[ ] is old law to be omitted.
LBD05172-01-9
S. 343 2
TITLE, THE FOLLOWING DEFINITIONS SHALL HAVE THE FOLLOWING MEANINGS
UNLESS THEIR CONTEXT REQUIRES OTHERWISE:
(A) "ACUPUNCTURIST" SHALL MEAN LICENSED AS HAVING COMPLETED A FORMAL
COURSE OF STUDY AND HAVING PASSED AN EXAMINATION IN ACCORDANCE WITH THE
EDUCATION LAW, THE REGULATIONS OF THE COMMISSIONER OF EDUCATION, AND THE
REQUIREMENTS OF THE BOARD OF REGENTS. ACUPUNCTURISTS ARE REQUIRED BY THE
EDUCATION LAW TO ADVISE, IN WRITING, EACH PATIENT OF THE REQUIREMENT
THAT HE OR SHE CONSULT WITH A PHYSICIAN FOR THE CONDITION OR CONDITIONS
NECESSITATING ACUPUNCTURE CARE, AS PRESCRIBED BY THE EDUCATION LAW.
(B) "CHAIR" OF THE BOARD SHALL MEAN EITHER THE CHAIR OR THE CHAIR'S
DESIGNEE.
(C) "CHIROPRACTOR" SHALL MEAN LICENSED AND HAVING COMPLETED TWO YEARS
OF PREPROFESSIONAL COLLEGE STUDY AND A FOUR-YEAR RESIDENT PROGRAM IN
CHIROPRACTIC IN ACCORDANCE WITH THE EDUCATION LAW, AND CONSISTENT WITH
THE LICENSING REQUIREMENTS OF THE COMMISSIONER OF EDUCATION.
(D) "DENTIST" SHALL MEAN LICENSED AND HAVING COMPLETED A FOUR-YEAR
COURSE OF STUDY LEADING TO A D.D.S. OR D.D.M. DEGREE, OR AN EQUIVALENT
DEGREE, IN ACCORDANCE WITH THE EDUCATION LAW AND THE LICENSING REQUIRE-
MENTS OF THE COMMISSIONER OF EDUCATION.
(E) "EMPLOYER" SHALL MEAN A SELF-INSURED EMPLOYER OR, IF INSURED, THE
INSURANCE CARRIER.
(F) "INDEPENDENT MEDICAL EXAMINATION" SHALL MEAN AN EXAMINATION
PERFORMED BY A MEDICAL PROVIDER, AUTHORIZED UNDER THIS SECTION TO
PERFORM SUCH EXAMINATION, FOR THE PURPOSE OF EXAMINING OR EVALUATING
INJURY OR ILLNESS PURSUANT TO PARAGRAPH (B) OF SUBDIVISION FOUR OF
SECTION THIRTEEN-A AND SECTION ONE HUNDRED THIRTY-SEVEN OF THIS CHAPTER
AND AS MORE FULLY SET FORTH IN REGULATION.
(G) "NURSE PRACTITIONER" SHALL MEAN A LICENSED REGISTERED PROFESSIONAL
NURSE CERTIFIED PURSUANT TO SECTION SIXTY-NINE HUNDRED TEN OF THE EDUCA-
TION LAW.
(H) "OCCUPATIONAL THERAPIST" SHALL MEAN LICENSED AS HAVING A BACH-
ELOR'S OR MASTER'S DEGREE IN OCCUPATIONAL THERAPY FROM A REGISTERED
PROGRAM WITH THE EDUCATION DEPARTMENT OR RECEIPT OF A DIPLOMA OR DEGREE
RESULTING FROM COMPLETION OF NOT LESS THAN FOUR YEARS OF POSTSECONDARY
STUDY, WHICH INCLUDES THE PROFESSIONAL STUDY OF OCCUPATIONAL THERAPY IN
ACCORDANCE WITH THE EDUCATION LAW AND THE REGULATIONS OF THE COMMISSION-
ER OF EDUCATION.
(I) "PHYSICAL THERAPIST" SHALL MEAN LICENSED AS HAVING COMPLETED A
MASTER'S DEGREE OR HIGHER IN PHYSICAL THERAPY IN ACCORDANCE WITH THE
EDUCATION LAW AND THE LICENSING REQUIREMENTS OF THE COMMISSIONER OF
EDUCATION.
(J) "PHYSICIAN" SHALL MEAN LICENSED WITH A DEGREE OF DOCTOR OF MEDI-
CINE, M.D., OR DOCTOR OF OSTEOPATHIC MEDICINE, D.O., OR AN EQUIVALENT
DEGREE IN ACCORDANCE WITH THE EDUCATION LAW AND THE LICENSING REQUIRE-
MENTS OF THE STATE BOARD OF MEDICINE AND THE REGULATIONS OF THE COMMIS-
SIONER OF EDUCATION.
(K) "PHYSICIAN ASSISTANT" SHALL MEAN A LICENSED PROVIDER WHO HAS GRAD-
UATED FROM A TWO- TO FOUR-YEAR STATE-APPROVED PHYSICIAN ASSISTANT
PROGRAM, HAS PASSED A LICENSING EXAMINATION, AND WHOSE ACTIONS AND
DUTIES ARE WITHIN THE SCOPE OF PRACTICE OF THE SUPERVISING PHYSICIAN, IN
ACCORDANCE WITH THE EDUCATION LAW AND THE REGULATIONS OF THE COMMISSION-
ER OF EDUCATION.
