Bill Text: NY S08812 | 2017-2018 | General Assembly | Amended

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Bill Title: Extends the workers' compensation board's authority to resolve medical bill disputes and simplify the process.

Spectrum: Partisan Bill (Republican 2-0)

Status: (Introduced - Dead) 2018-06-13 - PRINT NUMBER 8812A [S08812 Detail]

Download: New_York-2017-S08812-Amended.html

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                STATE OF NEW YORK
        ________________________________________________________________________
                                         8812--A
                    IN SENATE
                                      May 22, 2018
                                       ___________
        Introduced  by  Sens.  AKSHAR, HANNON -- read twice and ordered printed,
          and when printed to be committed to the Committee on Labor --  commit-
          tee  discharged, bill amended, ordered reprinted as amended and recom-
          mitted to said committee
        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
    24  title,  the  following  definitions  shall  have  the following meanings
    25  unless their context requires otherwise:
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD15972-05-8
        S. 8812--A                          2
     1    (a) "Acupuncturist" shall mean licensed as having completed  a  formal
     2  course  of study and having passed an examination in accordance with the
     3  education law, the regulations of the commissioner of education, and the
     4  requirements of the board of regents. Acupuncturists are required by the
     5  education  law  to  advise,  in writing, each patient of the requirement
     6  that he or she consult with a physician for the condition or  conditions
     7  necessitating acupuncture care, as prescribed by the education law.
     8    (b)  "Chair"  of  the board shall mean either the chair or the chair's
     9  designee.
    10    (c) "Chiropractor" shall mean licensed and having completed two  years
    11  of  preprofessional  college  study  and a four-year resident program in
    12  chiropractic in accordance with the education law, and  consistent  with
    13  the licensing requirements of the commissioner of education.
    14    (d)  "Dentist"  shall  mean  licensed and having completed a four-year
    15  course of study leading to a D.D.S. or D.D.M. degree, or  an  equivalent
    16  degree,  in accordance with the education law and the licensing require-
    17  ments of the commissioner of education.
    18    (e) "Employer" shall mean a self-insured employer or, if insured,  the
    19  insurance carrier.
    20    (f)  "Independent  medical  examination"  shall  mean  an  examination
    21  performed by a  medical  provider,  authorized  under  this  section  to
    22  perform  such  examination,  for  the purpose of examining or evaluating
    23  injury or illness pursuant to  paragraph  (b)  of  subdivision  four  of
    24  section  thirteen-a and section one hundred thirty-seven of this chapter
    25  and as more fully set forth in regulation.
    26    (g) "Nurse practitioner" shall mean a licensed registered professional
    27  nurse certified pursuant to section sixty-nine hundred ten of the educa-
    28  tion law.
    29    (h) "Occupational therapist" shall mean licensed  as  having  a  bach-
    30  elor's  or  master's  degree  in  occupational therapy from a registered
    31  program with the education department or receipt of a diploma or  degree
    32  resulting  from  completion of not less than four years of postsecondary
    33  study, which includes the professional study of occupational therapy  in
    34  accordance with the education law and the regulations of the commission-
    35  er of education.
    36    (i)  "Physical  therapist"  shall  mean licensed as having completed a
    37  master's degree or higher in physical therapy  in  accordance  with  the
    38  education  law  and  the  licensing  requirements of the commissioner of
    39  education.
    40    (j) "Physician" shall mean licensed with a degree of doctor  of  medi-
    41  cine,  M.D.,  or  doctor of osteopathic medicine, D.O., or an equivalent
    42  degree in accordance with the education law and the  licensing  require-
    43  ments  of the state board of medicine and the regulations of the commis-
    44  sioner of education.
    45    (k) "Physician assistant" shall mean a licensed provider who has grad-
    46  uated from  a  two-  to  four-year  state-approved  physician  assistant
    47  program,  has  passed  a  licensing  examination,  and whose actions and
    48  duties are within the scope of practice of the supervising physician, in
    49  accordance with the education law and the regulations of the commission-
    50  er of education.
    51    (l) "Podiatrist" shall mean a doctor of podiatric medicine licensed as
    52  having received a doctoral degree in podiatric  medicine  in  accordance
    53  with  the regulations of the commissioner of education and the education
    54  law, and must satisfactorily meet all other requirements  of  the  state
    55  board for podiatric medicine.
        S. 8812--A                          3
     1    (m) "Provider" shall mean a duly licensed acupuncturist, chiropractor,
     2  independent  medical  examiner,  nurse practitioner, physical therapist,
     3  physician, physician  assistant,  podiatrist,  psychologist,  or  social
     4  worker authorized by the chair.
     5    (n)  "Psychologist"  shall mean licensed as having received a doctoral
     6  degree in psychology from a program of psychology  registered  with  the
     7  state  education  department  or  the  substantial equivalent thereof in
     8  accordance with the education law, the requirements of the  state  board
     9  for psychology, and the regulations of the commissioner of education.
    10    (o)  "Social  worker"  shall mean a licensed clinical social worker. A
    11  licensed clinical social worker  has  completed  a  master's  degree  of
    12  social  work  that  includes completion of a core curriculum of at least
    13  twelve credit hours of clinical courses or the equivalent  post-graduate
    14  clinical  coursework, in accordance with the education law and the regu-
    15  lations of the commissioner of education.
