Bill Text: NY S01492 | 2017-2018 | General Assembly | Introduced


Bill Title: Authorizes licensed clinical social workers to provide services to injured employees under workers' compensation coverage.

Spectrum: Partisan Bill (Democrat 3-0)

Status: (Introduced - Dead) 2018-01-03 - REFERRED TO LABOR [S01492 Detail]

Download: New_York-2017-S01492-Introduced.html


                STATE OF NEW YORK
        ________________________________________________________________________
                                          1492
                               2017-2018 Regular Sessions
                    IN SENATE
                                     January 9, 2017
                                       ___________
        Introduced  by  Sens.  AVELLA,  KLEIN,  SAVINO -- 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  care  and  treatment  of  injured  employees by licensed clinical
          social workers
          The People of the State of New York, represented in Senate and  Assem-
        bly, do enact as follows:
     1    Section  1.  The  workers' compensation law is amended by adding a new
     2  section 13-p to read as follows:
     3    § 13-p. Care and treatment of injured employees by  licensed  clinical
     4  social  workers. 1. For the purposes of this section, "chair" shall mean
     5  the chair of the board.
     6    2. (a) An injured employee, injured  under  circumstances  which  make
     7  such  injury  compensable  under  this article, may lawfully be treated,
     8  upon the referral of an authorized physician,  by  a  licensed  clinical
     9  social  worker,  licensed  pursuant to article one hundred fifty-four of
    10  the education law, authorized by the chair to render  licensed  clinical
    11  social  work  services  pursuant to this section. Such services shall be
    12  within the scope of such licensed clinical social  workers'  specialized
    13  training and qualifications as defined in article one hundred fifty-four
    14  of the education law. Licensed clinical social workers authorized by the
    15  chair to provide services pursuant to this section, shall not be author-
    16  ized to perform independent medical examinations, except for independent
    17  medical  examinations  related  to the need for licensed clinical social
    18  work services.
    19    (b) Medical bureaus, medical centers jointly  operated  by  labor  and
    20  management  representatives,  hospitals and health maintenance organiza-
    21  tions, authorized to provide medical care pursuant to section thirteen-c
    22  of this chapter, may provide licensed clinical social work services when
    23  required, upon the referral of an authorized  physician,  provided  such
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD00990-01-7

        S. 1492                             2
     1  care is rendered by a duly licensed and authorized clinical social work-
     2  er, as required by this section.
     3    (c)  A  licensed  clinical social worker rendering service pursuant to
     4  this section shall maintain records of the patient's condition and clin-
     5  ical social work treatment, and such records or reports shall be submit-
     6  ted to the chair on such forms and  at  such  times  as  the  chair  may
     7  require.
     8    3.  A  licensed  clinical social worker, licensed to practice licensed
     9  clinical social work in this state, who is desirous of being  authorized
    10  to  render  licensed  clinical  social  work services under this section
    11  and/or to conduct independent medical examinations  in  accordance  with
    12  paragraph (b) of subdivision four of this section shall file an applica-
    13  tion  for authorization under this section with the clinical social work
    14  practice committee. The applicant shall agree  to  refrain  from  subse-
    15  quently  treating  for  remuneration,  as  a private patient, any person
    16  seeking licensed clinical social work  services,  or  submitting  to  an
    17  independent  medical examination, in connection with, or as a result of,
    18  any injury compensable under this chapter, if he or she has been removed
    19  from the list of licensed clinical social workers authorized  to  render
    20  licensed  clinical  social work services under this chapter. This agree-
    21  ment shall run to the benefit of the  injured  person  so  treated,  and
    22  shall  be available as a defense in any action by such licensed clinical
    23  social worker for payment for treatment rendered by such licensed  clin-
    24  ical  social  worker after being removed from the list of licensed clin-
    25  ical social workers authorized to render licensed clinical  social  work
    26  services  or  to  conduct  independent  medical  examinations under this
    27  section. The clinical social work practice committee if  it  deems  such
    28  licensed  clinical  social  worker duly qualified shall recommend to the
    29  chair that such person be authorized to render licensed clinical  social
    30  work  services  and/or to conduct independent medical examinations under
    31  this section. Such recommendations shall be only advisory to  the  chair
    32  and  shall  not  be  binding  or conclusive. The chair shall prepare and
    33  establish a schedule for the  state  or  schedules  limited  to  defined
    34  localities  of  charges  and  fees  for  licensed  clinical  social work
    35  services, to be determined in accordance with and be subject  to  change
    36  pursuant to rules promulgated by the chair. Before preparing such sched-
    37  ule  for  the  state or schedules for limited localities the chair shall
    38  request the clinical social work practice committee to  submit  to  such
    39  chair a report on the amount of remuneration deemed by such committee to
    40  be  fair  and  adequate  for  the types of licensed clinical social work
    41  services to be rendered under this chapter, but consideration  shall  be
    42  given  to  the  view of other interested parties. The amounts payable by
    43  the employer for such treatment and  services  shall  be  the  fees  and
    44  charges established by such schedule.
    45    4.  (a)  No  claim for licensed clinical social work services shall be
    46  valid and enforceable as against the employer or employees unless within
    47  forty-eight hours following the first treatment  the  licensed  clinical
    48  social  worker  giving  such care or treatment furnishes to the employer
    49  and directly to the chair a preliminary notice of such injury and treat-
    50  ment, and within fifteen days thereafter  a  more  complete  report  and
    51  subsequent  thereto  progress  reports  as  requested  in writing by the
    52  chair, board, employer or insurance carrier, at intervals  of  not  less
    53  than  three  weeks  apart  or at less frequent intervals if requested on
    54  forms prescribed by the chair. The board may excuse the failure to  give
    55  such notices within the designated periods when it finds it to be in the
    56  interest of justice to do so.

