00667-01-3

S. 1114                             2

device  shall  be  deemed  an  injury except that no disability benefits
shall be payable with respect to such injury under  section  fifteen  of
this  article. Such a replacement or repair of artificial members of the
body  or  such other devices, eye-glasses, false teeth, artificial eyes,
orthotics, prosthetic devices, functional assistive and adaptive devices
or appliances or the providing of medical treatment and care as  defined
herein  shall  not  constitute the payment of compensation under section
twenty-five-a of this article. All  fees  and  other  charges  for  such
treatment  and  services  shall be limited to such charges as prevail in
the same community for similar treatment of injured persons  of  a  like
standard of living.
  The  chair  shall  prepare  and establish a schedule for the state, or
schedules limited to defined localities, of charges and  fees  for  such
medical treatment and care, and including all medical, dental, surgical,
optometric or other attendance or treatment, nurse and hospital service,
medicine, optometric services, crutches, eye-glasses, false teeth, arti-
ficial  eyes,  orthotics,  prosthetic  devices, functional assistive and
adaptive devices and apparatus in accordance with and to be  subject  to
change pursuant to rules promulgated by the chair. Before preparing such
schedule  for  the  state  or schedules for limited localities the chair
shall request the president of the medical society of the state  of  New
York and the president of the New York state osteopathic medical society
to submit to him or her a report on the amount of remuneration deemed by
such society to be fair and adequate for the types of medical care to be
rendered  under  this  chapter,  but consideration shall be given to the
view of other interested parties. In the case of physical  therapy  fees
schedules  the chair shall request the president of a recognized profes-
sional association representing physical therapists in the state of  New
York  to  submit  to  him  or her a report on the amount of remuneration
deemed by such association to be fair and reasonable  for  the  type  of
physical therapy services rendered under this chapter, but consideration
shall  be  given  to  the  views of other interested parties.  The chair
shall also prepare and establish a schedule for the state, or  schedules
limited to defined localities, of charges and fees for outpatient hospi-
tal  services  not  covered  under  the  medical fee schedule previously
referred to in this subdivision, to be determined in accordance with and
to be subject to change pursuant to  rules  promulgated  by  the  chair.
Before  preparing  such  schedule for the state or schedules for limited
localities the chair shall request the president of the hospital associ-
ation of New York state to submit to him or her a report on  the  amount
of  remuneration  deemed by such association to be fair and adequate for
the types of hospital outpatient care to be rendered under this chapter,
but consideration shall be  given  to  the  views  of  other  interested
parties.  In  the  case of occupational therapy fees schedules the chair
shall request the president of  a  recognized  professional  association
representing  occupational therapists in the state of New York to submit
to him or her a report on the amount  of  remuneration  deemed  by  such
association to be fair and reasonable for the type of occupational ther-
apy  services  rendered  under  this chapter, but consideration shall be
given to the views of other interested parties. IN THE CASE  OF  MASSAGE
THERAPY  FEE SCHEDULES THE CHAIR SHALL REQUEST THE PRESIDENT OF A RECOG-
NIZED PROFESSIONAL ASSOCIATION REPRESENTING LICENSED MASSAGE  THERAPISTS
IN  THE STATE OF NEW YORK TO SUBMIT TO HIM OR HER A REPORT ON THE AMOUNT
OF REMUNERATION DEEMED BY SUCH ASSOCIATION TO BE FAIR AND REASONABLE FOR
THE TYPE OF OCCUPATIONAL THERAPY SERVICES RENDERED UNDER  THIS  CHAPTER,
BUT  CONSIDERATION  SHALL  BE  GIVEN  TO  THE  VIEWS OF OTHER INTERESTED