    16    2. Any [physician] provider licensed [to practice  medicine]  pursuant
    17  to  the education law to provide medical care and treatment in the state
    18  of New York may render emergency [medical]  care  and  treatment  in  an
    19  emergency  hospital or urgent care setting providing emergency treatment
    20  under this  chapter  without  authorization  by  the  chair  under  this
    21  section; [and
    22    (b)]  (a)  Such  licensed  [physician]  provider as identified in this
    23  subdivision who is [a member of  a  constituted  medical  staff  of  any
    24  hospital] on staff at any hospital or urgent care center providing emer-
    25  gency treatment may [render] continue such medical care under this chap-
    26  ter  while  an  injured  employee  remains a patient in such hospital or
    27  urgent care setting; and
    28    [(c)] (b) Under the [active and personal]  direct  supervision  of  an
    29  authorized  [physician]  provider,  medical  care  may  be rendered by a
    30  registered nurse or other person trained  in  laboratory  or  diagnostic
    31  techniques  within  the  scope of such person's specialized training and
    32  qualifications. This supervision shall be evidenced by signed records of
    33  instructions for treatment and signed records of the patient's condition
    34  and progress. Reports of such treatment and supervision shall be made by
    35  such [physician] provider to the chair [on such forms and] in the format
    36  prescribed by the chair at such times as the chair may require.
    37    [(d) Upon the referral which may be directive as to  treatment  of  an
    38  authorized  physician  physical  therapy  care may be rendered by a duly
    39  licensed physical therapist. Where physical  therapy  care  is  rendered
    40  records  of  the patient's condition and progress, together with records
    41  of instruction for treatment, if any, shall be maintained by  the  phys-
    42  ical  therapist  and  physician.  Said records shall be submitted to the
    43  chair on such forms and at such times as the chair may require.
    44    (e) Upon the prescription or referral of an authorized physician occu-
    45  pational therapy care may be rendered by a  duly  licensed  occupational
    46  therapist.  Where  occupational  therapy care is rendered records of the
    47  patient's condition and progress, together with records  of  instruction
    48  for  treatment, if any shall be maintained by the occupational therapist
    49  and physician. Said records shall be submitted to the chair on forms and
    50  at such times as the chair may require.
    51    (f)] (c) Where it would place an unreasonable burden upon the employer
    52  or carrier to arrange for, or for the claimant to attend, an independent
    53  medical examination by an authorized [physician] provider, the  employer
    54  or carrier shall arrange for such examination to be performed by a qual-
    55  ified  [physician]  provider  in  a  medical  facility convenient to the
    56  claimant.
        S. 8812--A                          4
     1    [2.] (d) Upon the prescription or referral of an authorized physician,
     2  or nurse practitioner acting within the scope of his  or  her  practice,
     3  care  or  treatment may be rendered to an injured employee by an author-
     4  ized  physical  therapist,  occupational  therapist   or   acupuncturist
     5  provided the conditions and the treatment performed are among the condi-
     6  tions  that the physical therapist, occupational therapist or acupunctu-
     7  rist is authorized to treat pursuant to the education law or  the  regu-
     8  lations  of  the  commissioner  of  education.    Where any such care or
     9  treatment is rendered, records of the patient's condition and  progress,
    10  together  with  records  of  instruction for treatment, if any, shall be
    11  maintained by the physical therapist, occupational therapist or acupunc-
    12  turist rendering treatment and by the referring physician or nurse prac-
    13  titioner. Said records shall be submitted to the chair on forms  and  at
    14  such times as the chair may require.
    15    (e)  A record, report or opinion of a physical therapist, occupational
    16  therapist, acupuncturist or physician assistant shall not be  considered
    17  as  evidence  of  the  causal  relationship  of  any condition to a work
    18  related accident or occupational disease under this chapter. Nor  may  a
    19  record,  report  or opinion of a physical therapist, occupational thera-
    20  pist or acupuncturist be considered evidence of disability.  Nor  may  a
    21  record,  report  or  opinion  of  a  physician  assistant  be considered
    22  evidence of the presence of a permanent or  initial  disability  or  the
    23  degree  thereof.   Nor may a physical therapist, occupational therapist,
    24  acupuncturist or physician  assistant  perform  an  independent  medical
    25  examination concerning a claim under this chapter.
    26    (f)  A  nurse  practitioner,  or licensed certified social worker, may
    27  perform an independent medical examination on behalf of an employer only
    28  to the extent that the examination concerns  treatment  rendered  by  an
    29  identical  provider  type,  but  may  not perform an independent medical
    30  examination  on  behalf  of  the  employer  concerning  (1)  the  causal
    31  relationship of any condition to a work related accident or occupational
    32  disease  under  this  chapter or (2) the presence of a disability or the
    33  degree thereof.
    34    3. A [physician licensed to practice medicine in the state of New York
    35  who is] provider properly licensed or certified pursuant  to  the  regu-
    36  lations  of  the  commissioner  of education and the requirements of the
    37  education law desirous of being authorized to render medical care  under
    38  this  chapter  and/or  to  conduct  independent  medical examinations in
    39  accordance with paragraph (b) of subdivision four of section  thirteen-a
    40  and  section  one  hundred  thirty-seven  of  this chapter shall file an
    41  application for authorization under this chapter with the [medical soci-
    42  ety in the county in which his or her office is located, or with a board
    43  designated by such society, or with a board designated by the  chair  as
    44  provided  in this section. In such application the applicant shall state
    45  his or her training and qualifications, and shall agree to limit his  or
    46  her  professional activities under this chapter to such medical care and
    47  independent medical examinations, as his or her experience and  training
    48  qualify  him  or  her  to  render.  The applicant shall further agree to
    49  refrain] chair or chair's designee. Prior to receiving authorization,  a
    50  physician must, together with submission of an application to the chair,
    51  submit  such  application  to the medical society of the county in which
    52  the physician's office is located or of a board designated by such coun-
    53  ty society or of a board representing duly licensed  physicians  of  any
    54  other  school  of medical practice in such county, and submit the recom-
    55  mendation to the board. In the event such county society or board  fails
    56  to  take  action  upon a physician's application within forty-five days,
        S. 8812--A                          5
     1  the chair may complete review of the application without such  approval.
