NY State Senate Bill 2015-S2874A

Senate Bill S2874A

2015-2016 Legislative Session

Requires the availability of and reimbursement for chiropractic care under the workers' compensation law to be provided on the same basis as care by a physician

download bill text pdf

Archive: Last Bill Status - In Senate Committee Labor Committee

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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	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jun 07, 2016	print number 2874a
Jun 07, 2016	amend and recommit to labor
Jan 06, 2016	referred to labor
Jan 29, 2015	referred to labor

Bill Amendments

Original

A (Active)

2015-S2874 - Details

Current Committee:: Senate Labor
Law Section:: Workers' Compensation Law
Laws Affected:: Amd §13-l, add §356, Work Comp L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S5233
2011-2012: S1405
2013-2014: S3681

2015-S2874 - Summary

Requires the availability of and reimbursement for chiropractic care under the workers' compensation law to be provided on the same basis as care by a physician under such law.

2015-S2874 - Sponsor Memo

                                BILL NUMBER:S2874

TITLE OF BILL:

An  act  to  amend  the  workers'  compensation  law,  in  relation to
chiropractic care

PURPOSE OR GENERAL IDEA OF BILL:

This  bill  would  end  years  of  the  most  blatant   discriminatory
regulation  against  the consumers of chiropractic care. Chiropractors
have been paid one flat fee for all treatment services rendered to  an
injured  worker  for  31  years  while  all other providers, including
non-doctor providers,  are  paid  for  virtually  every  service  they
perform.  Chiropractors  are  mandated  by statute to provide the same
level of care to an injured worker as to a private  patient,  but  are
not  reimbursed for the services - they are given only a flat "limited
office visit" fee. No other state has a separate and distinct Workers'
Compensation fee schedule for  chiropractors.  Chiropractors  are  not
even   reimbursed   for  a  main  staple  of  their  practice,  spinal
adjustments (spinal manipulation).   This policy  forces  health  care
consumers  to  consult  additional  providers for these services. This
legislation would recognize that chiropractors provide  a  variety  of
services and to clarify that the workers' compensation system must pay
for  the  individual modalities employed by chiropractors in rendering
primary health care services to injured workers.

SUMMARY OF SPECIFIC PROVISIONS:

This would amend the Workers' Compensation Law  to  provide  that  the
Workers'   Compensation   Board   must   reimburse  chiropractors  for
individual services and modalities lawfully rendered by  chiropractors
in treatment of an injured worker.

Section 4 sets forth the effective date of this amendment.

JUSTIFICATION:

In  rendering  care,  chiropractors  --  like  all  other primary care
practitioners -- engage in  a  number  of  individual  diagnostic  and
treatment  services  and modalities. Most other primary care providers
are compensated by the Workers' Compensation System for each  discrete
service  rendered  in  diagnosing  and  treating  injured workers. For
example, both the medical and  physical  therapy  fee  schedule  under
Workers'   Compensation  is  a  number  of  pages  long,  listing  and
compensating the full range of individual medical services employed in
caring for injured workers. Although Workers' Compensation  ostensibly
recognizes  the  panoply  of  chiropractic  services, the fee schedule
confines payment to office visits.  However, there is  no  recognition
that  a  variety  of  individual chiropractic modalities are routinely
employed in accurately diagnosing and treating injured  workers.  This
bill  recognizes  the  full scope of chiropractic services and directs
the Workers' Compensation Board to pay for individual  diagnostic  and
treatment services and modalities rendered.

PRIOR LEGISLATIVE HISTORY:


2005-2014 - Died in Labor Committee.

FISCAL IMPLICATIONS:

None.

EFFECTIVE DATE:

January 1, 2016.

2015-S2874 - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  2874

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            January 29, 2015
                               ___________

Introduced  by  Sen.  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 chiroprac-
  tic care