        S. 1492                             3
     1    (b)  Upon  receipt of the notice provided for by paragraph (a) of this
     2  subdivision, the employer, the carrier, and the claimant each  shall  be
     3  entitled  to have the claimant examined by a qualified licensed clinical
     4  social worker, authorized by the chair in  accordance  with  subdivision
     5  three of this section and section one hundred thirty-seven of this chap-
     6  ter,  at  a medical facility convenient to the claimant and in the pres-
     7  ence of the claimant's licensed clinical social worker, and  refusal  by
     8  the  claimant  to submit to such independent medical examination at such
     9  time or times as may reasonably be necessary in the opinion of the board
    10  shall bar the claimant from  recovering  compensation,  for  any  period
    11  during which he or she has refused to submit to such examination.
    12    (c)  Where  it would place an unreasonable burden upon the employer or
    13  carrier to arrange for, or for the claimant to  attend,  an  independent
    14  medical  examination  by  an authorized licensed clinical social worker,
    15  the employer or  carrier  shall  arrange  for  such  examination  to  be
    16  performed  by  a  qualified licensed clinical social worker in a medical
    17  facility convenient to the claimant.
    18    (d) The independent licensed clinical social work examiner licensed by
    19  this state shall provide such reports and shall submit to  investigation
    20  as required by the chair.
    21    (e)  In  order to qualify as admissible medical evidence, for purposes
    22  of adjudicating any claim under this chapter, any  report  submitted  to
    23  the  board  by  an  independent  licensed  clinical social work examiner
    24  licensed by this state shall include the following:
    25    (i) a signed statement certifying that the report is a full and truth-
    26  ful representation of the  independent  licensed  clinical  social  work
    27  examiner's  professional  opinion  with respect to the claimant's condi-
    28  tion,
    29    (ii) such examiner's board issued authorization number,
    30    (iii) the name of the individual or entity requesting the examination,
    31    (iv) if applicable, the registration number  as  required  by  section
    32  thirteen-n of this article, and
    33    (v) such other information as the chair may require by regulation.
    34    5.  Fees  for  licensed clinical social work services shall be payable
    35  only to a duly authorized licensed clinical social worker as licensed in
    36  article one hundred fifty-four of the education law, or  to  the  agent,
    37  executor or administrator of the estate of such licensed clinical social
    38  worker.    No  licensed  clinical social worker rendering treatment to a
    39  compensation claimant shall collect or receive a fee from such  claimant
    40  within  this  state,  but  shall  have  recourse for payment of services
    41  rendered only to the employer under the provisions of this section.
    42    6. Whenever his or her attendance at a hearing is required  the  clin-
    43  ical  social worker of the injured employee shall be entitled to receive
    44  a fee from the employer in an amount to be fixed by the board, in  addi-
    45  tion  to  any  fee payable under section eight thousand one of the civil
    46  practice law and rules.
    47    7. (a) The provisions of subdivisions one and three of  section  thir-
    48  teen-g  of  this  article  with  respect to the conditions under which a
    49  hospital, physician, or self-employed physical or occupational therapist
    50  may request payment or arbitration of a bill, or under  which  an  award
    51  may  be  made  for  payment  of  such bill, shall be applicable to bills
    52  rendered by a licensed clinical social worker for services  rendered  to
    53  an injured employee.
    54    (b)  If  the  parties fail to agree as to the licensed clinical social
    55  work services rendered under this chapter to a claimant, and the  amount
    56  of  the  disputed  bill  is  one  thousand dollars or less, or where the