     2  Upon  approval  of the application by the chair or the chair's designee,
     3  the applicant shall further agree to refrain  from subsequently treating
     4  for  remuneration,  as  a  private  patient,  any person seeking medical
     5  treatment, or submitting  to  an  independent  medical  examination,  in
     6  connection  with,  or  as a result of, any injury compensable under this
     7  chapter, if he or she has been removed from  the  list  of  [physicians]
     8  providers  authorized  to  render medical care or to conduct independent
     9  medical examinations under this chapter, or if the person  seeking  such
    10  treatment, or submitting to an independent medical examination, has been
    11  transferred  from  his  or her care in accordance with the provisions of
    12  this chapter. This agreement shall run to the  benefit  of  the  injured
    13  person so treated or examined, and shall be available to him or her as a
    14  defense  in  any  action  by  such  [physician] provider for payment for
    15  treatment rendered by a [physician] provider after he or  she  has  been
    16  removed  from  the  list  of [physicians] providers authorized to render
    17  medical care or to conduct independent medical examinations  under  this
    18  chapter,  or  after  the  injured person was transferred from his or her
    19  care in accordance with the provisions of  this  chapter.  [The  medical
    20  society  or  the  board  designated  by  it,  or  the board as otherwise
    21  provided under this section, if it deems such  licensed  physician  duly
    22  qualified,  shall  recommend to the chair that such physician be author-
    23  ized to render medical care and/or conduct independent medical  examina-
    24  tions  under  this  chapter,  and  such recommendation and authorization
    25  shall specify the character of the medical care or  independent  medical
    26  examination  which  such physician is qualified and authorized to render
    27  under this chapter. Such recommendations shall be advisory to the  chair
    28  only  and  shall  not  be  binding  or  conclusive  upon him or her. The
    29  licensed  physician  may  present  to  the  medical  society  or  board,
    30  evidences  of additional qualifications at any time subsequent to his or
    31  her original application. If the  medical  society  or  board  fails  to
    32  recommend  to the chair that a physician be authorized to render medical
    33  care and/or to conduct independent medical examinations under this chap-
    34  ter, the physician may appeal to the medical appeals unit.  The  medical
    35  society  or  the  board  designated  by  it,  or  the board as otherwise
    36  provided under this section, may upon its own initiative, or shall  upon
    37  request  of  the  chair,  review  at  any time the qualifications of any
    38  physician as to the character of the medical care or independent medical
    39  examinations which such physician has  theretofore  been  authorized  to
    40  render  under  this  chapter  and  may  recommend to the chair that such
    41  physician be authorized to render medical care or to conduct independent
    42  medical examinations thereafter of the character which such physician is
    43  then qualified to render. On such advisory recommendation the chair  may
    44  review  and  after reasonable investigation may revise the authorization
    45  of a physician in respect to the character of  medical  care  and/or  to
    46  conduct  independent  medical examinations which he or she is authorized
    47  to render. If the medical society or board recommends to the chair  that
    48  a physician be authorized to render medical care and/or to conduct inde-
    49  pendent medical examinations under this chapter of a character different
    50  from  the  character of medical care or independent medical examinations
    51  he or she has been theretofore authorized to render, such physician  may
    52  appeal from such recommendation to the medical appeals unit.
    53    3.]  4.  Laboratories and bureaus engaged in x-ray diagnosis or treat-
    54  ment or in physiotherapy  or  other  therapeutic  procedures  and  which
    55  participate  in  the diagnosis or treatment of injured [workmen] workers
    56  under this chapter shall be operated or supervised by [qualified  physi-
        S. 8812--A                          6

     1  cians duly] providers authorized under this chapter and shall be subject
     2  to  the  provisions of section thirteen-c of this article. The person in
     3  charge of diagnostic clinical laboratories duly  authorized  under  this
     4  chapter  shall  possess  the  qualifications  established  by the public
     5  health and health planning council for approval by the state commission-
     6  er of health or, in the city of New York, the qualifications approved by
     7  the board of health of said city and shall  maintain  the  standards  of
     8  work required for such approval.
     9    §  2. Section 13-g of the workers' compensation law, as added by chap-
    10  ter 258 of the laws of 1935, subdivision 1 as amended by chapter 674  of
    11  the  laws  of 1994, subdivisions 2 and 3 as amended by section 4 of part
    12  GG of chapter 57 of the laws  of  2013,  subdivision  4  as  amended  by
    13  section  3 of part D of chapter 55 of the laws of 2015, subdivision 5 as
    14  amended by chapter 578 of the laws of 1959 and subdivision 6 as  amended
    15  by chapter 639 of the laws of 1996, is amended to read as follows:
    16    § 13-g. Payment of bills for medical care.  (1) Within forty-five days
    17  after  a bill for medical care or supplies delivered pursuant to section
    18  thirteen of this article has been  rendered  to  the  employer  [by  the
    19  hospital,  physician or self-employed physical or occupational therapist
    20  who has rendered treatment pursuant  to  a  referral  from  the  injured
    21  employee's  authorized  physician or authorized podiatrist for treatment
    22  to the injured employee], such employer must pay the bill or notify  the
    23  [hospital, physician or self-employed physical or occupational therapist
    24  in  writing]  medical care provider or supplier in the format prescribed
    25  by the chair that the bill is not being paid and explain the reasons for
    26  non-payment. In the event that the employer fails  to  make  payment  or
    27  notify  the  [hospital,  physician  or self-employed physical or occupa-
    28  tional therapist] medical care provider or supplier within  such  forty-
    29  five  day  period  that payment is not being made, the [hospital, physi-
    30  cian, self-employed physical  therapist  or  self-employed  occupational
    31  therapist] medical care provider or supplier may notify the board in the
    32  format  prescribed  by the chair [in writing] that the bill has not been
    33  paid and request that the board make an award for payment of such  bill.