(L) "PODIATRIST" SHALL MEAN A DOCTOR OF PODIATRIC MEDICINE LICENSED AS
HAVING RECEIVED A DOCTORAL DEGREE IN PODIATRIC MEDICINE IN ACCORDANCE
WITH THE REGULATIONS OF THE COMMISSIONER OF EDUCATION AND THE EDUCATION
S. 343 3
LAW, AND MUST SATISFACTORILY MEET ALL OTHER REQUIREMENTS OF THE STATE
BOARD FOR PODIATRIC MEDICINE.
(M) "PROVIDER" SHALL MEAN A DULY LICENSED ACUPUNCTURIST, CHIROPRACTOR,
INDEPENDENT MEDICAL EXAMINER, NURSE PRACTITIONER, PHYSICAL THERAPIST,
PHYSICIAN, PHYSICIAN ASSISTANT, PODIATRIST, PSYCHOLOGIST, OR SOCIAL
WORKER AUTHORIZED BY THE CHAIR.
(N) "PSYCHOLOGIST" SHALL MEAN LICENSED AS HAVING RECEIVED A DOCTORAL
DEGREE IN PSYCHOLOGY FROM A PROGRAM OF PSYCHOLOGY REGISTERED WITH THE
STATE EDUCATION DEPARTMENT OR THE SUBSTANTIAL EQUIVALENT THEREOF IN
ACCORDANCE WITH THE EDUCATION LAW, THE REQUIREMENTS OF THE STATE BOARD
FOR PSYCHOLOGY, AND THE REGULATIONS OF THE COMMISSIONER OF EDUCATION.
(O) "SOCIAL WORKER" SHALL MEAN A LICENSED CLINICAL SOCIAL WORKER. A
LICENSED CLINICAL SOCIAL WORKER HAS COMPLETED A MASTER'S DEGREE OF
SOCIAL WORK THAT INCLUDES COMPLETION OF A CORE CURRICULUM OF AT LEAST
TWELVE CREDIT HOURS OF CLINICAL COURSES OR THE EQUIVALENT POST-GRADUATE
CLINICAL COURSEWORK, IN ACCORDANCE WITH THE EDUCATION LAW AND THE REGU-
LATIONS OF THE COMMISSIONER OF EDUCATION.
2. Any [physician] PROVIDER licensed [to practice medicine] PURSUANT
TO THE EDUCATION LAW TO PROVIDE MEDICAL CARE AND TREATMENT in the state
of New York may render emergency [medical] care AND TREATMENT IN AN
EMERGENCY HOSPITAL OR URGENT CARE SETTING PROVIDING EMERGENCY TREATMENT
under this chapter without authorization by the chair under this
section; [and
(b)] (A) SUCH licensed [physician] PROVIDER AS IDENTIFIED IN THIS
SUBDIVISION who is [a member of a constituted medical staff of any
hospital] ON STAFF AT ANY HOSPITAL OR URGENT CARE CENTER PROVIDING EMER-
GENCY TREATMENT may [render] CONTINUE SUCH medical care under this chap-
ter while an injured employee remains a patient in such hospital OR
URGENT CARE SETTING; and
[(c)] (B) Under the [active and personal] DIRECT supervision of an
authorized [physician] PROVIDER, medical care may be rendered by a
registered nurse or other person trained in laboratory or diagnostic
techniques within the scope of such person's specialized training and
qualifications. This supervision shall be evidenced by signed records of
instructions for treatment and signed records of the patient's condition
and progress. Reports of such treatment and supervision shall be made by
such [physician] PROVIDER to the chair [on such forms and] IN THE FORMAT
PRESCRIBED BY THE CHAIR at such times as the chair may require.
[(d) Upon the referral which may be directive as to treatment of an
authorized physician physical therapy care may be rendered by a duly
licensed physical therapist. Where physical therapy care is rendered
records of the patient's condition and progress, together with records
of instruction for treatment, if any, shall be maintained by the phys-
ical therapist and physician. Said records shall be submitted to the
chair on such forms and at such times as the chair may require.
(e) Upon the prescription or referral of an authorized physician occu-
pational therapy care may be rendered by a duly licensed occupational
therapist. Where occupational therapy care is rendered records of the
patient's condition and progress, together with records of instruction
for treatment, if any shall be maintained by the occupational therapist
and physician. Said records shall be submitted to the chair on forms and
at such times as the chair may require.
(f)] (C) Where it would place an unreasonable burden upon the employer
or carrier to arrange for, or for the claimant to attend, an independent
medical examination by an authorized [physician] PROVIDER, the employer
or carrier shall arrange for such examination to be performed by a qual-
S. 343 4
ified [physician] PROVIDER in a medical facility convenient to the
claimant.
