Assembly Bill A6832A

2023-2024 Legislative Session

Relates to workers' access to treatment

download bill text pdf

Sponsored By

Current Bill Status Via S6929 - Passed Assembly

  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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Actions
Votes

Bill Amendments

co-Sponsors

2023-A6832 - Details

See Senate Version of this Bill:
S6929
Law Section:
Workers' Compensation Law
Laws Affected:
Amd §13-a, Work Comp L

2023-A6832 - Summary

Allows for treatment costing less than $1,500 to be done without prior approval, and more clearly defines the list of "pre-authorized procedures" as a floor on treatment as opposed to its current status as a ceiling; allows non-network providers of testing to be compensated at the provider network rate negotiated by the carrier.

2023-A6832 - Bill Text download pdf 

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   6832
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                May 8, 2023
                                ___________
 
 Introduced by M. of A. LUNSFORD -- read once and referred to the Commit-
   tee on Labor
 
 AN  ACT  to amend the workers' compensation law, in relation to workers'
   access to treatment
 
   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:

   Section  1. Subdivision (i) of section 13 of the workers' compensation
 law is amended by adding a new paragraph 6 to read as follows:
   (6) A NON-NETWORK PHARMACY THAT PROVIDES CAUSALLY RELATED  MEDICATIONS
 TO  A  CLAIMANT SHALL BE ENTITLED TO PAYMENT AT THE NETWORK RATE NEGOTI-
 ATED BETWEEN THE CARRIER AND THEIR PHARMACY NETWORK.
   § 2. Subdivision 5 of section 13-a of the workers'  compensation  law,
 as amended by section 8 of part CC of chapter 55 of the laws of 2019, is
 amended to read as follows:
   (5)  No  claim  for  specialist  consultations,  surgical  operations,
 physiotherapeutic or occupational therapy procedures, x-ray examinations
 or special diagnostic laboratory tests costing more  than  one  thousand
 FIVE  HUNDRED  dollars  shall  be valid and enforceable, as against such
 employer, unless such special services shall have been authorized by the
 employer or by the board, or unless such authorization has  been  unrea-
 sonably  withheld, or withheld for a period of more than thirty calendar
 days from receipt of a request for authorization, or unless such special
 services are required in an emergency, provided, however, that the basis
 for a denial of such authorization by the employer must be  based  on  a
 conflicting  second  opinion  rendered  by a physician authorized by the
 board. The board, with the approval of the superintendent  of  financial
 services,  shall  issue and maintain a list of pre-authorized procedures
 under this section. Such list  of  pre-authorized  procedures  shall  be
 issued and maintained SOLELY for the purpose of expediting authorization
 of  treatment of injured workers. Such list of pre-authorized procedures
 shall not prohibit varied treatment [when the treating  provider  demon-

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09959-02-3

co-Sponsors

2023-A6832A (ACTIVE) - Details

See Senate Version of this Bill:
S6929
Law Section:
Workers' Compensation Law
Laws Affected:
Amd §13-a, Work Comp L

2023-A6832A (ACTIVE) - Summary

Allows for treatment costing less than $1,500 to be done without prior approval, and more clearly defines the list of "pre-authorized procedures" as a floor on treatment as opposed to its current status as a ceiling; allows non-network providers of testing to be compensated at the provider network rate negotiated by the carrier.

2023-A6832A (ACTIVE) - Bill Text download pdf 

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  6832--A
 
                        2023-2024 Regular Sessions
 
                           I N  A S S E M B L Y
 
                                May 8, 2023
                                ___________
 
 Introduced  by  M.  of A. LUNSFORD, BRONSON -- read once and referred to
   the Committee on Labor -- committee discharged, bill amended,  ordered
   reprinted as amended and recommitted to said committee
 
 AN  ACT  to amend the workers' compensation law, in relation to workers'
   access to treatment

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   §  1.  Subdivision 5 of section 13-a of the workers' compensation law,
 as amended by section 8 of part CC of chapter 55 of the laws of 2019, is
 amended to read as follows:
   (5)  No  claim  for  specialist  consultations,  surgical  operations,
 physiotherapeutic or occupational therapy procedures, x-ray examinations
 or  special  diagnostic  laboratory tests costing more than one thousand
 FIVE HUNDRED dollars shall be valid and  enforceable,  as  against  such
 employer, unless such special services shall have been authorized by the
 employer  or  by the board, or unless such authorization has been unrea-
 sonably withheld, or withheld for a period of more than thirty  calendar
 days from receipt of a request for authorization, or unless such special
 services are required in an emergency, provided, however, that the basis
 for  a  denial  of such authorization by the employer must be based on a
 conflicting second opinion rendered by a  physician  authorized  by  the
 board.  The  board, with the approval of the superintendent of financial
 services, shall issue and maintain a list of  pre-authorized  procedures
 under  this  section.  Such  list  of pre-authorized procedures shall be
 issued and maintained SOLELY for the purpose of expediting authorization
 of treatment of injured workers. Such list of pre-authorized  procedures
 shall  not  prohibit varied treatment [when the treating provider demon-
 strates the appropriateness and medical necessity of  such],  NOR  SHALL
 THE  LIST  BE  USED  AS A BASIS TO DENY treatment NOT CONTAINED THEREIN.
 REQUESTS FOR VARIED TREATMENT NEED ONLY COMPLY WITH  THE  PROVISIONS  OF
 THIS SUBDIVISION.
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD09959-03-3

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