Relates to application of guidelines for medical treatment for injured workers; prohibits retroactive application.
TITLE OF BILL: An act to amend the workers' compensation law, in relation to application of guidelines for medical treatment for injured workers
PURPOSE: To ensure that Medical Treatment Guidelines adopted by the Worker's Compensation Board in 2010 will no longer be applied retroactively.
SUMMARY OF PROVISIONS: Section 1 of Subdivision 5 of section 13-a of the worker's compensation law, as amended by chapter 6 of the laws of 2007, is amended to ensure that no guideline providing for medical treatment or rules or regulations shall be applied retroactively to cases with a date of accident of disablement that is prior to the date of such guideline, rule or regulation.
JUSTIFICATION: In 2010 the Workers Compensation Board adopted Medical Treatment guidelines and process regulations, which applied retroactively to all cases then in effect. As a result workers who had previously received a determination that they were entitled to specific treatments, would have their care limited. The guidelines as written have caused confusion in the medical community and disrupted the provision of needed medical care. Additionally, these guidelines appear to violate Worker's compensation law, section 13 (a) which guarantees an injured worker medical coverage for "such period as the nature of the injury of process of recovery may require." This bill would restore needed care, and a sense of fairness in those cases that predate the recent adoption of these medical treatment guidelines
LEGISLATIVE HISTORY: This is a new bill.
FISCAL IMPLICATIONS: To be determined.
EFFECTIVE DATE: This act shall take effect immediately.
STATE OF NEW YORK ________________________________________________________________________ 3741 2011-2012 Regular Sessions IN SENATE March 2, 2011 ___________Introduced by Sen. MAZIARZ -- 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 applica- tion of guidelines for medical treatment for injured workers THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Subdivision 5 of section 13-a of the workers' compensation law, as amended by chapter 6 of the laws of 2007, is amended to read as follows: (5) No claim for specialist consultations, surgical operations, physiotherapeutic or occupational therapy procedures, x-ray examinations or special diagnostic laboratory tests costing more than one thousand dollars shall be valid and enforceable, as against such employer, unless such special services shall have been authorized by the employer or by the board, or unless such authorization has been unreasonably withheld, or withheld for a period of more than thirty calendar days from receipt of a request for authorization, or unless such special services are required in an emergency, provided, however, that the basis for a denial of such authorization by the employer must be based on a conflicting second opinion rendered by a physician authorized by the board. The board, with the approval of the superintendent of insurance, shall issue and maintain a list of pre-authorized procedures under this section. NO GUIDELINE PROVIDING FOR MEDICAL TREATMENT, OR RULES OR REGULATIONS PERTAINING THERETO, SHALL BE APPLIED BY THE BOARD BY RETROACTIVELY TO CASES WITH A DATE OF ACCIDENT OR DATE OF DISABLEMENT THAT IS PRIOR TO THE DATE OF ANY SUCH GUIDELINE, RULE OR REGULATION. S 2. This act shall take effect immediately.EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD09865-01-1