[2.] (D) UPON THE PRESCRIPTION OR REFERRAL OF AN AUTHORIZED PHYSICIAN,
OR NURSE PRACTITIONER ACTING WITHIN THE SCOPE OF HIS OR HER PRACTICE,
CARE OR TREATMENT MAY BE RENDERED TO AN INJURED EMPLOYEE BY AN AUTHOR-
IZED PHYSICAL THERAPIST, OCCUPATIONAL THERAPIST OR ACUPUNCTURIST
PROVIDED THE CONDITIONS AND THE TREATMENT PERFORMED ARE AMONG THE CONDI-
TIONS THAT THE PHYSICAL THERAPIST, OCCUPATIONAL THERAPIST OR ACUPUNCTU-
RIST IS AUTHORIZED TO TREAT PURSUANT TO THE EDUCATION LAW OR THE REGU-
LATIONS OF THE COMMISSIONER OF EDUCATION. WHERE ANY SUCH CARE OR
TREATMENT IS RENDERED, RECORDS OF THE PATIENT'S CONDITION AND PROGRESS,
TOGETHER WITH RECORDS OF INSTRUCTION FOR TREATMENT, IF ANY, SHALL BE
MAINTAINED BY THE PHYSICAL THERAPIST, OCCUPATIONAL THERAPIST OR ACUPUNC-
TURIST RENDERING TREATMENT AND BY THE REFERRING PHYSICIAN OR NURSE PRAC-
TITIONER. SAID RECORDS SHALL BE SUBMITTED TO THE CHAIR ON FORMS AND AT
SUCH TIMES AS THE CHAIR MAY REQUIRE.
(E) A RECORD, REPORT OR OPINION OF A PHYSICAL THERAPIST, OCCUPATIONAL
THERAPIST, ACUPUNCTURIST OR PHYSICIAN ASSISTANT SHALL NOT BE CONSIDERED
AS EVIDENCE OF THE CAUSAL RELATIONSHIP OF ANY CONDITION TO A WORK
RELATED ACCIDENT OR OCCUPATIONAL DISEASE UNDER THIS CHAPTER. NOR MAY A
RECORD, REPORT OR OPINION OF A PHYSICAL THERAPIST, OCCUPATIONAL THERA-
PIST OR ACUPUNCTURIST BE CONSIDERED EVIDENCE OF DISABILITY. NOR MAY A
RECORD, REPORT OR OPINION OF A PHYSICIAN ASSISTANT BE CONSIDERED
EVIDENCE OF THE PRESENCE OF A PERMANENT OR INITIAL DISABILITY OR THE
DEGREE THEREOF. NOR MAY A PHYSICAL THERAPIST, OCCUPATIONAL THERAPIST,
ACUPUNCTURIST OR PHYSICIAN ASSISTANT PERFORM AN INDEPENDENT MEDICAL
EXAMINATION CONCERNING A CLAIM UNDER THIS CHAPTER.
(F) A NURSE PRACTITIONER, OR LICENSED CERTIFIED SOCIAL WORKER, MAY
PERFORM AN INDEPENDENT MEDICAL EXAMINATION ON BEHALF OF AN EMPLOYER ONLY
TO THE EXTENT THAT THE EXAMINATION CONCERNS TREATMENT RENDERED BY AN
IDENTICAL PROVIDER TYPE, BUT MAY NOT PERFORM AN INDEPENDENT MEDICAL
EXAMINATION ON BEHALF OF THE EMPLOYER CONCERNING (1) THE CAUSAL
RELATIONSHIP OF ANY CONDITION TO A WORK RELATED ACCIDENT OR OCCUPATIONAL
DISEASE UNDER THIS CHAPTER OR (2) THE PRESENCE OF A DISABILITY OR THE
DEGREE THEREOF.
3. A [physician licensed to practice medicine in the state of New York
who is] PROVIDER PROPERLY LICENSED OR CERTIFIED PURSUANT TO THE REGU-
LATIONS OF THE COMMISSIONER OF EDUCATION AND THE REQUIREMENTS OF THE
EDUCATION LAW desirous of being authorized to render medical care under
this chapter and/or to conduct independent medical examinations in
accordance with paragraph (b) of subdivision four of section thirteen-a
and section one hundred thirty-seven of this chapter shall file an
application for authorization under this chapter with the [medical soci-
ety in the county in which his or her office is located, or with a board
designated by such society, or with a board designated by the chair as
provided in this section. In such application the applicant shall state
his or her training and qualifications, and shall agree to limit his or
her professional activities under this chapter to such medical care and
independent medical examinations, as his or her experience and training
qualify him or her to render. The applicant shall further agree to
refrain] CHAIR OR CHAIR'S DESIGNEE. PRIOR TO RECEIVING AUTHORIZATION, A
PHYSICIAN MUST, TOGETHER WITH SUBMISSION OF AN APPLICATION TO THE CHAIR,
SUBMIT SUCH APPLICATION TO THE MEDICAL SOCIETY OF THE COUNTY IN WHICH
THE PHYSICIAN'S OFFICE IS LOCATED OR OF A BOARD DESIGNATED BY SUCH COUN-
TY SOCIETY OR OF A BOARD REPRESENTING DULY LICENSED PHYSICIANS OF ANY
OTHER SCHOOL OF MEDICAL PRACTICE IN SUCH COUNTY, AND SUBMIT THE RECOM-
S. 343 5
MENDATION TO THE BOARD. IN THE EVENT SUCH COUNTY SOCIETY OR BOARD FAILS
TO TAKE ACTION UPON A PHYSICIAN'S APPLICATION WITHIN FORTY-FIVE DAYS,
THE CHAIR MAY COMPLETE REVIEW OF THE APPLICATION WITHOUT SUCH APPROVAL.