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1. Legislative intent. The legislature recognizes that multi-
ple health professionals are trained and licensed to diagnose and  treat
the same or similar conditions through the use of modalities, therapies,
treatments,  services  and  philosophies  that  vary  from profession to
profession. It is the specific intent of this legislature to assure that
workers' compensation policies, plans and contracts that provide  cover-
age for the diagnosis and treatment of conditions, complaints, ailments,
disorders  or injuries, that may be diagnosed and treated by a doctor of
chiropractic, must provide equivalent access, coverage and fees for  the
diagnosis and treatment of those conditions, complaints or injuries by a
duly licensed doctor of chiropractic, within the lawful scope of chirop-
ractic  practice  even  if  different terminology, philosophy, services,
treatments or modalities are used by the various health professions; and
such equivalent coverage shall not be abridged by any regulation.
  S 2. Subdivision 2 of section 13-l of the workers'  compensation  law,
as  amended  by  chapter  473 of the laws of 2000, is amended to read as
follows:
  2. (A) An employee injured under circumstances which make such  injury
compensable  under  this  article,  when  care is required for an injury
which consists solely of a condition which may lawfully be treated by  a
chiropractor  as  defined in section sixty-five hundred fifty-one of the
education law may select to treat him or her, any  duly  registered  and
licensed  chiropractor of the state of New York, authorized by the chair
to render chiropractic care as hereinafter provided. If  the  injury  or
condition is one which is outside the limits prescribed by the education

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD08380-01-5

S. 2874                             2

law  for  chiropractic care and treatment, the said chiropractor must so
advise the said injured employee and instruct him or her  to  consult  a
physician  of said employee's choice for appropriate care and treatment.
Such  physician  shall  thenceforth have supervision of the treatment of
said condition including the future treatment to be administered to  the
patient  by  the chiropractor. A chiropractor licensed and registered to
practice chiropractic in the state of New York, who is desirous of being
authorized to render chiropractic care  under  this  section  and/or  to
conduct  independent  medical  examinations in accordance with paragraph
(b) of subdivision three of this section shall file an  application  for
authorization  under this section with the chiropractic practice commit-
tee. In such application he or she shall agree to  refrain  from  subse-
quently  treating  for  remuneration,  as  a private patient, any person
seeking chiropractic treatment, or submitting to an independent  medical
examination, in connection with, or as a result of, any injury compensa-
ble  under  this chapter, if he or she has been removed from the list of
chiropractors authorized to render chiropractic care or to conduct inde-
pendent medical examinations under this chapter, or if the person  seek-
ing  such treatment has been transferred from his or her care in accord-
ance with the provisions of this section. This agreement  shall  run  to
the  benefit of the injured person so treated, or examined, and shall be
available to him or her as a defense in any action by such  chiropractor
for  payment rendered by a chiropractor after he or she has been removed
from the list of chiropractors authorized to render chiropractic care or
to conduct independent medical examinations under this section, or after
the injured person was transferred from his or her  care  in  accordance
with the provisions of this section. The chiropractic practice committee
if it deems such licensed chiropractor duly qualified shall recommend to
the  chair that such be authorized to render chiropractic care and/or to
conduct independent medical examinations under this section. Such recom-
mendations shall be advisory to the chair only and shall not be  binding
or  conclusive  upon him or her. The chair shall prepare and establish a
schedule for the state, or schedules limited to  defined  localities  of
charges  and  fees for chiropractic treatment and care, to be determined
in accordance with and to be subject to change pursuant to rules promul-
gated by the chair.  THE CHIROPRACTIC FEE SCHEDULE PREPARED  AND  ESTAB-
LISHED  BY THE CHAIR SHALL PROVIDE FOR THE PAYMENT OF REMUNERATION WHICH
IS EQUIVALENT TO THAT APPLICABLE TO CARE OR TREATMENT PROVIDED BY PHYSI-
CIANS IN THE DIAGNOSIS, TREATMENT AND MANAGEMENT OF THE SAME OR  SIMILAR
CONDITIONS, INJURIES, COMPLAINTS, DISORDERS OR AILMENTS, EVEN IF DIFFER-
ING NOMENCLATURE IS USED TO DESCRIBE THE CONDITION, INJURY, TREATMENT OR
SERVICE.  Before  preparing such schedule for the state or schedules for
limited localities the chair shall  request  the  chiropractic  practice
committee to submit to him or her a report on the amount of remuneration
deemed  by  such  committee  to  be  fair  and adequate for the types of
chiropractic care to be rendered under this chapter,  but  consideration
shall  be  given  to  the  view of other interested parties, the amounts
payable by the employer for such treatment and  services  shall  be  the
fees  and  charges  established by such schedule.  CHIROPRACTIC CARE AND
TREATMENT MAY BE SUBJECT TO REASONABLE UTILIZATION REVIEW, PROVIDED THAT
ANY SUCH REVIEW: (I) SHALL NOT DISCRIMINATE AGAINST  CHIROPRACTIC  CARE,
AND  (II)  SHALL  BE NO MORE RESTRICTIVE THAN THAT APPLICABLE TO CARE OR
TREATMENT PROVIDED BY PHYSICIANS IN THE DIAGNOSIS, TREATMENT AND MANAGE-
MENT OF THE SAME OR SIMILAR CONDITIONS, INJURIES, COMPLAINTS,  DISORDERS
OR  AILMENTS,  EVEN  IF  DIFFERING  NOMENCLATURE IS USED TO DESCRIBE THE
CONDITION, INJURY, TREATMENT OR SERVICE.  NOTHING  IN  THIS  SUBDIVISION