        S. 1492                             4
     1  amount of the  disputed  bill  exceeds  one  thousand  dollars  and  the
     2  licensed  clinical social worker expressly so requests, such value shall
     3  be decided by a single arbitrator process, pursuant to rules promulgated
     4  by  the  chair.  The  chair shall appoint a member in good standing of a
     5  recognized  professional  association  representing  licensed   clinical
     6  social  workers  in  this  state to determine the value of such disputed
     7  bill. Decisions rendered under the single arbitrator  process  shall  be
     8  conclusive upon the parties as to the value of the services in dispute.
     9    (c)  If  the  parties fail to agree as to the licensed clinical social
    10  work services rendered under this chapter to a claimant, and the  amount
    11  of the disputed bill exceeds one thousand dollars and the licensed clin-
    12  ical  social worker does not expressly request a single arbitrator proc-
    13  ess in accordance with paragraph (b) of  this  subdivision,  such  value
    14  shall  be decided by the clinical social work practice committee and the
    15  majority decision of such committee shall be conclusive upon the parties
    16  as to the value of the services rendered.
    17    (d) The board or the chair may make an award  not  in  excess  of  the
    18  established  fee  schedules  for  any  such  bill  or part thereof which
    19  remains unpaid in the same manner as an award for bills  rendered  under
    20  subdivisions  one  and  three of section thirteen-g of this article, and
    21  such award may be collected in like manner as an award of  compensation.
    22  The chair shall assess the sum of fifty dollars against the employer for
    23  each  such  award  made  by  the board, which sum shall be paid into the
    24  state treasury. Where a licensed clinical social worker's bill has  been
    25  determined to be due and owing in accordance with the provisions of this
    26  section  the  board shall include in the amount of the award interest of
    27  not more than one and one-half percent per month payable to the licensed
    28  clinical social worker in accordance  with  the  rules  and  regulations
    29  promulgated by the board.
    30    (e)  A provider initiating an arbitration, including a single arbitra-
    31  tor process, pursuant to this section shall pay a fee, as determined  by
    32  regulations  promulgated  by  the  chair,  to be used to cover the costs
    33  related to the conduct of such arbitration. Upon resolution in favor  of
    34  such  party,  the  amount  due, based upon the bill in dispute, shall be
    35  increased by the amount of the fee paid by such party. Where  a  partial
    36  award  is made, the amount due, based upon the bill in dispute, shall be
    37  increased by a part of such fee.
    38    8. Within the limits prescribed by  the  education  law  for  licensed
    39  clinical  social work services, the report or testimony of an authorized
    40  licensed clinical social worker concerning the condition of  an  injured
    41  employee  and  treatment  thereof shall be deemed competent evidence and
    42  the professional opinion of the licensed clinical social  worker  as  to
    43  causal  relation  and  as to required services shall be deemed competent
    44  but shall not be controlling. Nothing in this section shall be deemed to
    45  deprive any employer or insurance carrier of  any  right  to  a  medical
    46  examination or presentation of medical testimony now conferred by law.
    47    9.  The  chair  shall  promulgate  rules governing the procedure to be
    48  followed by those rendering licensed clinical social work services under
    49  this section, which rules so far as practicable  shall  conform  to  the
    50  rules  presently  in  effect with reference to medical care furnished to
    51  claimants in workers' compensation. In connection with the  promulgation
    52  of  said  rules  the chair may consult the clinical social work practice
    53  committee and may take into consideration the view of  other  interested
    54  parties.
    55    10.  The  chair  shall appoint for and with jurisdiction in the entire
    56  state a single clinical social work practice committee composed of three