UPON APPROVAL OF THE APPLICATION BY THE CHAIR OR THE CHAIR'S DESIGNEE,
THE APPLICANT SHALL FURTHER AGREE TO REFRAIN from subsequently treating
for remuneration, as a private patient, any person seeking medical
treatment, or submitting to an independent medical examination, in
connection with, or as a result of, any injury compensable under this
chapter, if he or she has been removed from the list of [physicians]
PROVIDERS authorized to render medical care or to conduct independent
medical examinations under this chapter, or if the person seeking such
treatment, or submitting to an independent medical examination, has been
transferred from his or her care in accordance with the provisions of
this chapter. This agreement shall run to the benefit of the injured
person so treated or examined, and shall be available to him or her as a
defense in any action by such [physician] PROVIDER for payment for
treatment rendered by a [physician] PROVIDER after he or she has been
removed from the list of [physicians] PROVIDERS authorized to render
medical care or to conduct independent medical examinations under this
chapter, or after the injured person was transferred from his or her
care in accordance with the provisions of this chapter. [The medical
society or the board designated by it, or the board as otherwise
provided under this section, if it deems such licensed physician duly
qualified, shall recommend to the chair that such physician be author-
ized to render medical care and/or conduct independent medical examina-
tions under this chapter, and such recommendation and authorization
shall specify the character of the medical care or independent medical
examination which such physician is qualified and authorized to render
under this chapter. Such recommendations shall be advisory to the chair
only and shall not be binding or conclusive upon him or her. The
licensed physician may present to the medical society or board,
evidences of additional qualifications at any time subsequent to his or
her original application. If the medical society or board fails to
recommend to the chair that a physician be authorized to render medical
care and/or to conduct independent medical examinations under this chap-
ter, the physician may appeal to the medical appeals unit. The medical
society or the board designated by it, or the board as otherwise
provided under this section, may upon its own initiative, or shall upon
request of the chair, review at any time the qualifications of any
physician as to the character of the medical care or independent medical
examinations which such physician has theretofore been authorized to
render under this chapter and may recommend to the chair that such
physician be authorized to render medical care or to conduct independent
medical examinations thereafter of the character which such physician is
then qualified to render. On such advisory recommendation the chair may
review and after reasonable investigation may revise the authorization
of a physician in respect to the character of medical care and/or to
conduct independent medical examinations which he or she is authorized
to render. If the medical society or board recommends to the chair that
a physician be authorized to render medical care and/or to conduct inde-
pendent medical examinations under this chapter of a character different
from the character of medical care or independent medical examinations
he or she has been theretofore authorized to render, such physician may
appeal from such recommendation to the medical appeals unit.
3.] 4. Laboratories and bureaus engaged in x-ray diagnosis or treat-
ment or in physiotherapy or other therapeutic procedures and which
S. 343 6
participate in the diagnosis or treatment of injured [workmen] WORKERS
under this chapter shall be operated or supervised by [qualified physi-
cians duly] PROVIDERS authorized under this chapter and shall be subject
to the provisions of section thirteen-c of this article. The person in
charge of diagnostic clinical laboratories duly authorized under this
chapter shall possess the qualifications established by the public
health and health planning council for approval by the state commission-
er of health or, in the city of New York, the qualifications approved by
the board of health of said city and shall maintain the standards of
work required for such approval.
§ 2. Section 13-g of the workers' compensation law, as added by chap-
ter 258 of the laws of 1935, subdivision 1 as amended by chapter 674 of
the laws of 1994, subdivisions 2 and 3 as amended by section 4 of part
GG of chapter 57 of the laws of 2013, subdivision 4 as amended by
section 3 of part D of chapter 55 of the laws of 2015, subdivision 5 as
amended by chapter 578 of the laws of 1959 and subdivision 6 as amended
by chapter 639 of the laws of 1996, is amended to read as follows:
§ 13-g. Payment of bills for medical care. (1) Within forty-five days
after a bill FOR MEDICAL CARE OR SUPPLIES DELIVERED PURSUANT TO SECTION
THIRTEEN OF THIS ARTICLE has been rendered to the employer [by the
hospital, physician or self-employed physical or occupational therapist
who has rendered treatment pursuant to a referral from the injured
employee's authorized physician or authorized podiatrist for treatment
to the injured employee], such employer must pay the bill or notify the
[hospital, physician or self-employed physical or occupational therapist
in writing] MEDICAL CARE PROVIDER OR SUPPLIER IN THE FORMAT PRESCRIBED
BY THE CHAIR 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 or occupa-
tional therapist] MEDICAL CARE PROVIDER OR SUPPLIER within such forty-
five day period that payment is not being made, the [hospital, physi-
cian, self-employed physical therapist or self-employed occupational
therapist] MEDICAL CARE PROVIDER OR SUPPLIER may notify THE BOARD IN THE
FORMAT PRESCRIBED BY 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 or occupational therapist, in accordance with the provisions of
subdivision two or subdivision three of this section, as appropriate,
and] AS SET FORTH IN rules and regulations promulgated by the chair.
