Relates to the rates of payment for the treatment and care of injured employees.
TITLE OF BILL: An act to amend the workers' compensation law, in relation to the rates of payment for the treatment and care of injured employees; and providing for the repeal of such provisions upon expiration thereof
PURPOSE OF BILL: The bill would provide for the continuation of reimbursement for certain medical treatments under the workers compensation system in the event the federal government changes the codes associated with such treatments.
SUMMARY OF PROVISIONS: The bill would provide for the continuation of reimbursement to medical providers for certain kinds of medical care in the event that the federal government changes the codes for those medical treatments. The codes are in statute and would become moot if re-coded at the federal level. The bill would provide for continued use of the current codes until promulgation of the new codes. Reimbursement would then be linked to those new codes.
JUSTIFICATION: Back injuries are a common problem for injured employees seeking benefits from the Workers' Compensation program. For many diagnoses, spinal fusion surgery is the recommended treatment for such individuals and results in superior outcomes than other treatments. In most cases, the use of spinal implants is the preferable method of performing fusion surgery and has become the medical standard of care. From a financial standpoint, however, performing fusion surgery with implants involves a higher surgical cost, that cost is more than recouped in saving derived from a shorter hospital stay, more effective rehabilitation and better results. The ability of the patient to return to work sooner presents additional savings for employers and insurers with a Workers' Compensation injury or disability.
LEGISLATIVE HISTORY: This is a new bill.
FISCAL IMPLICATIONS: None.
EFFECTIVE DATE: This act shall take effect immediately.
STATE OF NEW YORK ________________________________________________________________________ 4559--A 2011-2012 Regular Sessions IN SENATE April 12, 2011 ___________Introduced by Sen. ROBACH -- read twice and ordered printed, and when printed to be committed to the Committee on Labor -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee AN ACT to amend the workers' compensation law, in relation to the rates of payment for the treatment and care of injured employees; and providing 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: Section 1. Section 13 of the workers' compensation law is amended by adding a new subdivision (a-1) to read as follows: (A-1) NOTWITHSTANDING THE PROVISIONS OF SUBDIVISION FOUR OF SECTION TWENTY-EIGHT HUNDRED SEVEN AND SUBDIVISION ONE OF SECTION TWENTY-EIGHT HUNDRED SEVEN-C OF THE PUBLIC HEALTH LAW, PAYMENTS TO GENERAL HOSPITALS FOR AP-DRGS 755-758 (SPINAL FUSION; BACK AND NECK PROCEDURES), 806-807 (COMBINED ANTERIOR AND POSTERIOR SPINAL FUSIONS), 836-837 (SPINAL PROCE- DURES), AND 864-865 (CERVICAL SPINAL FUSION) FROM APRIL FIRST, TWO THOU- SAND SIX THROUGH NOVEMBER THIRTIETH, TWO THOUSAND NINE AND FOR APR-DRGS 23 (SPINAL PROCEDURES), 303 (DORSAL AND LUMBAR FUSION PROCEDURES FOR CURVATURE OF BACK), 304 (DORSAL AND LUMBAR FUSION PROCEDURES EXCEPT FOR CURVATURE OF BACK), 310 (INTERVERTEBRAL DISC EXCISION AND DECOM- PRESSION), AND 321 (CERVICAL SPINAL FUSION AND OTHER BACK/NECK PROCE- DURES EXCLUDING DISC EXCISION/DECOMPRESSION) BEGINNING ON AND AFTER DECEMBER FIRST, TWO THOUSAND NINE SHALL BE AT THE RATES OF PAYMENT DETERMINED PURSUANT TO SECTION TWENTY-EIGHT HUNDRED SEVEN-C OF THE PUBLIC HEALTH LAW FOR STATE GOVERNMENTAL AGENCIES, EXCLUDING ADJUSTMENTS PURSUANT TO SUBDIVISION FOURTEEN-F OF SUCH SECTION TWENTY-EIGHT HUNDRED SEVEN-C, PLUS THE PROVIDER'S DOCUMENTED COST FOR ANY IMPLANTABLE HARD- WARE, INSTRUMENTATION, AND OTHER SURGICALLY-NECESSARY BINDING AGENTS/MATERIALS WHICH SHOULD BE RECORDED UNDER REVENUE CODE 278 ON THEEXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD09984-05-1 S. 4559--A 2
CLAIM, PLUS AN ADDITIONAL TEN PERCENT OF SUCH DOCUMENTED COST NOT TO EXCEED A MAXIMUM OF THREE HUNDRED FIFTY DOLLARS. S 2. This act shall take effect immediately; and shall be deemed to have been in full force and effect on and after April 1, 2006, and shall expire on April 1, 2012 when upon such date the provisions of this act shall be deemed repealed.