    34  The  board  or  the  chair may make an award not in excess of the estab-
    35  lished fee schedules for any such bill or  part  thereof  which  remains
    36  unpaid  after  said forty-five day period or thirty days after all other
    37  questions duly and timely raised in accordance with  the  provisions  of
    38  this  chapter,  relating  to the employer's liability for the payment of
    39  such amount, shall have been finally determined adversely to the employ-
    40  er, whichever is later, in accordance  with  rules  promulgated  by  the
    41  chair,  and  such  award  may be collected in like manner as an award of
    42  compensation. The chair shall assess the sum of  fifty  dollars  against
    43  the  employer  for each such award made by the board, which sum shall be
    44  paid into the state treasury.
    45    In the event that the employer has provided an explanation in  writing
    46  why the bill has not been paid, in part or in full, within the aforesaid
    47  time  period,  and  the parties can not agree as to the value of medical
    48  aid rendered under this chapter, such value shall be  decided  by  arbi-
    49  tration  [if requested by the hospital, physician or self-employed phys-
    50  ical or occupational therapist, in accordance  with  the  provisions  of
    51  subdivision  two  or  subdivision three of this section, as appropriate,
    52  and] as set forth in rules and regulations promulgated by the chair.
    53    Where a [physician,  physical  or  occupational  therapist]  bill  for
    54  medical  care  or  supplies  has  been determined to be due and owing in
    55  accordance with the provisions of this section the board  shall  include
    56  in  the  amount  of the award interest of not more than one and one-half
        S. 8812--A                          7
     1  [per cent] percent (1 1/2%) per month payable to the  [physician,  phys-
     2  ical  or  occupational  therapist] medical care provider or supplier, in
     3  accordance with the rules and  regulations  promulgated  by  the  board.
     4  Interest shall be calculated from the forty-fifth day after the bill was
     5  rendered  or  from  the thirtieth day after all other questions duly and
     6  timely raised in accordance with the provisions of this chapter,  relat-
     7  ing  to  the  employer's liability for the payment of such amount, shall
     8  have been finally determined adversely to  the  employer,  whichever  is
     9  later, in accordance with rules promulgated by the chair.
    10    (2)  (a)  If  the  parties  fail  to agree to the value of medical aid
    11  rendered under this chapter and the amount of the disputed bill  is  one
    12  thousand  dollars or less, or if the amount of the disputed medical bill
    13  exceeds one thousand dollars and the [health] medical care  provider  or
    14  supplier  expressly so requests, such value shall be decided by a single
    15  arbitrator process, pursuant to rules promulgated  by  the  chair.  [The
    16  chair  shall appoint a physician who is a member in good standing of the
    17  medical society of the state of New York to determine the value of  such
    18  disputed  medical  bill.    Where  the physician whose charges are being
    19  arbitrated is a member in good standing  of  the  New  York  osteopathic
    20  society, the value of such disputed bill shall be determined by a member
    21  in  good  standing  of the New York osteopathic society appointed by the
    22  chair. Where the physician whose  charges  are  being  arbitrated  is  a
    23  member  in  good standing of the New York homeopathic society, the value
    24  of such disputed bill shall be determined by a member in  good  standing
    25  of  the  New  York homeopathic society appointed by the chair. Where the
    26  value of physical therapy services or occupational therapy  services  is
    27  at issue, such value shall be determined by a member in good standing of
    28  a   recognized  professional  association  representing  its  respective
    29  profession in the state of New York appointed by the  chair.]  Decisions
    30  rendered  under  the  single arbitrator process shall be conclusive upon
    31  the parties as to the value of the services in dispute.
    32    (b) If the parties fail to agree  as  to  the  value  of  medical  aid
    33  rendered  under this chapter and the amount of the disputed bill exceeds
    34  one thousand dollars, such value shall  be  decided  by  an  arbitration
    35  committee unless the [health] medical care provider or supplier express-
    36  ly requests a single arbitrator process in accordance with paragraph (a)
    37  of  this  subdivision.   The arbitration committee shall [consist of one
    38  physician designated by the president of  the  medical  society  of  the
    39  county in which the medical services were rendered, one physician who is
    40  a  member  of the medical society of the state of New York, appointed by
    41  the employer or carrier, and one physician, also a member of the medical
    42  society of the state of New York, appointed by the chair of the workers'
    43  compensation board. If the physician whose charges are being  arbitrated
    44  is  a member in good standing of the New York osteopathic society or the
    45  New York homeopathic society, the members of such arbitration  committee
    46  shall  be  physicians  of  such organization, one to be appointed by the
    47  president of that organization, one by the employer or carrier  and  the
    48  third  by  the chair of the workers' compensation board. Where the value
    49  of physical therapy services is at issue and the amount of the  disputed
    50  bill  exceeds  one  thousand  dollars,  the  arbitration committee shall
    51  consist of a member in good standing of a recognized professional  asso-
    52  ciation  representing  physical  therapists  in  the  state  of New York
    53  appointed by the president of such organization, a physician  designated
    54  by  the  employer  or carrier and a physician designated by the chair of
    55  the workers' compensation board provided however, that the  chair  finds
    56  that there are a sufficient number of physical therapy arbitrations in a
        S. 8812--A                          8

     1  geographical area comprised of one or more counties to warrant a commit-
     2  tee so comprised. In all other cases where the value of physical therapy
     3  services  is  at  issue  and the amount of the disputed bill exceeds one
     4  thousand  dollars, the arbitration committee shall be similarly selected
     5  and identical in  composition,  provided  that  the  physical  therapist
     6  member  shall  serve  without remuneration, and provided further that in
     7  the event a physical therapist is not available, the committee shall  be
     8  comprised  of three physicians designated in the same manner as in cases
     9  where the value of medical aid is at issue.