Where a [physician, physical or occupational therapist] bill FOR
MEDICAL CARE OR SUPPLIES has been determined to be due and owing in
S. 343 7
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] PERCENT (1 1/2%) per month payable to the [physician, phys-
ical or occupational therapist] MEDICAL CARE PROVIDER OR SUPPLIER, in
accordance with the rules and regulations promulgated 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, relat-
ing to the employer's liability for the payment of such amount, shall
have been finally determined adversely to the employer, whichever is
later, in accordance with rules promulgated by the chair.
(2) (a) If the parties fail to agree to the value of medical aid
rendered under this chapter and the amount of the disputed bill is one
thousand dollars or less, or if the amount of the disputed medical bill
exceeds one thousand dollars and the [health] MEDICAL care provider OR
SUPPLIER expressly so requests, such value shall be decided by a single
arbitrator process, pursuant to rules promulgated by the chair. [The
chair shall appoint a physician who is a member in good standing of the
medical society of the state of New York to determine the value of such
disputed medical bill. Where the physician whose charges are being
arbitrated is a member in good standing of the New York osteopathic
society, the value of such disputed bill shall be determined by a member
in good standing of the New York osteopathic society appointed by the
chair. Where the physician whose charges are being arbitrated is a
member in good standing of the New York homeopathic society, the value
of such disputed bill shall be determined by a member in good standing
of the New York homeopathic society appointed by the chair. Where the
value of physical therapy services or occupational therapy services is
at issue, such value shall be determined by a member in good standing of
a recognized professional association representing its respective
profession in the state of New York appointed by the chair.] Decisions
rendered under the single arbitrator process shall be conclusive upon
the parties as to the value of the services in dispute.
(b) If the parties fail to agree as to the value of medical aid
rendered under this chapter and the amount of the disputed bill exceeds
one thousand dollars, such value shall be decided by an arbitration
committee unless the [health] MEDICAL care provider OR SUPPLIER express-
ly requests a single arbitrator process in accordance with paragraph (a)
of this subdivision. The arbitration committee shall [consist of one
physician designated by the president 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 chair of the workers'
compensation board. If the physician 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 chair of the workers' compensation board. Where the value
of physical therapy services is at issue and the amount of the disputed
bill exceeds one thousand dollars, the arbitration committee shall
consist of a member in good standing of a recognized professional asso-
ciation 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 chair of
S. 343 8
the workers' compensation board provided however, that the 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 and the amount of the disputed bill exceeds one
thousand dollars, the arbitration committee shall be similarly selected
and identical in composition, provided that the physical therapist
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.
(c) Where the value of occupational therapy services is at issue the
arbitration committee shall consist of a member in good standing of a
recognized professional association representing occupational therapists
in the state of New York appointed by the president of such organiza-
tion; a physician designated by the employer or carrier and a physician
designated by the chair of the workers' compensation board provided,
however, that the 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 and
the amount of the disputed bill exceeds one thousand dollars, the arbi-
tration committee shall be similarly selected and identical in composi-
tion, provided that the occupational therapist member shall serve with-
out 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.] HAVE THREE MEMBERS DESIGNATED BY THE CHAIR IN
CONSULTATION WITH THE MEDICAL DIRECTOR'S OFFICE OF THE WORKERS' COMPEN-
SATION BOARD. The majority decision of any such arbitration committee
shall be conclusive upon the parties as to the value of the services in
dispute.
(3) [(a) If an employer shall have notified the hospital in writing,
as provided in subdivision one of this section, why the bill has not
been paid, in part or in full, and the amount of the disputed bill is
one thousand dollars or less, or where the amount of the disputed
medical bill exceeds one thousand dollars and the hospital expressly so
requests, such value shall be decided by a single arbitrator process,
pursuant to rules promulgated by the chair. The chair shall appoint a
physician in good standing licensed to practice in New York state to
determine the value of such disputed bill. Decisions rendered under the
administrative resolution procedure shall be conclusive upon the parties
as to the value of the services in dispute.
(b) If an employer shall have notified the hospital in writing, as
provided in subdivision one of this section, why the bill has not been
paid, in part or in full, and the amount of the disputed bill exceeds
one thousand dollars, the value of such bill shall be determined by an
arbitration committee appointed by the chair for that purpose, which
committee shall consider all of the charges of the hospital, unless the
hospital expressly requests a single arbitrator process pursuant to
paragraph (a) of this subdivision. The committee shall consist of three
physicians. One member of the committee may be nominated by the chair
upon recommendation of the president of the hospital association of New
York state and one member may be nominated by the employer or insurance
carrier. The majority decision of any such committee shall be conclusive
upon the parties as to the value of the services rendered. The chair may
S. 343 9
make reasonable rules and regulations consistent with the provisions of
this section.
(4)] A provider OR SUPPLIER initiating an arbitration, including a
single arbitrator process, pursuant to this section shall not pay a fee
to cover the costs related to the conduct of such arbitration. [Each
member of an arbitration committee for medical bills, and each member of
an arbitration committee for hospital bills shall be entitled to receive
and shall be paid a fee for each day's attendance at an arbitration
session in any one count in an amount fixed by the chair of the workers'
compensation board.
