Bill S2364-2009

Permits any medical provider authorized by the workers' compensation board to treat injured workers

Permits any medical provider authorized by the workers' compensation board to treat injured workers.

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  • Jan 6, 2010: REFERRED TO LABOR
  • Feb 19, 2009: REFERRED TO LABOR

Memo

 BILL NUMBER:  S2364

TITLE OF BILL : An act to amend the workers' compensation law, in relation to permitting any medical provider authorized by the workers' compensation board to treat injured workers

PURPOSE : To permit any medical provider authorized by the Workers' Compensation Board to treat injured workers to perform diagnostic testing under all circumstances provided they accept the designated carrier's published fee for those services. If no fee schedule is published and submitted to the Worker's Compensation Chair, the prevailing fee schedule will apply.

EXISTING LAW : Workers' compensation insurance carriers and self-insureds may enter into private contracts with medical networks to provide diagnostic testing to injured workers including x-rays, MRI, CAT scan, electrical based tests, and other diagnostic screening tools. Previously, these tests were performed by the patient's doctor, the provider to whom the patient was referred by his/her physician, or the place where the patient chose to go. This change limiting patient choice was included as part of the Workers Compensation Reform Act of 2007.

JUSTIFICATION : This legislation will reinstate patient choice in diagnostic testing under the Workers' Compensation Law. Injured workers will once again be able to receive diagnostic testing from their physicians, providers referred by their doctors, or other providers of their choice.

PRIOR LEGISLATIVE HISTORY : 2008: S.8474 Referred to Rules

FISCAL IMPLICATIONS : None to the State.

EFFECTIVE DATE : This Act will take effect immediately.

Text

STATE OF NEW YORK ________________________________________________________________________ 2364 2009-2010 Regular Sessions IN SENATE February 19, 2009 ___________
Introduced by Sen. ONORATO -- 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 permitting any medical provider authorized by the workers' compensation board to treat injured workers THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subdivision 7 of section 13-a of the workers' compensation law, as added by chapter 6 of the laws of 2007, is amended to read as follows: (7)(a) Notwithstanding any other provision of this chapter to the contrary, any insurance carrier authorized to transact the business of workers' compensation insurance in this state, self-insurer or the state insurance fund may contract with a network or networks, legally and properly organized, to perform diagnostic tests, x-ray examinations, magnetic resonance imaging, or other radiological examinations or tests of claimants and may require claimant to obtain or undergo such diagnos- tic test, x-ray examinations, magnetic resonance imaging or other radio- logical examinations or tests with a provider or at a facility that is affiliated with the network or networks with which the carrier contracts, except if a medical emergency occurs requiring an immediate diagnostic test, x-ray examination, magnetic resonance imaging or other radiological examination or test or if the network with which the insur- ance carrier, self-insurer or the state insurance fund contracts does not have a provider or facility able to perform the examination or test within a reasonable distance from the claimant's residence or place of employment, as defined by regulation of the board. (b) ANY MEDICAL PROVIDER AUTHORIZED BY THE WORKERS' COMPENSATION BOARD TO TREAT INJURED WORKERS IS PERMITTED TO PERFORM DIAGNOSTIC TESTING, X-RAY EXAMINATIONS, MAGNETIC RESONANCE IMAGING, OR OTHER RADIOLOGICAL EXAMINATIONS OR TESTS UNDER ALL CIRCUMSTANCES, PROVIDED, HOWEVER, SUCH
PROVIDER ACCEPTS THE DESIGNATED INSURANCE CARRIER'S PUBLISHED FEE FOR SUCH SERVICES. IF AN INSURANCE CARRIER'S FEE SCHEDULE IS NOT PUBLISHED AND SUBMITTED TO THE CHAIR OF THE WORKERS' COMPENSATION BOARD, THE PREVAILING FEE SCHEDULE SHALL APPLY. (C) Any insurance carrier, self-insurer or the state insurance fund which requires claimants to obtain or undergo diagnostic tests, x-ray examinations, magnetic resonance imaging or other radiological examina- tions or tests with a provider or at a facility affiliated with a network or networks with which it contracts, must notify the claimant of the name and contact information for the network or networks at the same time the written statement of the claimant's rights as required by subdivision two of section one hundred ten of this chapter or immediate- ly after imposing such requirement if the time period within which the written statement of the claimant's rights as required by subdivision two of section one hundred ten of this chapter has expired. [(c)] (D) At the time a request for authorization for special diagnos- tic tests, x-ray examinations, magnetic resonance imaging or other radi- ological examinations or tests costing more than one thousand dollars as required by subdivision five of this section is approved, the insurance carrier, self-insurer or state insurance fund, or if so delegated the network with which the insurance carrier, self-insurer or state insur- ance fund has contracted, shall notify the physician requesting authori- zation of the requirement that the claimant obtain or undergo the special diagnostic test, x-ray examination, magnetic resonance imaging or other radiological examination or test with a provider or at a facil- ity affiliated with the network or networks with which it has contracted, the contact information for the network and a list of the providers and facilities within the claimant's geographic location, as defined by regulation of the board. The claimant, in consultation with the provider who requested the special diagnostic test, x-ray examina- tion, magnetic resonance imaging or other radiological test or exam, will determine the provider or facility from within the network which will perform such diagnostic test, x-ray examination, magnetic resonance imaging or other radiological examination or test. [(d)] (E) The results of the special diagnostic test, x-ray examina- tion, magnetic resonance imaging or other radiological test or exam must be sent to the physician who requested the test or exam immediately upon completion of the report detailing the results. S 2. This act shall take effect immediately.

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