S. 2874                             3

SHALL  BE  CONSTRUED  AS  IMPEDING OR PREVENTING EITHER THE PROVISION OR
COVERAGE OF CHIROPRACTIC CARE AND TREATMENT BY DULY LICENSED DOCTORS  OF
CHIROPRACTIC,  WITHIN  THE  LAWFUL  SCOPE  OF  CHIROPRACTIC PRACTICE, IN
HOSPITAL FACILITIES ON STAFF OR EMPLOYEE BASIS.
  (B)  EVERY  POLICY WHICH INCLUDES COVERAGE FOR PHYSICIAN SERVICES IN A
PHYSICIAN'S OFFICE, OTHER THAN  A  POLICY  THAT  PROVIDES  MANAGED  CARE
COVERAGE,  SHALL  PROVIDE  COVERAGE FOR CARE PROVIDED IN THE PRACTICE OF
CHIROPRACTIC, AS DEFINED IN SECTION SIXTY-FIVE HUNDRED FIFTY-ONE OF  THE
EDUCATION LAW, PROVIDED BY A DOCTOR OF CHIROPRACTIC LICENSED PURSUANT TO
ARTICLE  ONE HUNDRED THIRTY-TWO OF THE EDUCATION LAW, IN CONNECTION WITH
THE DETECTION OR CORRECTION BY MANUAL OR MECHANICAL MEANS OF  STRUCTURAL
IMBALANCE,  DISTORTION  OR SUBLUXATION IN THE HUMAN BODY FOR THE PURPOSE
OF REMOVING NERVE INTERFERENCE, AND  THE  EFFECTS  THEREOF,  WHERE  SUCH
INTERFERENCE  IS THE RESULT OF OR RELATED TO DISTORTION, MISALIGNMENT OR
SUBLUXATION OF  OR  IN  THE  VERTEBRAL  COLUMN.  CHIROPRACTIC  CARE  AND
SERVICES  MAY  BE  SUBJECT  TO  REASONABLE  FEE SCHEDULES AND REASONABLE
UTILIZATION REVIEW, PROVIDED THAT ANY SUCH  SCHEDULES  AND  REVIEW:  (I)
SHALL  NOT DISCRIMINATE AGAINST CHIROPRACTIC CARE, AND (II) INDIVIDUALLY
AND COLLECTIVELY SHALL BE NO  MORE  RESTRICTIVE  THAN  THOSE  APPLICABLE
UNDER  THE SAME POLICY TO CARE OR SERVICES PROVIDED BY PHYSICIANS IN THE
DIAGNOSIS, TREATMENT AND MANAGEMENT OF THE SAME OR  SIMILAR  CONDITIONS,
INJURIES, COMPLAINTS, DISORDERS OR AILMENTS, EVEN IF DIFFERING NOMENCLA-
TURE  IS USED TO DESCRIBE THE CONDITION, INJURY, COMPLAINT, TREATMENT OR
SERVICE. NOTHING IN THIS SUBDIVISION SHALL BE CONSTRUED AS  IMPEDING  OR
PREVENTING  EITHER  THE  PROVISION  OR COVERAGE OF CHIROPRACTIC CARE AND
SERVICES BY DULY LICENSED DOCTORS OF  CHIROPRACTIC,  WITHIN  THE  LAWFUL
SCOPE  OF  CHIROPRACTIC  PRACTICE,  IN HOSPITAL FACILITIES ON A STAFF OR
EMPLOYEE BASIS.
  (C) THE COVERAGE REQUIRED BY THIS SUBDIVISION SHALL NOT BE ABRIDGED BY
ANY REGULATION PROMULGATED BY THE CHAIR, THE BOARD OR THE SUPERINTENDENT
OF FINANCIAL SERVICES.
  S 3. The workers' compensation law is amended by adding a new  section
356 to read as follows:
  S  356.  PREFERRED PROVIDER ORGANIZATIONS; CHIROPRACTIC TREATMENT.  1.
EACH PREFERRED PROVIDER ORGANIZATION SHALL PROVIDE COVERAGE FOR CARE AND
TREATMENT PROVIDED IN THE COURSE OF THE  PRACTICE  OF  CHIROPRACTIC,  AS
DEFINED  IN  SECTION  SIXTY-FIVE HUNDRED FIFTY-ONE OF THE EDUCATION LAW,
PROVIDED BY A DOCTOR OF CHIROPRACTIC LICENSED PURSUANT  TO  ARTICLE  ONE
HUNDRED  THIRTY-TWO  OF  THE  EDUCATION  LAW,  IN  CONNECTION  WITH  THE
DETECTION OR CORRECTION BY MANUAL  OR  MECHANICAL  MEANS  OF  STRUCTURAL
IMBALANCE,  DISTORTION  OR SUBLUXATION IN THE HUMAN BODY FOR THE PURPOSE
OF REMOVING NERVE INTERFERENCE, AND  THE  EFFECTS  THEREOF,  WHERE  SUCH
INTERFERENCE  IS THE RESULT OF OR RELATED TO DISTORTION, MISALIGNMENT OR
SUBLUXATION OF OR IN THE VERTEBRAL COLUMN. CHIROPRACTIC CARE AND  TREAT-
MENT MAY BE SUBJECT TO REASONABLE FEE SCHEDULES, AND REASONABLE UTILIZA-
TION  REVIEW, PROVIDED THAT ANY SUCH SCHEDULES AND REVIEW: (A) SHALL NOT
DISCRIMINATE AGAINST CHIROPRACTIC CARE; AND (B) INDIVIDUALLY AND COLLEC-
TIVELY SHALL BE NO MORE RESTRICTIVE THAN  THOSE  APPLICABLE  WITHIN  THE
PREFERRED  PROVIDER ORGANIZATION TO CARE OR TREATMENT PROVIDED BY PHYSI-
CIANS IN THE DIAGNOSIS, TREATMENT AND MANAGEMENT OF THE SAME OR  SIMILAR
CONDITIONS,  INJURIES  OR  COMPLAINTS, EVEN IF DIFFERING NOMENCLATURE IS
USED TO DESCRIBE THE CONDITION, INJURY, COMPLAINT, TREATMENT OR SERVICE.
NOTHING IN THIS SECTION SHALL BE CONSTRUED  AS  IMPEDING  OR  PREVENTING
EITHER  THE  PROVISION OR COVERAGE OF CHIROPRACTIC CARE AND TREATMENT BY
DULY LICENSED DOCTORS  OF  CHIROPRACTIC,  WITHIN  THE  LAWFUL  SCOPE  OF