(5)] (4) In claims where the employer has failed to secure compen-
sation to his employees as required by section fifty of this chapter,
the board may make an award for the value of medical [and podiatry]
services, SUPPLIES or treatment rendered to such employees, in accord-
ance with the schedules of fees and charges prepared and established
under the provisions of [section thirteen, subdivision a, and section
thirteen-k, subdivision two, of] this chapter[, and for the reasonable
value of hospital care in accordance with the charges currently in force
in hospitals in the same community for cases coming within the
provisions of this chapter]. Such award shall be made to the [physician,
podiatrist, or hospital] MEDICAL CARE PROVIDER OR SUPPLIER entitled
thereto. A default in the payment of such award may be enforced in the
manner provided for the enforcement of compensation awards as set forth
in section twenty-six of this [chapter] ARTICLE.
In all cases coming under this subdivision the payment of the claim
[of the physician, podiatrist, or hospital for medical, podiatry, or
surgical services or treatment] FOR MEDICAL CARE OR SUPPLIES shall be
subordinate to that of the claimant or his OR HER beneficiaries.
[(6) Notwithstanding any inconsistent provision of law, arbitration
regarding payments for inpatient hospital services for any patient
discharged on or after January first, nineteen hundred ninety-one and
prior to December thirty-first, nineteen hundred ninety-six shall be
resolved in accordance with paragraph (d) of subdivision three of
section twenty-eight hundred seven-c of the public health law.]
§ 3. Subdivisions 1 and 2 and paragraph (b) of subdivision 3 of
section 13-k of the workers' compensation law, subdivision 1 as added by
chapter 787 of the laws of 1952 and subdivision 2 and paragraph (b) of
subdivision 3 as amended by chapter 473 of the laws of 2000, are amended
to read as follows:
1. When the term "chairman" is hereinafter used, it shall be deemed to
mean the [chairman] CHAIR of the [workmen's] WORKERS' compensation board
of the state of New York.
2. An employee injured under circumstances which make such injury
compensable under this article, when care is required for an injury to
the foot which injury or resultant condition therefrom may lawfully be
treated by a duly registered and licensed podiatrist of the state of New
York, may select to treat him or her any podiatrist authorized by the
chair to render [podiatry] PODIATRIC MEDICAL care, as hereinafter
provided. If the injury or condition is one which is without the limits
prescribed by the education law for [podiatry] PODIATRIC MEDICAL care
and treatment, or the injuries involved affect other parts of the body
in addition to the foot, the said podiatrist must so advise the said
injured employee and instruct him or her to consult a physician of said
employee's choice for appropriate care and treatment. Such physician
shall thenceforth have overall supervision of the treatment of said
patient including the future treatment to be administered to the patient
S. 343 10
by the podiatrist. If for any reason during the period when [podiatry]
PODIATRIC MEDICAL treatment and care is required, the employee wishes to
transfer his or her treatment and care to another authorized podiatrist
he or she may do so, in accordance with rules prescribed by the chair,
provided however that the employer shall be liable for the proper fees
of the original podiatrist for the care and treatment he or she shall
have rendered. [A podiatrist licensed and registered to practice podia-
try in the state of New York who is desirous of being authorized to
render podiatry care under this section and/or to conduct independent
medical examinations in accordance with paragraph (b) of subdivision
three of this section shall file an application for authorization under
this section with the podiatry practice committee. In such application
he or she shall agree to refrain from subsequently treating for remuner-
ation, as a private patient, any person seeking podiatry treatment, or
submitting to an independent medical examination, in connection with, or
as a result of, any injury compensable under this chapter, if he or she
has been removed from the list of podiatrists authorized to render
podiatry care or to conduct independent medical examinations under this
chapter, or if the person seeking such treatment has been transferred
from his or her care in accordance with the provisions of this section.
This agreement shall run to the benefit of the injured person so treated
or examined, and shall be available to him or her as a defense in any
action by such podiatrist for payment for treatment rendered by a podia-
trist after he or she has been removed from the list of podiatrists
authorized to render podiatry care or to conduct independent medical
examinations under this section, or after the injured person was trans-
ferred from his or her care in accordance with the provisions of this
section. The podiatry practice committee if it deems such licensed
podiatrist duly qualified shall recommend to the chair that such podia-
trist be authorized to render podiatry care and/or to conduct independ-
ent medical examinations under this section. Such recommendation shall
be advisory to the chair only and shall not be binding or conclusive
upon him or her.] The chair shall prepare and establish a schedule for
the state, or schedules limited to defined localities, of charges and
fees for [podiatry] PODIATRIC MEDICAL treatment and care, to be deter-
mined 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 [podia-
try] PODIATRIC MEDICINE practice committee to submit to him or her a
report on the amount of remuneration deemed by such committee to be fair
and adequate for the types of [podiatry] PODIATRIC MEDICAL care to be
rendered under this chapter, but consideration shall be given to the
view of other interested parties. The amounts payable by the employer
for such treatment and services shall be the fees and charges estab-
lished by such schedule.
(b) Upon receipt of the notice provided for by paragraph (a) of this
subdivision, the employer, the carrier and the claimant each shall be
entitled to have the claimant examined by a qualified podiatrist author-
ized by the chair in accordance with [subdivision two of this] section
THIRTEEN-B and section one hundred thirty-seven of this chapter, at a
medical facility convenient to the claimant and in the presence of the
claimant's podiatrist, and refusal by the claimant to submit to such
independent medical examination at such time or times as may reasonably
be necessary in the opinion of the board shall bar the claimant from
recovering compensation for any period during which he or she has
refused to submit to such examination.