    10    (c) Where the value of occupational therapy services is at  issue  the
    11  arbitration  committee  shall  consist of a member in good standing of a
    12  recognized professional association representing occupational therapists
    13  in the state of New York appointed by the president  of  such  organiza-
    14  tion;  a physician designated by the employer or carrier and a physician
    15  designated by the chair of the  workers'  compensation  board  provided,
    16  however,  that  the  chair  finds  that there are a sufficient number of
    17  occupational therapy arbitrations in a geographical  area  comprised  of
    18  one  or more counties to warrant a committee so comprised.  In all other
    19  cases where the value of occupational therapy services is at  issue  and
    20  the  amount of the disputed bill exceeds one thousand dollars, the arbi-
    21  tration committee shall be similarly selected and identical in  composi-
    22  tion,  provided that the occupational therapist member shall serve with-
    23  out remuneration, and provided further that in the event an occupational
    24  therapist is not available, the committee shall be  comprised  of  three
    25  physicians  designated in the same manner as in cases where the value of
    26  medical aid is at issue.] have three members designated by the chair  in
    27  consultation  with the medical director's office of the workers' compen-
    28  sation board. The majority decision of any  such  arbitration  committee
    29  shall  be conclusive upon the parties as to the value of the services in
    30  dispute.
    31    (3) [(a) If an employer shall have notified the hospital  in  writing,
    32  as  provided  in  subdivision  one of this section, why the bill has not
    33  been paid, in part or in full, and the amount of the  disputed  bill  is
    34  one  thousand  dollars  or  less,  or  where  the amount of the disputed
    35  medical bill exceeds one thousand dollars and the hospital expressly  so
    36  requests,  such  value  shall be decided by a single arbitrator process,
    37  pursuant to rules promulgated by the chair. The chair  shall  appoint  a
    38  physician  in  good  standing  licensed to practice in New York state to
    39  determine the value of such disputed bill. Decisions rendered under  the
    40  administrative resolution procedure shall be conclusive upon the parties
    41  as to the value of the services in dispute.
    42    (b)  If  an  employer  shall have notified the hospital in writing, as
    43  provided in subdivision one of this section, why the bill has  not  been
    44  paid,  in  part  or in full, and the amount of the disputed bill exceeds
    45  one thousand dollars, the value of such bill shall be determined  by  an
    46  arbitration  committee  appointed  by  the chair for that purpose, which
    47  committee shall consider all of the charges of the hospital, unless  the
    48  hospital  expressly  requests  a  single  arbitrator process pursuant to
    49  paragraph (a) of this subdivision. The committee shall consist of  three
    50  physicians.  One  member  of the committee may be nominated by the chair
    51  upon recommendation of the president of the hospital association of  New
    52  York  state and one member may be nominated by the employer or insurance
    53  carrier. The majority decision of any such committee shall be conclusive
    54  upon the parties as to the value of the services rendered. The chair may
    55  make reasonable rules and regulations consistent with the provisions  of
    56  this section.
        S. 8812--A                          9

     1    (4)]  A  provider  or  supplier initiating an arbitration, including a
     2  single arbitrator process, pursuant to this section shall not pay a  fee
     3  to  cover  the  costs  related to the conduct of such arbitration. [Each
     4  member of an arbitration committee for medical bills, and each member of
     5  an arbitration committee for hospital bills shall be entitled to receive
     6  and  shall  be  paid  a  fee for each day's attendance at an arbitration
     7  session in any one count in an amount fixed by the chair of the workers'
     8  compensation board.
     9    (5)] (4) In claims where the employer has  failed  to  secure  compen-
    10  sation  to  his  employees as required by section fifty of this chapter,
    11  the board may make an award for the  value  of  medical  [and  podiatry]
    12  services,  supplies  or treatment rendered to such employees, in accord-
    13  ance with the schedules of fees and  charges  prepared  and  established
    14  under  the  provisions  of [section thirteen, subdivision a, and section
    15  thirteen-k, subdivision two, of] this chapter[, and for  the  reasonable
    16  value of hospital care in accordance with the charges currently in force
    17  in  hospitals  in  the  same  community  for  cases  coming  within  the
    18  provisions of this chapter]. Such award shall be made to the [physician,
    19  podiatrist, or hospital] medical  care  provider  or  supplier  entitled
    20  thereto.  A  default in the payment of such award may be enforced in the
    21  manner provided for the enforcement of compensation awards as set  forth
    22  in section twenty-six of this [chapter] article.
    23    In  all  cases  coming under this subdivision the payment of the claim
    24  [of the physician, podiatrist, or hospital  for  medical,  podiatry,  or
    25  surgical  services  or  treatment] for medical care or supplies shall be
    26  subordinate to that of the claimant or his or her beneficiaries.
    27    [(6) Notwithstanding any inconsistent provision  of  law,  arbitration
    28  regarding  payments  for  inpatient  hospital  services  for any patient
    29  discharged on or after January first, nineteen  hundred  ninety-one  and
    30  prior  to  December  thirty-first,  nineteen hundred ninety-six shall be
    31  resolved in accordance  with  paragraph  (d)  of  subdivision  three  of
    32  section twenty-eight hundred seven-c of the public health law.]
    33    §  3.  Subdivisions  1  and  2  and  paragraph (b) of subdivision 3 of
    34  section 13-k of the workers' compensation law, subdivision 1 as added by
    35  chapter 787 of the laws of 1952 and subdivision 2 and paragraph  (b)  of
    36  subdivision 3 as amended by chapter 473 of the laws of 2000, are amended
    37  to read as follows:
    38    1. When the term "chairman" is hereinafter used, it shall be deemed to
    39  mean the [chairman] chair of the [workmen's] workers' compensation board
    40  of the state of New York.