S. 1114                             3

PARTIES. The amounts payable by the  employer  for  such  treatment  and
services  shall  be  the  fees and charges established by such schedule.
Nothing in this schedule, however, shall prevent  voluntary  payment  of
amounts  higher or lower than the fees and charges fixed therein, but no
physician rendering medical treatment or care, and no physical, LICENSED
MASSAGE or occupational therapist rendering their  respective  physical,
MASSAGE  or  occupational  therapy  services  may receive payment in any
higher amount unless such increased amount has been  authorized  by  the
employer, or by decision as provided in section thirteen-g of this arti-
cle.  Nothing  in  this  section  shall  be  construed as preventing the
employment of a duly authorized  physician  on  a  salary  basis  by  an
authorized compensation medical bureau or laboratory.
  S 2. Subdivisions 1 and 2 of section 13-g of the workers' compensation
law,  subdivision  1  as  amended by chapter 674 of the laws of 1994 and
subdivision 2 as amended by chapter 649 of the laws of 1985, are amended
to read as follows:
  (1) Within forty-five days after a  bill  has  been  rendered  to  the
employer  by the hospital, physician or self-employed physical, LICENSED
MASSAGE or occupational therapist who has rendered treatment pursuant to
a referral from the injured employee's authorized physician  or  author-
ized  podiatrist  for  treatment  to the injured employee, such employer
must pay the bill or notify the  hospital,  physician  or  self-employed
physical, LICENSED MASSAGE or occupational therapist in writing that the
bill  is  not being paid and explain the reasons for non-payment. In the
event that the employer fails to make payment or  notify  the  hospital,
physician  or  self-employed  physical, LICENSED MASSAGE or occupational
therapist within such forty-five day period that payment  is  not  being
made,  the  hospital,  physician,  self-employed  physical  therapist OR
SELF-EMPLOYED LICENSED MASSAGE THERAPIST or  self-employed  occupational
therapist  may  notify  the  chair in writing that the bill has not been
paid and request that the board make an award for payment of such  bill.
The  board  or  the  chair may make an award not in excess of the estab-
lished fee schedules for any such bill or  part  thereof  which  remains
unpaid  after  said forty-five day period or thirty days after all other
questions duly and timely raised in accordance with  the  provisions  of
this  chapter,  relating  to the employer's liability for the payment of
such amount, shall have been finally determined adversely to the employ-
er, whichever is later, in accordance  with  rules  promulgated  by  the
chair,  and  such  award  may be collected in like manner as an award of
compensation. The chair shall assess the sum of  fifty  dollars  against
the  employer  for each such award made by the board, which sum shall be
paid into the state treasury.
  In the event that the employer has provided an explanation in  writing
why the bill has not been paid, in part or in full, within the aforesaid
time  period,  and  the parties can not agree as to the value of medical
aid rendered under this chapter, such value shall be  decided  by  arbi-
tration  if  requested by the hospital, physician or self-employed phys-
ical, LICENSED MASSAGE or occupational therapist, in accordance with the
provisions of subdivision two or subdivision three of this  section,  as
appropriate, and rules and regulations promulgated by the chair.
  Where  a  physician, physical, LICENSED MASSAGE or occupational thera-
pist bill has been determined to be due and owing in accordance with the
provisions of this section the board shall include in the amount of  the
award  interest  of not more than one and one-half per cent (1 1/2%) per
month payable to the physician, physical, LICENSED  MASSAGE  or  occupa-
tional  therapist,  in accordance with the rules and regulations promul-

S. 1114                             4

gated by the board. Interest shall be calculated  from  the  forty-fifth
day  after  the  bill  was  rendered or from the thirtieth day after all
other questions duly and timely raised in accordance with the provisions
of this chapter, relating to the employer's liability for the payment of
such amount, shall have been finally determined adversely to the employ-
er,  whichever  is  later,  in  accordance with rules promulgated by the
chair.
  (2) If the parties fail to agree  as  to  the  value  of  medical  aid
rendered  under  this  chapter,  such value shall be decided by an arbi-
tration committee consisting of one physician designated by  the  presi-
dent  of the medical society of the county in which the medical services
were rendered, one physician who is a member of the medical  society  of
the  state  of  New  York, appointed by the employer or carrier, and one
physician, also a member of the medical society  of  the  state  of  New
York,  appointed  by  the  [chairman] CHAIR of the workers' compensation
board. The majority decision of any such committee shall  be  conclusive
upon the parties as to the value of the services rendered. If the physi-
cian  whose charges are being arbitrated is a member in good standing of
the New York osteopathic society or the New  York  homeopathic  society,
the  members  of  such arbitration committee shall be physicians of such
organization, one to be appointed by the president of that organization,
one by the employer or carrier and the third by the [chairman] CHAIR  of
the  workers'  compensation  board.  Where the value of physical therapy
services is at issue the arbitration committee shall consist of a member
in good standing of a recognized professional  association  representing
physical  therapists in the state of New York appointed by the president
of such organization, a physician designated by the employer or  carrier
and  a  physician  designated  by  the  [chairman] CHAIR of the workers'
compensation board provided however, that  the  [chairman]  CHAIR  finds
that there are a sufficient number of physical therapy arbitrations in a
geographical area comprised of one or more counties to warrant a commit-
tee so comprised. In all other cases where the value of physical therapy
services  is  at  issue,  the  arbitration  committee shall be similarly
selected and identical in composition, provided that the physical thera-
pist member shall serve without remuneration, and provided further  that
in  the event a physical therapist is not available, the committee shall
be comprised of three physicians designated in the  same  manner  as  in
cases where the value of medical aid is at issue.
  Where the value of occupational therapy services is at issue the arbi-
tration committee shall consist of a member in good standing of a recog-
nized  professional  association representing occupational therapists in
the state of New York appointed by the president of such organization; a
physician designated by the employer or carrier and a  physician  desig-
nated  by  the  [chairman]  CHAIR  of  the  workers'  compensation board
provided, however, that the [chairman] CHAIR  finds  that  there  are  a
sufficient number of occupational therapy arbitrations in a geographical
area  comprised  of  one  or  more  counties  to  warrant a committee so
comprised. In all other cases where the value  of  occupational  therapy
services  is  at  issue,  the  arbitration  committee shall be similarly
selected and identical in composition, provided  that  the  occupational
therapist  member shall serve without remuneration, and provided further
that in the event  an  occupational  therapist  is  not  available,  the
committee  shall be comprised of three physicians designated in the same
manner as in cases where the value of medical aid is at issue.
  S 3. This act shall take effect immediately.