S. 2874                             4

CHIROPRACTIC  PRACTICE,  IN  HOSPITAL  FACILITIES ON A STAFF OR EMPLOYEE
BASIS.
  2.  EACH  PREFERRED  PROVIDER  ORGANIZATION SHALL INCLUDE A SUFFICIENT
NUMBER OF CHIROPRACTORS WITHIN EACH GEOGRAPHIC AREA TO ASSURE ACCESS  TO
CHIROPRACTIC TREATMENT THAT IS EQUAL TO THAT AVAILABLE TO MEDICAL TREAT-
MENT WITHIN THE SAME PREFERRED PROVIDER ORGANIZATION.
  3.  AN  EMPLOYEE  MAY  SEEK  CHIROPRACTIC  TREATMENT  FROM OUTSIDE THE
PREFERRED PROVIDER ORGANIZATION THIRTY DAYS AFTER HIS OR HER VISIT TO  A
PREFERRED PROVIDER ORGANIZATION PROVIDER. IN THE EVENT THAT SUCH EMPLOY-
EE SEEKS CHIROPRACTIC TREATMENT OUTSIDE THE PREFERRED PROVIDER ORGANIZA-
TION,  THE  EMPLOYER MAY REQUIRE A SECOND OPINION FROM A PROVIDER WITHIN
THE PREFERRED PROVIDER ORGANIZATION.
  4. AN EMPLOYEE MAY SEEK A SECOND OPINION WITH RESPECT TO SUCH  CHIROP-
RACTIC  TREATMENT  FROM  ANOTHER  PROVIDER WITHIN THE PREFERRED PROVIDER
ORGANIZATION AT ANY TIME.
  5. THE COVERAGE REQUIRED BY THIS SECTION SHALL NOT BE ABRIDGED BY  ANY
REGULATION PROMULGATED BY THE CHAIR OR THE BOARD.
  S  4.  This  act  shall take effect January 1, 2016 and shall apply to
policies and contracts issued, renewed, modified, altered or amended  on
or after such effective date.