    41    2.  An  employee  injured  under  circumstances which make such injury
    42  compensable under this article, when care is required for an  injury  to
    43  the  foot  which injury or resultant condition therefrom may lawfully be
    44  treated by a duly registered and licensed podiatrist of the state of New
    45  York, may select to treat him or her any podiatrist  authorized  by  the
    46  chair  to  render  [podiatry]  podiatric  medical  care,  as hereinafter
    47  provided. If the injury or condition is one which is without the  limits
    48  prescribed  by  the  education law for [podiatry] podiatric medical care
    49  and treatment, or the injuries involved affect other parts of  the  body
    50  in  addition  to  the  foot, the said podiatrist must so advise the said
    51  injured employee and instruct him or her to consult a physician of  said
    52  employee's  choice  for  appropriate  care and treatment. Such physician
    53  shall thenceforth have overall supervision  of  the  treatment  of  said
    54  patient including the future treatment to be administered to the patient
    55  by  the  podiatrist. If for any reason during the period when [podiatry]
    56  podiatric medical treatment and care is required, the employee wishes to
        S. 8812--A                         10
     1  transfer his or her treatment and care to another authorized  podiatrist
     2  he  or  she may do so, in accordance with rules prescribed by the chair,
     3  provided however that the employer shall be liable for the  proper  fees
     4  of  the  original  podiatrist for the care and treatment he or she shall
     5  have rendered. [A podiatrist licensed and registered to practice  podia-
     6  try  in  the  state  of  New York who is desirous of being authorized to
     7  render podiatry care under this section and/or  to  conduct  independent
     8  medical  examinations  in  accordance  with paragraph (b) of subdivision
     9  three of this section shall file an application for authorization  under
    10  this  section with the podiatry practice committee.  In such application
    11  he or she shall agree to refrain from subsequently treating for remuner-
    12  ation, as a private patient, any person seeking podiatry  treatment,  or
    13  submitting to an independent medical examination, in connection with, or
    14  as  a result of, any injury compensable under this chapter, if he or she
    15  has been removed from the  list  of  podiatrists  authorized  to  render
    16  podiatry  care or to conduct independent medical examinations under this
    17  chapter, or if the person seeking such treatment  has  been  transferred
    18  from  his or her care in accordance with the provisions of this section.
    19  This agreement shall run to the benefit of the injured person so treated
    20  or examined, and shall be available to him or her as a  defense  in  any
    21  action by such podiatrist for payment for treatment rendered by a podia-
    22  trist  after  he  or  she  has been removed from the list of podiatrists
    23  authorized to render podiatry care or  to  conduct  independent  medical
    24  examinations  under this section, or after the injured person was trans-
    25  ferred from his or her care in accordance with the  provisions  of  this
    26  section.  The  podiatry  practice  committee  if  it deems such licensed
    27  podiatrist duly qualified shall recommend to the chair that such  podia-
    28  trist  be authorized to render podiatry care and/or to conduct independ-
    29  ent medical examinations under this section. Such  recommendation  shall
    30  be  advisory  to  the  chair only and shall not be binding or conclusive
    31  upon him or her.] The chair shall prepare and establish a  schedule  for
    32  the  state,  or  schedules limited to defined localities, of charges and
    33  fees for [podiatry] podiatric medical treatment and care, to  be  deter-
    34  mined  in  accordance with and to be subject to change pursuant to rules
    35  promulgated by the chair. Before preparing such schedule for  the  state
    36  or  schedules for limited localities the chair shall request the [podia-
    37  try] podiatric medicine practice committee to submit to  him  or  her  a
    38  report on the amount of remuneration deemed by such committee to be fair
    39  and  adequate  for  the types of [podiatry] podiatric medical care to be
    40  rendered under this chapter, but consideration shall  be  given  to  the
    41  view  of  other interested parties.  The amounts payable by the employer
    42  for such treatment and services shall be the  fees  and  charges  estab-
    43  lished by such schedule.
    44    (b)  Upon  receipt of the notice provided for by paragraph (a) of this
    45  subdivision, the employer, the carrier and the claimant  each  shall  be
    46  entitled to have the claimant examined by a qualified podiatrist author-
    47  ized  by  the chair in accordance with [subdivision two of this] section
    48  thirteen-b and section one hundred thirty-seven of this  chapter,  at  a
    49  medical  facility  convenient to the claimant and in the presence of the
    50  claimant's podiatrist, and refusal by the claimant  to  submit  to  such
    51  independent  medical examination at such time or times as may reasonably
    52  be necessary in the opinion of the board shall  bar  the  claimant  from
    53  recovering  compensation  for  any  period  during  which  he or she has
    54  refused to submit to such examination.
    55    § 4. Subdivisions 1 and 2  and  paragraph  (b)  of  subdivision  3  of
    56  section 13-l of the workers' compensation law, subdivision 1 as added by
        S. 8812--A                         11
     1  chapter  940  of the laws of 1973 and subdivision 2 and paragraph (b) of
     2  subdivision 3 as amended by chapter 473 of the laws of 2000, are amended
     3  to read as follows:
     4    1.  Where  the term "chairman" is hereinafter used, it shall be deemed
     5  to mean the [chairman] chair of the  [workmen's]  workers'  compensation
     6  board of the state of New York.
     7    2.  An  employee  injured  under  circumstances which make such injury
     8  compensable under this article, when care  is  required  for  an  injury
     9  which  consists solely of a condition which may lawfully be treated by a
    10  chiropractor as defined in section sixty-five hundred fifty-one  of  the
    11  education  law  may  select to treat him or her, any duly registered and
    12  licensed chiropractor of the state of New York, authorized by the  chair
    13  to  render  chiropractic  care as hereinafter provided. If the injury or
    14  condition is one which is outside the limits prescribed by the education
    15  law for chiropractic care and treatment, the said chiropractor  must  so
    16  advise  the  said  injured employee and instruct him or her to consult a
    17  physician of said employee's choice for appropriate care and  treatment.