S. 343 11
§ 4. Subdivisions 1 and 2 and paragraph (b) of subdivision 3 of
section 13-l of the workers' compensation law, subdivision 1 as added by
chapter 940 of the laws of 1973 and subdivision 2 and paragraph (b) of
subdivision 3 as amended by chapter 473 of the laws of 2000, are amended
to read as follows:
1. Where the term "chairman" is hereinafter used, it shall be deemed
to mean the [chairman] CHAIR of the [workmen's] WORKERS' compensation
board of the state of New York.
2. An employee injured under circumstances which make such injury
compensable under this article, when care is required for an injury
which consists solely of a condition which may lawfully be treated by a
chiropractor as defined in section sixty-five hundred fifty-one of the
education law may select to treat him or her, any duly registered and
licensed chiropractor of the state of New York, authorized by the chair
to render chiropractic care as hereinafter provided. If the injury or
condition is one which is outside the limits prescribed by the education
law for chiropractic care and treatment, the said chiropractor must so
advise the said injured employee and instruct him or her to consult a
physician of said employee's choice for appropriate care and treatment.
Such physician shall thenceforth have supervision of the treatment of
said condition including the future treatment to be administered to the
patient by the chiropractor. [A chiropractor licensed and registered to
practice chiropractic in the state of New York, who is desirous of being
authorized to render chiropractic care under this section and/or to
conduct independent medical examinations in accordance with paragraph
(b) of subdivision three of this section shall file an application for
authorization under this section with the chiropractic practice commit-
tee. In such application he or she shall agree to refrain from subse-
quently treating for remuneration, as a private patient, any person
seeking chiropractic treatment, or submitting to an independent medical
examination, in connection with, or as a result of, any injury compensa-
ble under this chapter, if he or she has been removed from the list of
chiropractors authorized to render chiropractic care or to conduct inde-
pendent medical examinations under this chapter, or if the person seek-
ing such treatment has been transferred from his or her care in accord-
ance with the provisions of this section. This agreement shall run to
the benefit of the injured person so treated, or examined, and shall be
available to him or her as a defense in any action by such chiropractor
for payment rendered by a chiropractor after he or she has been removed
from the list of chiropractors authorized to render chiropractic care or
to conduct independent medical examinations under this section, or after
the injured person was transferred from his or her care in accordance
with the provisions of this section. The chiropractic practice committee
if it deems such licensed chiropractor duly qualified shall recommend to
the chair that such be authorized to render chiropractic care and/or to
conduct independent medical examinations under this section. Such recom-
mendations shall be advisory to the chair only and shall not be binding
or conclusive upon him or her.] The chair shall prepare and establish a
schedule for the state, or schedules limited to defined localities of
charges and fees for chiropractic treatment and care, to be determined
in accordance with and to be subject to change pursuant to rules promul-
gated by the chair. Before preparing such schedule for the state or
schedules for limited localities the chair shall request the chiroprac-
tic practice committee to submit to him or her a report on the amount of
remuneration deemed by such committee to be fair and adequate for the
types of chiropractic care to be rendered under this chapter, but
S. 343 12
consideration shall be given to the view of other interested parties,
the amounts payable by the employer for such treatment and services
shall be the fees and charges established by such schedule.
(b) Upon receipt of the notice provided for by paragraph (a) of this
subdivision, the employer, the carrier, and the claimant each shall be
entitled to have the claimant examined by a qualified chiropractor
authorized by the chair in accordance with [subdivision two of this]
section THIRTEEN-B and section one hundred thirty-seven of this chapter
at a medical facility convenient to the claimant and in the presence of
the claimant's chiropractor, and refusal by the claimant to submit to
such independent medical examination at such time or times as may
reasonably be necessary in the opinion of the board shall bar the claim-
ant from recovering compensation, for any period during which he or she
has refused to submit to such examination.
§ 5. Subdivisions 1, 2 and 3 and paragraph (b) of subdivision 4 of
section 13-m of the workers' compensation law, subdivisions 1 and 2 as
added by chapter 589 of the laws of 1989 and subdivision 3 and paragraph
(b) of subdivision 4 as amended by chapter 473 of the laws of 2000, are
amended to read as follows:
1. Where the term "chairman" is hereinafter used, it shall be deemed
to mean the [chairman] CHAIR of the workers' compensation board of the
state of New York.
2. (a) An injured employee, injured under circumstances which make
such injury compensable under this article, may lawfully be treated[,
upon the referral of an authorized physician,] by a psychologist, duly
registered and licensed by the state of New York, authorized by the
[chairman] CHAIR to render psychological care pursuant to [this] section
THIRTEEN-B OF THIS ARTICLE. Such services shall be within the scope of
such psychologist's specialized training and qualifications as defined
in article one hundred fifty-three of the education law.
(b) Medical bureaus, medical centers jointly operated by labor and
management representatives, hospitals and health maintenance organiza-
tions, authorized to provide medical care pursuant to section thirteen-c
of this [chapter] ARTICLE, may provide psychological services when
required[, upon the referral of an authorized physician, provided such
care is rendered by a duly registered, licensed and authorized psychol-
ogist, as required by this section].