2015-S2874A (ACTIVE) - Details

Current Committee:: Senate Labor
Law Section:: Workers' Compensation Law
Laws Affected:: Amd §13-l, add §356, Work Comp L
Versions Introduced in Other Legislative Sessions:: 2009-2010: S5233
2011-2012: S1405
2013-2014: S3681

2015-S2874A (ACTIVE) - Summary

Requires the availability of and reimbursement for chiropractic care under the workers' compensation law to be provided on the same basis as care by a physician under such law.

2015-S2874A (ACTIVE) - Sponsor Memo

                                 BILL NUMBER:  S2874A

 TITLE OF BILL :

An act to amend the workers' compensation law, in relation to
chiropractic care

 PURPOSE OR GENERAL IDEA OF BILL :

This bill would end years of the most blatant discriminatory
regulation against the consumers of chiropractic care. Chiropractors
have been paid one flat fee for all treatment services rendered to an
injured worker for 31 years while all other providers, including
non-doctor providers, are paid for virtually every service they
perform. Chiropractors are mandated by statute to provide the same
level of care to an injured worker as to a private patient, but are
not reimbursed for the services - they are given only a flat "limited
office visit" fee. No other state has a separate and distinct Workers'
Compensation fee schedule for chiropractors. Chiropractors are not
even reimbursed for a main staple of their practice, spinal
adjustments (spinal manipulation).  This policy forces health care
consumers to consult additional providers for these services. This
legislation would recognize that chiropractors provide a variety of
services and to clarify that the workers' compensation system must pay
for the individual modalities employed by chiropractors in rendering
primary health care services to injured workers.

 SUMMARY OF SPECIFIC PROVISIONS :

This would amend the Workers' Compensation Law to provide that the
Workers' Compensation Board must reimburse chiropractors for
individual services and modalities lawfully rendered by chiropractors
in treatment of an injured worker.  Section 4 sets forth the effective
date of this amendment.

 JUSTIFICATION :

In rendering care, chiropractors -- like all other primary care
practitioners -- engage in a number of individual diagnostic and
treatment services and modalities. Most other primary care providers
are compensated by the Workers' Compensation System for each discrete
service rendered in diagnosing and treating injured workers. For
example, both the medical and physical therapy fee schedule under
Workers' Compensation is a number of pages long, listing and
compensating the full range of individual medical services employed in
caring for injured workers. Although Workers' Compensation ostensibly
recognizes the panoply of chiropractic services, the fee schedule
confines payment to office visits.  However, there is no recognition
that a variety of individual chiropractic modalities are routinely
employed in accurately diagnosing and treating injured workers. This
bill recognizes the full scope of chiropractic services and directs
the Workers' Compensation Board to pay for individual diagnostic and
treatment services and modalities rendered.

 PRIOR LEGISLATIVE HISTORY :

2005-2015 - Died in Labor Committee.

 FISCAL IMPLICATIONS :

None.

 EFFECTIVE DATE :
January 1, 2017.

2015-S2874A (ACTIVE) - Bill Text download pdf

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 2874--A

                       2015-2016 Regular Sessions

                            I N  S E N A T E

                            January 29, 2015
                               ___________

Introduced  by  Sen.  SAVINO -- read twice and ordered printed, and when
  printed to be committed to the Committee on Labor  --  recommitted  to
  the  Committee  on  Labor  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 workers' compensation law, in relation to chiroprac-
  tic care

  THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section 1. Legislative intent. The legislature recognizes that  multi-
ple  health professionals are trained and licensed to diagnose and treat
the same or similar conditions through the use of modalities, therapies,
treatments, services and  philosophies  that  vary  from  profession  to
profession. It is the specific intent of this legislature to assure that
workers'  compensation policies, plans and contracts that provide cover-
age for the diagnosis and treatment of conditions, complaints, ailments,
disorders or injuries, that may be diagnosed and treated by a doctor  of
chiropractic,  must provide equivalent access, coverage and fees for the
diagnosis and treatment of those conditions, complaints or injuries by a
duly licensed doctor of chiropractic, within the lawful scope of chirop-
ractic practice even if  different  terminology,  philosophy,  services,
treatments or modalities are used by the various health professions; and
such equivalent coverage shall not be abridged by any regulation.
  S  2.  Subdivision 2 of section 13-l of the workers' compensation law,
as amended by chapter 473 of the laws of 2000, is  amended  to  read  as
follows:
  2.  (A) An employee injured under circumstances which make such injury
compensable under this article, when care  is  required  for  an  injury
which  consists solely of a condition which may lawfully be treated by a
chiropractor as defined in section sixty-five hundred fifty-one  of  the
education  law  may  select to treat him or her, any duly registered and