    18  Such  physician  shall  thenceforth have supervision of the treatment of
    19  said condition including the future treatment to be administered to  the
    20  patient  by the chiropractor. [A chiropractor licensed and registered to
    21  practice chiropractic in the state of New York, who is desirous of being
    22  authorized to render chiropractic care  under  this  section  and/or  to
    23  conduct  independent  medical  examinations in accordance with paragraph
    24  (b) of subdivision three of this section shall file an  application  for
    25  authorization  under this section with the chiropractic practice commit-
    26  tee. In such application he or she shall agree to  refrain  from  subse-
    27  quently  treating  for  remuneration,  as  a private patient, any person
    28  seeking chiropractic treatment, or submitting to an independent  medical
    29  examination, in connection with, or as a result of, any injury compensa-
    30  ble  under  this chapter, if he or she has been removed from the list of
    31  chiropractors authorized to render chiropractic care or to conduct inde-
    32  pendent medical examinations under this chapter, or if the person  seek-
    33  ing  such treatment has been transferred from his or her care in accord-
    34  ance with the provisions of this section. This agreement  shall  run  to
    35  the  benefit of the injured person so treated, or examined, and shall be
    36  available to him or her as a defense in any action by such  chiropractor
    37  for  payment rendered by a chiropractor after he or she has been removed
    38  from the list of chiropractors authorized to render chiropractic care or
    39  to conduct independent medical examinations under this section, or after
    40  the injured person was transferred from his or her  care  in  accordance
    41  with the provisions of this section. The chiropractic practice committee
    42  if it deems such licensed chiropractor duly qualified shall recommend to
    43  the  chair that such be authorized to render chiropractic care and/or to
    44  conduct independent medical examinations under this section. Such recom-
    45  mendations shall be advisory to the chair only and shall not be  binding
    46  or  conclusive upon him or her.] The chair shall prepare and establish a
    47  schedule for the state, or schedules limited to  defined  localities  of
    48  charges  and  fees for chiropractic treatment and care, to be determined
    49  in accordance with and to be subject to change pursuant to rules promul-
    50  gated by the chair.  Before preparing such schedule  for  the  state  or
    51  schedules  for limited localities the chair shall request the chiroprac-
    52  tic practice committee to submit to him or her a report on the amount of
    53  remuneration deemed by such committee to be fair and  adequate  for  the
    54  types  of  chiropractic  care  to  be  rendered  under this chapter, but
    55  consideration shall be given to the view of  other  interested  parties,
        S. 8812--A                         12
     1  the  amounts  payable  by  the  employer for such treatment and services
     2  shall be the fees and charges established by such schedule.
     3    (b)  Upon  receipt of the notice provided for by paragraph (a) of this
     4  subdivision, the employer, the carrier, and the claimant each  shall  be
     5  entitled  to  have  the  claimant  examined  by a qualified chiropractor
     6  authorized by the chair in accordance with  [subdivision  two  of  this]
     7  section  thirteen-b and section one hundred thirty-seven of this chapter
     8  at a medical facility convenient to the claimant and in the presence  of
     9  the  claimant's  chiropractor,  and refusal by the claimant to submit to
    10  such independent medical examination  at  such  time  or  times  as  may
    11  reasonably be necessary in the opinion of the board shall bar the claim-
    12  ant  from recovering compensation, for any period during which he or she
    13  has refused to submit to such examination.
    14    § 5. Subdivisions 1, 2 and 3 and paragraph (b)  of  subdivision  4  of
    15  section  13-m  of the workers' compensation law, subdivisions 1 and 2 as
    16  added by chapter 589 of the laws of 1989 and subdivision 3 and paragraph
    17  (b) of subdivision 4 as amended by chapter 473 of the laws of 2000,  are
    18  amended to read as follows:
    19    1.  Where  the term "chairman" is hereinafter used, it shall be deemed
    20  to mean the [chairman] chair of the workers' compensation board  of  the
    21  state of New York.
    22    2.  (a)  An  injured  employee, injured under circumstances which make
    23  such injury compensable under this article, may  lawfully  be  treated[,
    24  upon  the  referral of an authorized physician,] by a psychologist, duly
    25  registered and licensed by the state of  New  York,  authorized  by  the
    26  [chairman] chair to render psychological care pursuant to [this] section
    27  thirteen-b  of  this article. Such services shall be within the scope of
    28  such psychologist's specialized training and qualifications  as  defined
    29  in article one hundred fifty-three of the education law.
    30    (b)  Medical  bureaus,  medical  centers jointly operated by labor and
    31  management representatives, hospitals and health  maintenance  organiza-
    32  tions, authorized to provide medical care pursuant to section thirteen-c
    33  of  this  [chapter]  article,  may  provide  psychological services when
    34  required[, upon the referral of an authorized physician,  provided  such
    35  care  is rendered by a duly registered, licensed and authorized psychol-
    36  ogist, as required by this section].
    37    (c) A psychologist rendering service pursuant to  this  section  shall
    38  maintain records of the patient's psychological condition and treatment,
    39  and  such  records or reports shall be submitted to the [chairman] chair
    40  on such forms and at such times as the [chairman] chair may require.