(c) A psychologist rendering service pursuant to this section shall
maintain records of the patient's psychological condition and treatment,
and such records or reports shall be submitted to the [chairman] CHAIR
on such forms and at such times as the [chairman] CHAIR may require.
3. [A psychologist, licensed and registered to practice psychology in
the state of New York, who is desirous of being authorized to render
psychological care under this section and/or to conduct independent
medical examinations in accordance with paragraph (b) of subdivision
four of this section shall file an application for authorization under
this section with the psychology practice committee. The applicant shall
agree to refrain from subsequently treating for remuneration, as a
private patient, any person seeking psychological treatment, or submit-
ting to an independent medical examination, in connection with, or as a
result of, any injury compensable under this chapter, if he or she has
been removed from the list of psychologists authorized to render psycho-
logical care under this chapter. This agreement shall run to the benefit
of the injured person so treated, and shall be available as a defense in
any action by such psychologist for payment for treatment rendered by
such psychologist after being removed from the list of psychologists
S. 343 13
authorized to render psychological care or to conduct independent
medical examinations under this section. The psychology practice commit-
tee if it deems such licensed psychologist duly qualified shall recom-
mend to the chair that such person be authorized to render psychological
care and/or to conduct independent medical examinations under this
section. Such recommendations shall be only advisory to the chair and
shall not be binding or conclusive.] The chair shall prepare and estab-
lish a schedule for the state or schedules limited to defined localities
of charges and fees for psychological treatment and care, to be deter-
mined in accordance with and 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 psychol-
ogy practice committee to submit to such chair a report on the amount of
remuneration deemed by such committee to be fair and adequate for the
types of psychological care to be rendered under this chapter, but
consideration shall be given to the view of other interested parties.
The amounts payable by the employer for such treatment and services
shall be the fees and charges established by such schedule.
(b) Upon receipt of the notice provided for by paragraph (a) of this
subdivision, the employer, the carrier, and the claimant each shall be
entitled to have the claimant examined by a qualified psychologist,
authorized by the chair in accordance with [subdivision three of this]
section THIRTEEN-B and section one hundred thirty-seven of this chapter,
at a medical facility convenient to the claimant and in the presence of
the claimant's psychologist, and refusal by the claimant to submit to
such independent medical examination at such time or times as may
reasonably be necessary in the opinion of the board shall bar the claim-
ant from recovering compensation, for any period during which he or she
has refused to submit to such examination.
§ 6. Section 54-b of the workers' compensation law, as amended by
chapter 6 of the laws of 2007, is amended to read as follows:
§ 54-b. Enforcement on failure to pay award or judgment. In case of
default by a carrier or self-insured employer in the payment of any
compensation due under an award for the period of thirty days after
payment is due and payable, or in the case of failure by a carrier or
self-insured employer to make full payment of an award for medical care
OR SUPPLIES issued by the board or the chair pursuant to section thir-
teen-g of this chapter, the chair in any such case or on the chair's
consent any party to an award may file with the county clerk for the
county in which the injury occurred or the county in which the carrier
or self-insured employer has his or her principal place of business, (1)
a certified copy of the decision of the board awarding compensation or
ending, diminishing or increasing compensation previously awarded, from
which no appeal has been taken within the time allowed therefor, or if
an appeal has been taken by a carrier or self-insured employer who has
not complied with the provisions of section fifty of this article, where
he or she fails to deposit with the chair the amount of the award as
security for its payment within ten days after the same is due and paya-
ble, or (2) a certified copy of the award for medical care OR SUPPLIES
issued pursuant to section thirteen-g of this chapter, and thereupon
judgment must be entered in the supreme court by the clerk of such coun-
ty in conformity therewith immediately upon such filing. If the payment
in default be an installment, the board may declare the entire award due
and judgment may be entered in accordance with the provisions of this
section. Such judgment shall be entered in the same manner, have the
same effect and be subject to the same proceedings as though rendered in
S. 343 14
a suit duly heard and determined by the supreme court, except that no
appeal may be taken therefrom. The court shall vacate or modify such
judgment to conform to any later award or decision of the board upon
presentation of a certified copy of such award or decision. The award
may be so compromised by the board as in the discretion of the board may
best serve the interest of the persons entitled to receive the compen-
sation or benefits. Where an award has been made against a carrier or
self-insured employer in accordance with the provisions of subdivision
nine of section fifteen, or of section twenty-five-a of this chapter,
such an award may be similarly compromised by the board, upon notice to
a representative of the fund to which the award is payable, but if there
be no representative of any such fund, notice shall be given to such
representative as may be designated by the chair of the board; and
notwithstanding any other provision of law, such compromise shall be
effective without the necessity of any approval by the state comp-
troller. Neither the chair nor any party in interest shall be required
to pay any fee to any public officer for filing or recording any paper
or instrument or for issuing a transcript of any judgment executed in
pursuance of this section. The carrier or self-insured employer shall be
liable for all costs and attorneys fees necessary to enforce the award.
For the purposes of this section, the term "carrier" shall include the
state insurance fund and any stock corporation, mutual corporation or
reciprocal insurer authorized to transact the business of workers'
compensation insurance in this state.
§ 7. This act shall take effect on the ninetieth day after it shall
have become a law.