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD08380-02-6

S. 2874--A                          2

licensed chiropractor of the state of New York, authorized by the  chair
to  render  chiropractic  care as hereinafter provided. If the injury or
condition is one which is outside the limits prescribed by the education
law  for  chiropractic care and treatment, the said chiropractor must so
advise the said injured employee and instruct him or her  to  consult  a
physician  of said employee's choice for appropriate care and treatment.
Such physician shall thenceforth have supervision of  the  treatment  of
said  condition including the future treatment to be administered to the
patient by the chiropractor. A chiropractor licensed and  registered  to
practice chiropractic in the state of New York, who is desirous of being
authorized  to  render  chiropractic  care  under this section and/or to
conduct independent medical examinations in  accordance  with  paragraph
(b)  of  subdivision three of this section shall file an application for
authorization under this section with the chiropractic practice  commit-
tee.  In  such  application he or she shall agree to refrain from subse-
quently treating for remuneration, as  a  private  patient,  any  person
seeking  chiropractic treatment, or submitting to an independent medical
examination, in connection with, or as a result of, any injury compensa-
ble under this chapter, if he or she has been removed from the  list  of
chiropractors authorized to render chiropractic care or to conduct inde-
pendent  medical examinations under this chapter, or if the person seek-
ing such treatment has been transferred from his or her care in  accord-
ance  with  the  provisions of this section. This agreement shall run to
the benefit of the injured person so treated, or examined, and shall  be
available  to him or her as a defense in any action by such chiropractor
for payment rendered by a chiropractor after he or she has been  removed
from the list of chiropractors authorized to render chiropractic care or
to conduct independent medical examinations under this section, or after
the  injured  person  was transferred from his or her care in accordance
with the provisions of this section. The chiropractic practice committee
if it deems such licensed chiropractor duly qualified shall recommend to
the chair that such be authorized to render chiropractic care and/or  to
conduct independent medical examinations under this section. Such recom-
mendations  shall be advisory to the chair only and shall not be binding
or conclusive upon him or her. The chair shall prepare and  establish  a
schedule  for  the  state, or schedules limited to defined localities of
charges and fees for chiropractic treatment and care, to  be  determined
in accordance with and to be subject to change pursuant to rules promul-
gated  by  the chair.  THE CHIROPRACTIC FEE SCHEDULE PREPARED AND ESTAB-
LISHED BY THE CHAIR SHALL PROVIDE FOR THE PAYMENT OF REMUNERATION  WHICH
IS EQUIVALENT TO THAT APPLICABLE TO CARE OR TREATMENT PROVIDED BY PHYSI-
CIANS  IN THE DIAGNOSIS, TREATMENT AND MANAGEMENT OF THE SAME OR SIMILAR
CONDITIONS, INJURIES, COMPLAINTS, DISORDERS OR AILMENTS, EVEN IF DIFFER-
ING NOMENCLATURE IS USED TO DESCRIBE THE CONDITION, INJURY, TREATMENT OR
SERVICE. Before preparing such schedule for the state or  schedules  for
limited  localities  the  chair  shall request the chiropractic practice
committee to submit to him or her a report on the amount of remuneration
deemed by such committee to be  fair  and  adequate  for  the  types  of
chiropractic  care  to be rendered under this chapter, but consideration
shall be given to the view of  other  interested  parties,  the  amounts
payable  by  the  employer  for such treatment and services shall be the
fees and charges established by such schedule.   CHIROPRACTIC  CARE  AND
TREATMENT MAY BE SUBJECT TO REASONABLE UTILIZATION REVIEW, PROVIDED THAT
ANY  SUCH  REVIEW: (I) SHALL NOT DISCRIMINATE AGAINST CHIROPRACTIC CARE,
AND (II) SHALL BE NO MORE RESTRICTIVE THAN THAT APPLICABLE  TO  CARE  OR
TREATMENT PROVIDED BY PHYSICIANS IN THE DIAGNOSIS, TREATMENT AND MANAGE-