        S. 1492                             5
     1  duly licensed clinical social workers. Each  member  of  said  committee
     2  shall  receive  compensation  either on an annual basis or on a per diem
     3  basis to be fixed by the chair within amounts appropriated therefor. One
     4  of  said clinical social workers shall be designated by the chair as the
     5  chair of such committee.  No  member  of  said  committee  shall  render
     6  licensed  clinical  social  work  services  under this section nor be an
     7  employer or accept or participate in any fee from any insurance  company
     8  authorized  to  write  workers'  compensation insurance in this state or
     9  from any self-insurer, whether such employment or fee relates to a work-
    10  ers'  compensation  claim  or  otherwise.  The  attorney  general,  upon
    11  request, shall advise and assist such committee.
    12    11.  The  clinical  social  work practice committee shall investigate,
    13  hear and make findings with respect to all charges as to professional or
    14  other misconduct of any authorized licensed clinical  social  worker  as
    15  provided  under  rules  and procedures to be prescribed by the chair and
    16  shall report evidence of such misconduct, with its findings  and  recom-
    17  mendations  with  respect  thereto, to the chair. The findings, decision
    18  and recommendation of such clinical social work practice committee shall
    19  be advisory to the chair only, and shall not be  binding  or  conclusive
    20  upon  him or her. The chair shall remove from the list of licensed clin-
    21  ical social workers authorized to render licensed clinical  social  work
    22  services  under  this chapter or to conduct independent medical examina-
    23  tions in accordance with paragraph  (b)  of  subdivision  four  of  this
    24  section  the  name  of any licensed clinical social worker who he or she
    25  shall find after reasonable investigation is disqualified  because  such
    26  licensed clinical social worker:
    27    (a) has been guilty of professional or other misconduct or incompeten-
    28  cy  in  connection  with  the rendering of licensed clinical social work
    29  services, or
    30    (b) has exceeded the limits of his or her professional  competence  in
    31  rendering  licensed  clinical social work services under the law, or has
    32  made false statements regarding qualifications in  the  application  for
    33  authorization, or
    34    (c)  has  failed to submit timely, full and truthful licensed clinical
    35  social work reports of all findings to the employer and directly to  the
    36  chair of the board within the time limits provided in this section, or
    37    (d)  has  knowingly  made  a false statement or representation as to a
    38  material fact in any medical report made pursuant to this chapter or  in
    39  testifying  or  otherwise providing information for the purposes of this
    40  chapter, or
    41    (e) has solicited or has employed another to solicit  for  himself  or
    42  herself,  or  for another professional treatment, examination or care of
    43  an injured employee with any claim under this chapter, or
    44    (f) has refused to appear before, to testify, to submit to  a  deposi-
    45  tion,  or  answer upon request of the chair, board, clinical social work
    46  practice committee or any duly authorized  officer  of  the  state,  any
    47  legal  question or produce any relevant book or paper concerning conduct
    48  under an authorization granted under law, or
    49    (g) has directly or indirectly requested, received or participated  in
    50  the division, transference, assignment, rebating, splitting or refunding
    51  of a fee for, or has directly or indirectly requested, received or prof-
    52  ited  by  means  of  a  credit  or otherwise valuable consideration as a
    53  commission, discount or gratuity in connection with the treatment  of  a
    54  workers' compensation claimant.
    55    12. Any person who violates or attempts to violate, and any person who
    56  aids  another to violate or attempts to induce him or her to violate the

        S. 1492                             6
     1  provisions of paragraph (g) of subdivision eleven of this section  shall
     2  be guilty of a misdemeanor.
     3    13.  Nothing  in  this  section  shall be construed as limiting in any
     4  respect the power or duty of  the  chair  to  investigate  instances  of
     5  misconduct,  either before or after investigation by the clinical social
     6  work practice committee, or to temporarily suspend the authorization  of
     7  any  licensed  clinical  social  worker  believed  to  be guilty of such
     8  misconduct.  The provisions of subdivision one of section thirteen-d  of
     9  this  article  which  are  not  inconsistent with the provisions of this
    10  section shall be applicable as if fully set forth in this section.
    11    14. Nothing contained in this section shall prohibit licensed clinical
    12  social workers who practice as partners, in groups or as a  professional
    13  corporation  from  pooling fees and moneys received, either by the part-
    14  nership, professional corporation or group or by the individual  members
    15  thereof,  for  professional services furnished by any individual profes-
    16  sional member, or employee of such partnership,  corporation  or  group,
    17  nor shall the professionals constituting the partnerships, corporations,
    18  or  groups be prohibited from sharing, dividing or apportioning the fees
    19  and moneys received by them or by the partnership, corporation or  group
    20  in accordance with a partnership or other agreement.
    21    § 2. This act shall take effect on the one hundred eightieth day after
    22  it  shall  have  become  a law. Provided, however, that, effective imme-
    23  diately, the addition, amendment and/or repeal of any  rules  and  regu-
    24  lations  necessary to implement the provisions of this act on its effec-
    25  tive date, are authorized and directed to be completed on or before such
    26  date.
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