S T A T E O F N E W Y O R K ________________________________________________________________________ 3593--A 2011-2012 Regular Sessions I N S E N A T E February 28, 2011 ___________ Introduced by Sen. ADAMS -- read twice and ordered printed, and when printed to be committed to the Committee on Insurance -- recommitted to the Committee on Insurance in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the insurance law, in relation to medical proof in no-fault actions, and provides for the repeal of such provisions upon expiration thereof THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: 1 Section 1. The insurance law is amended by adding a new section 5110 2 to read as follows: 3 S 5110. MEDICAL PROOF IN NO-FAULT ACTIONS. 1. A PARTY WHO INITIATES AN 4 ACTION FOR MONEY, EXCLUSIVE OF INTEREST AND COSTS AND ATTORNEY FEES, 5 WHICH SEEKS REIMBURSEMENT FOR MEDICAL TREATMENT, TESTING, OR SUPPLIES 6 PURSUANT TO SECTION FIVE THOUSAND ONE HUNDRED SIX OF THIS ARTICLE, SHALL 7 AT TRIAL, SUBMIT THE SWORN STATEMENT OF THE LICENSED MEDICAL PROFES- 8 SIONAL THAT RENDERED, PRESCRIBED OR ORDERED THE MEDICAL TREATMENT ON THE 9 ISSUE OR ISSUES OF MEDICAL NECESSITY OR A SWORN STATEMENT FROM A REPRE- 10 SENTATIVE THAT CLAIMED SERVICES HAD BEEN BILLED IN ACCORDANCE WITH THE 11 WORKERS COMPENSATION FEE SCHEDULE PURSUANT TO SECTION FIVE THOUSAND ONE 12 HUNDRED EIGHT OF THIS ARTICLE. 13 2. THE LICENSED MEDICAL PROFESSIONAL SHALL AFFIRM THAT NO-FAULT BENE- 14 FITS WERE DULY ASSIGNED TO THE PLAINTIFF, THE CLAIMED TREATMENT, TESTING 15 OR SUPPLIES WERE RENDERED, PRESCRIBED OR ORDERED BY THE PLAINTIFF, 16 MEDICALLY NECESSARY TO TREAT ACCIDENT RELATED INJURIES AND SHALL INCLUDE 17 THE MATERIAL FACTS AND DOCUMENTS UPON WHICH THE OPINION OF MEDICAL 18 NECESSITY WAS BASED; OR, THE REPRESENTATIVE SHALL INCLUDE THE RELEVANT 19 SECTIONS OF THE FEE SCHEDULE AND THE MATERIAL FACTS AND DOCUMENTS THAT 20 SUPPORT THE CLAIMED SERVICES WERE BILLED IN ACCORDANCE WITH THE FEE 21 SCHEDULE. SUBMISSION OF SUCH SWORN STATEMENT SHALL NOT CREATE A PRESUMP- EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD07585-02-1 S. 3593--A 2 1 TION OF MEDICAL NECESSITY OR PROVIDE GREATER DEFERENCE TO THE TREATING 2 MEDICAL PROFESSIONAL OR ADHERENCE TO THE FEE SCHEDULE. 3 3. A PARTY OPPOSING SUCH ACTION MAY SUBMIT A SWORN STATEMENT ON THE 4 ISSUE OR ISSUES OF MEDICAL NECESSITY OR THAT THE CLAIMED SERVICES WERE 5 NOT BILLED IN ACCORDANCE WITH THE WORKERS COMPENSATION FEE SCHEDULE 6 PURSUANT TO SECTION FIVE THOUSAND ONE HUNDRED EIGHT OF THIS ARTICLE. 7 SUCH STATEMENT SHALL INCLUDE THE MATERIAL FACTS AND/OR DOCUMENTS UPON 8 WHICH SUCH STATEMENT IS BASED. 9 4. A COPY OF THE SWORN STATEMENT OR STATEMENTS SHALL BE FURNISHED TO 10 ALL PARTIES NO LATER THAN THE TIME THAT THE STATEMENT IS SUBMITTED TO 11 THE COURT. THE SWORN STATEMENT SHALL BE ACCEPTED BY THE COURT IN LIEU OF 12 TESTIMONY UNLESS, AFTER SUBMISSION OF THE SWORN STATEMENT, THE COURT 13 DETERMINES THAT IT WISHES TO HEAR TESTIMONY WHEREIN THE COURT SHALL THEN 14 DIRECT THAT ALL PARTIES SUBMITTING A SWORN STATEMENT SHALL HAVE THAT 15 PERSON APPEAR AND TESTIFY IN PERSON. 16 S 2. This act shall take effect immediately and shall: 17 1. apply to all actions and proceedings commenced on or after such 18 date; 19 2. apply to any action or proceeding which was commenced prior to such 20 effective date where, as of such date, either: (a) a trial of the issues 21 has not yet commenced, or (b) the parties have not yet entered into a 22 stipulation of settlement; and 23 3. expire and be deemed repealed December 31, 2018.