S. 2874--A                          3

MENT  OF THE SAME OR SIMILAR CONDITIONS, INJURIES, COMPLAINTS, DISORDERS
OR AILMENTS, EVEN IF DIFFERING NOMENCLATURE  IS  USED  TO  DESCRIBE  THE
CONDITION,  INJURY,  TREATMENT  OR  SERVICE. NOTHING IN THIS SUBDIVISION
SHALL  BE  CONSTRUED  AS  IMPEDING OR PREVENTING EITHER THE PROVISION OR
COVERAGE OF CHIROPRACTIC CARE AND TREATMENT BY DULY LICENSED DOCTORS  OF
CHIROPRACTIC,  WITHIN  THE  LAWFUL  SCOPE  OF  CHIROPRACTIC PRACTICE, IN
HOSPITAL FACILITIES ON STAFF OR EMPLOYEE BASIS.
  (B) EVERY POLICY WHICH INCLUDES COVERAGE FOR PHYSICIAN SERVICES  IN  A
PHYSICIAN'S  OFFICE,  OTHER  THAN  A  POLICY  THAT PROVIDES MANAGED CARE
COVERAGE, SHALL PROVIDE COVERAGE FOR CARE PROVIDED IN  THE  PRACTICE  OF
CHIROPRACTIC,  AS DEFINED IN SECTION SIXTY-FIVE HUNDRED FIFTY-ONE OF THE
EDUCATION LAW, PROVIDED BY A DOCTOR OF CHIROPRACTIC LICENSED PURSUANT TO
ARTICLE ONE HUNDRED THIRTY-TWO OF THE EDUCATION LAW, IN CONNECTION  WITH
THE  DETECTION OR CORRECTION BY MANUAL OR MECHANICAL MEANS OF STRUCTURAL
IMBALANCE, DISTORTION OR SUBLUXATION IN THE HUMAN BODY FOR  THE  PURPOSE
OF  REMOVING  NERVE  INTERFERENCE,  AND  THE EFFECTS THEREOF, WHERE SUCH
INTERFERENCE IS THE RESULT OF OR RELATED TO DISTORTION, MISALIGNMENT  OR
SUBLUXATION  OF  OR  IN  THE  VERTEBRAL  COLUMN.  CHIROPRACTIC  CARE AND
SERVICES MAY BE SUBJECT  TO  REASONABLE  FEE  SCHEDULES  AND  REASONABLE
UTILIZATION  REVIEW,  PROVIDED  THAT  ANY SUCH SCHEDULES AND REVIEW: (I)
SHALL NOT DISCRIMINATE AGAINST CHIROPRACTIC CARE, AND (II)  INDIVIDUALLY
AND  COLLECTIVELY  SHALL  BE  NO  MORE RESTRICTIVE THAN THOSE APPLICABLE
UNDER THE SAME POLICY TO CARE OR SERVICES PROVIDED BY PHYSICIANS IN  THE
DIAGNOSIS,  TREATMENT  AND MANAGEMENT OF THE SAME OR SIMILAR CONDITIONS,
INJURIES, COMPLAINTS, DISORDERS OR AILMENTS, EVEN IF DIFFERING NOMENCLA-
TURE IS USED TO DESCRIBE THE CONDITION, INJURY, COMPLAINT, TREATMENT  OR
SERVICE.  NOTHING  IN THIS SUBDIVISION SHALL BE CONSTRUED AS IMPEDING OR
PREVENTING EITHER THE PROVISION OR COVERAGE  OF  CHIROPRACTIC  CARE  AND
SERVICES  BY  DULY  LICENSED  DOCTORS OF CHIROPRACTIC, WITHIN THE LAWFUL
SCOPE OF CHIROPRACTIC PRACTICE, IN HOSPITAL FACILITIES  ON  A  STAFF  OR
EMPLOYEE BASIS.
  (C) THE COVERAGE REQUIRED BY THIS SUBDIVISION SHALL NOT BE ABRIDGED BY
ANY REGULATION PROMULGATED BY THE CHAIR, THE BOARD OR THE SUPERINTENDENT
OF FINANCIAL SERVICES.
  S  3. The workers' compensation law is amended by adding a new section
356 to read as follows:
  S 356. PREFERRED PROVIDER ORGANIZATIONS; CHIROPRACTIC TREATMENT.    1.
EACH PREFERRED PROVIDER ORGANIZATION SHALL PROVIDE COVERAGE FOR CARE AND
TREATMENT  PROVIDED  IN  THE  COURSE OF THE PRACTICE OF CHIROPRACTIC, AS
DEFINED IN SECTION SIXTY-FIVE HUNDRED FIFTY-ONE OF  THE  EDUCATION  LAW,
PROVIDED  BY  A  DOCTOR OF CHIROPRACTIC LICENSED PURSUANT TO ARTICLE ONE
HUNDRED  THIRTY-TWO  OF  THE  EDUCATION  LAW,  IN  CONNECTION  WITH  THE
DETECTION  OR  CORRECTION  BY  MANUAL  OR MECHANICAL MEANS OF STRUCTURAL
IMBALANCE, DISTORTION OR SUBLUXATION IN THE HUMAN BODY FOR  THE  PURPOSE
OF  REMOVING  NERVE  INTERFERENCE,  AND  THE EFFECTS THEREOF, WHERE SUCH
INTERFERENCE IS THE RESULT OF OR RELATED TO DISTORTION, MISALIGNMENT  OR
SUBLUXATION  OF OR IN THE VERTEBRAL COLUMN. CHIROPRACTIC CARE AND TREAT-
MENT MAY BE SUBJECT TO REASONABLE FEE SCHEDULES, AND REASONABLE UTILIZA-
TION REVIEW, PROVIDED THAT ANY SUCH SCHEDULES AND REVIEW: (A) SHALL  NOT
DISCRIMINATE AGAINST CHIROPRACTIC CARE; AND (B) INDIVIDUALLY AND COLLEC-
TIVELY  SHALL  BE  NO  MORE RESTRICTIVE THAN THOSE APPLICABLE WITHIN THE
PREFERRED PROVIDER ORGANIZATION TO CARE OR TREATMENT PROVIDED BY  PHYSI-
CIANS  IN THE DIAGNOSIS, TREATMENT AND MANAGEMENT OF THE SAME OR SIMILAR
CONDITIONS, INJURIES OR COMPLAINTS, EVEN IF  DIFFERING  NOMENCLATURE  IS
USED TO DESCRIBE THE CONDITION, INJURY, COMPLAINT, TREATMENT OR SERVICE.
NOTHING  IN  THIS  SECTION  SHALL BE CONSTRUED AS IMPEDING OR PREVENTING