    41    3. [A psychologist, licensed and registered to practice psychology  in
    42  the  state  of  New  York, who is desirous of being authorized to render
    43  psychological care under this  section  and/or  to  conduct  independent
    44  medical  examinations  in  accordance  with paragraph (b) of subdivision
    45  four of this section shall file an application for  authorization  under
    46  this section with the psychology practice committee. The applicant shall
    47  agree  to  refrain  from  subsequently  treating  for remuneration, as a
    48  private patient, any person seeking psychological treatment, or  submit-
    49  ting  to an independent medical examination, in connection with, or as a
    50  result of, any injury compensable under this chapter, if he or  she  has
    51  been removed from the list of psychologists authorized to render psycho-
    52  logical care under this chapter. This agreement shall run to the benefit
    53  of the injured person so treated, and shall be available as a defense in
    54  any  action  by  such psychologist for payment for treatment rendered by
    55  such psychologist after being removed from  the  list  of  psychologists
    56  authorized  to  render  psychological  care  or  to  conduct independent
        S. 8812--A                         13

     1  medical examinations under this section. The psychology practice commit-
     2  tee if it deems such licensed psychologist duly qualified  shall  recom-
     3  mend to the chair that such person be authorized to render psychological
     4  care  and/or  to  conduct  independent  medical  examinations under this
     5  section. Such recommendations shall be only advisory to  the  chair  and
     6  shall  not be binding or conclusive.] The chair shall prepare and estab-
     7  lish a schedule for the state or schedules limited to defined localities
     8  of charges and fees for psychological treatment and care, to  be  deter-
     9  mined  in  accordance  with  and  be subject to change pursuant to rules
    10  promulgated by the chair. Before preparing such schedule for  the  state
    11  or schedules for limited localities the chair shall request the psychol-
    12  ogy practice committee to submit to such chair a report on the amount of
    13  remuneration  deemed  by  such committee to be fair and adequate for the
    14  types of psychological care to  be  rendered  under  this  chapter,  but
    15  consideration  shall  be  given to the view of other interested parties.
    16  The amounts payable by the employer  for  such  treatment  and  services
    17  shall be the fees and charges established by such schedule.
    18    (b)  Upon  receipt of the notice provided for by paragraph (a) of this
    19  subdivision, the employer, the carrier, and the claimant each  shall  be
    20  entitled  to  have  the  claimant  examined by a qualified psychologist,
    21  authorized by the chair in accordance with [subdivision three  of  this]
    22  section thirteen-b and section one hundred thirty-seven of this chapter,
    23  at  a medical facility convenient to the claimant and in the presence of
    24  the claimant's psychologist, and refusal by the claimant  to  submit  to
    25  such  independent  medical  examination  at  such  time  or times as may
    26  reasonably be necessary in the opinion of the board shall bar the claim-
    27  ant from recovering compensation, for any period during which he or  she
    28  has refused to submit to such examination.
    29    §  6.  Section  54-b  of  the workers' compensation law, as amended by
    30  chapter 6 of the laws of 2007, is amended to read as follows:
    31    § 54-b. Enforcement on failure to pay award or judgment.  In  case  of
    32  default  by  a  carrier  or  self-insured employer in the payment of any
    33  compensation due under an award for the  period  of  thirty  days  after
    34  payment  is  due  and payable, or in the case of failure by a carrier or
    35  self-insured employer to make full payment of an award for medical  care
    36  or  supplies  issued by the board or the chair pursuant to section thir-
    37  teen-g of this chapter, the chair in any such case  or  on  the  chair's
    38  consent  any  party  to  an award may file with the county clerk for the
    39  county in which the injury occurred or the county in which  the  carrier
    40  or self-insured employer has his or her principal place of business, (1)
    41  a  certified  copy of the decision of the board awarding compensation or
    42  ending, diminishing or increasing compensation previously awarded,  from
    43  which  no  appeal has been taken within the time allowed therefor, or if
    44  an appeal has been taken by a carrier or self-insured employer  who  has
    45  not complied with the provisions of section fifty of this article, where
    46  he  or  she  fails  to deposit with the chair the amount of the award as
    47  security for its payment within ten days after the same is due and paya-
    48  ble, or (2) a certified copy of the award for medical care  or  supplies
    49  issued  pursuant  to  section  thirteen-g of this chapter, and thereupon
    50  judgment must be entered in the supreme court by the clerk of such coun-
    51  ty in conformity therewith immediately upon such filing. If the  payment
    52  in default be an installment, the board may declare the entire award due
    53  and  judgment  may  be entered in accordance with the provisions of this
    54  section. Such judgment shall be entered in the  same  manner,  have  the
    55  same effect and be subject to the same proceedings as though rendered in
    56  a  suit  duly  heard and determined by the supreme court, except that no
        S. 8812--A                         14
     1  appeal may be taken therefrom. The court shall  vacate  or  modify  such
     2  judgment  to  conform  to  any later award or decision of the board upon
     3  presentation of a certified copy of such award or  decision.  The  award
     4  may be so compromised by the board as in the discretion of the board may
     5  best  serve  the interest of the persons entitled to receive the compen-
     6  sation or benefits. Where an award has been made against  a  carrier  or
     7  self-insured  employer  in accordance with the provisions of subdivision
     8  nine of section fifteen, or of section twenty-five-a  of  this  chapter,
     9  such  an award may be similarly compromised by the board, upon notice to
    10  a representative of the fund to which the award is payable, but if there
    11  be no representative of any such fund, notice shall  be  given  to  such
    12  representative  as  may  be  designated  by  the chair of the board; and
    13  notwithstanding any other provision of law,  such  compromise  shall  be
    14  effective  without  the  necessity  of  any  approval by the state comp-
    15  troller. Neither the chair nor any party in interest shall  be  required
    16  to  pay  any fee to any public officer for filing or recording any paper
    17  or instrument or for issuing a transcript of any  judgment  executed  in
    18  pursuance of this section. The carrier or self-insured employer shall be
    19  liable  for all costs and attorneys fees necessary to enforce the award.
    20  For the purposes of this section, the term "carrier" shall  include  the
    21  state  insurance  fund  and any stock corporation, mutual corporation or
    22  reciprocal insurer authorized  to  transact  the  business  of  workers'
    23  compensation insurance in this state.
    24    §  7.  This  act shall take effect on the ninetieth day after it shall
    25  have become a law.