Bill Text: NY A07755 | 2011-2012 | General Assembly | Introduced

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Bill Title: Relates to pre-authorized procedures.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced - Dead) 2011-05-23 - enacting clause stricken [A07755 Detail]

Download: New_York-2011-A07755-Introduced.html

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                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         7755
                              2011-2012 Regular Sessions
                                 I N  A S S E M B L Y
                                     May 16, 2011
                                      ___________
       Introduced by M. of A. TENNEY -- read once and referred to the Committee
         on Labor
       AN  ACT  to  amend the workers' compensation law, in relation to pre-au-
         thorized procedures
         THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section  1. Subdivision 5 of section 13-a of the workers' compensation
    2  law, as amended by chapter 6 of the laws of 2007, is amended to read  as
    3  follows:
    4    (5)  No  claim  for  specialist  consultations,  surgical  operations,
    5  physiotherapeutic or occupational therapy procedures, x-ray examinations
    6  or special diagnostic laboratory tests costing more  than  one  thousand
    7  dollars shall be valid and enforceable, as against such employer, unless
    8  such  special  services shall have been authorized by the employer or by
    9  the board, or unless such authorization has been unreasonably  withheld,
   10  or  withheld for a period of more than thirty calendar days from receipt
   11  of a request for authorization, or  unless  such  special  services  are
   12  required in an emergency, provided, however, that the basis for a denial
   13  of  such  authorization  by  the employer must be based on a conflicting
   14  second opinion rendered by a physician  authorized  by  the  board.  The
   15  board, with the approval of the superintendent of insurance, shall issue
   16  and  maintain  a  list  of pre-authorized procedures under this section.
   17  SUCH LIST OF PRE-AUTHORIZED PROCEDURES SHALL BE  ISSUED  AND  MAINTAINED
   18  FOR  THE  SOLE PURPOSE OF EXPEDITING AUTHORIZATION OF PATIENT TREATMENT.
   19  SUCH LIST OF PRE-AUTHORIZED PROCEDURES SHALL NOT BE UTILIZED AS  MEDICAL
   20  GUIDELINES  OR  TO  DIRECT PATIENT CARE IN ANY WAY NOR SHALL ANY PRE-AU-
   21  THORIZED PROCEDURE BE GIVEN  PREFERENCE  OVER  AN  ALTERNATIVE  FORM  OF
   22  TREATMENT  THAT  HAS  NOT  BEEN  PLACED ON THE PRE-AUTHORIZED PROCEDURES
   23  LIST.
   24    S 2. This act shall take effect immediately.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD10942-01-1