S. 2874--A                          4

EITHER THE PROVISION OR COVERAGE OF CHIROPRACTIC CARE AND  TREATMENT  BY
DULY  LICENSED  DOCTORS  OF  CHIROPRACTIC,  WITHIN  THE  LAWFUL SCOPE OF
CHIROPRACTIC PRACTICE, IN HOSPITAL FACILITIES ON  A  STAFF  OR  EMPLOYEE
BASIS.
  2.  EACH  PREFERRED  PROVIDER  ORGANIZATION SHALL INCLUDE A SUFFICIENT
NUMBER OF CHIROPRACTORS WITHIN EACH GEOGRAPHIC AREA TO ASSURE ACCESS  TO
CHIROPRACTIC TREATMENT THAT IS EQUAL TO THAT AVAILABLE TO MEDICAL TREAT-
MENT WITHIN THE SAME PREFERRED PROVIDER ORGANIZATION.
  3.  AN  EMPLOYEE  MAY  SEEK  CHIROPRACTIC  TREATMENT  FROM OUTSIDE THE
PREFERRED PROVIDER ORGANIZATION THIRTY DAYS AFTER HIS OR HER VISIT TO  A
PREFERRED PROVIDER ORGANIZATION PROVIDER. IN THE EVENT THAT SUCH EMPLOY-
EE SEEKS CHIROPRACTIC TREATMENT OUTSIDE THE PREFERRED PROVIDER ORGANIZA-
TION,  THE  EMPLOYER MAY REQUIRE A SECOND OPINION FROM A PROVIDER WITHIN
THE PREFERRED PROVIDER ORGANIZATION.
  4. AN EMPLOYEE MAY SEEK A SECOND OPINION WITH RESPECT TO SUCH  CHIROP-
RACTIC  TREATMENT  FROM  ANOTHER  PROVIDER WITHIN THE PREFERRED PROVIDER
ORGANIZATION AT ANY TIME.
  5. THE COVERAGE REQUIRED BY THIS SECTION SHALL NOT BE ABRIDGED BY  ANY
REGULATION PROMULGATED BY THE CHAIR OR THE BOARD.
  S  4.  This  act  shall take effect January 1, 2017 and shall apply to
policies and contracts issued, renewed, modified, altered or amended  on
or after such effective date.

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