Bill Text: NY S05373 | 2011-2012 | General Assembly | Introduced


Bill Title: Enacts the "adversarial medical examination procedure act"; authorizes adversarial medical examinations and limits any physician-patient relationship resulting from such a medical examination; provides that the person subject to the examination shall have the right to representation.

Spectrum: Bipartisan Bill

Status: (Introduced - Dead) 2012-01-04 - REFERRED TO JUDICIARY [S05373 Detail]

Download: New_York-2011-S05373-Introduced.html
                           S T A T E   O F   N E W   Y O R K
       ________________________________________________________________________
                                         5373
                              2011-2012 Regular Sessions
                                   I N  S E N A T E
                                     May 13, 2011
                                      ___________
       Introduced  by  Sen.  DeFRANCISCO -- read twice and ordered printed, and
         when printed to be committed to the Committee on Judiciary
       AN ACT to amend the civil practice law and rules, the insurance law, the
         workers' compensation law, the general municipal law and the court  of
         claims  act, in relation to enacting the "adversarial medical examina-
         tion procedure act"
         THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
       BLY, DO ENACT AS FOLLOWS:
    1    Section  1.  Short title.  This act shall be known and may be cited as
    2  the "adversarial medical examination procedure act".
    3    S 2. The legislature hereby finds and declares that the conducting  of
    4  physical  and  mental examinations in the course of civil litigation and
    5  other civil proceedings has evolved in a manner  inconsistent  with  the
    6  civil  practice  law  and  rules and fundamental notions of due process.
    7  Indeed, a commonly used term  for  such  examinations,  an  "independent
    8  medical  examination,"  is  itself  a  misnomer  because  the  physician
    9  conducting such examination is not at all independent, but  is  in  fact
   10  being  compensated  by  a party or insurer whose interests are typically
   11  adverse to those of the party being  examined.  Further,  parties  being
   12  examined  are  frequently required to provide written responses to ques-
   13  tions outside the discovery process prescribed in the civil practice law
   14  and rules or relevant claims process  and  without  the  opportunity  to
   15  obtain advice of counsel, even though such written responses can and are
   16  being  used  as admissions and/or to later impeach the examined party in
   17  the course of such proceeding.  Accordingly, the name by which  such  an
   18  examination  is  called  needs  to be changed to reflect the true adver-
   19  sarial nature of such examination; the process for obtaining information
   20  from the party to be examined which is necessary to the proper  conduct-
   21  ing  of the examination needs to be brought within the carefully consid-
   22  ered discovery process which already exists in the  civil  practice  law
   23  and rules or claims process.
        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD01389-02-1
       S. 5373                             2
    1    S 3. Section 3121 of the civil practice law and rules, subdivision (a)
    2  as  amended  by  chapter  294 of the laws of 1984, is amended to read as
    3  follows:
    4    S  3121.  [Physical  or  mental]  ADVERSARIAL MEDICAL examination. (a)
    5  Notice of AN ADVERSARIAL MEDICAL examination. After commencement  of  an
    6  action  in which the mental or physical condition or the blood relation-
    7  ship of a party, or of an agent, employee or person in  the  custody  or
    8  under  the  legal  control  of a party, is in controversy, any party may
    9  serve notice on another party to submit to a physical, mental  or  blood
   10  [examination]  "ADVERSARIAL  MEDICAL EXAMINATION" by a designated physi-
   11  cian, or to produce for such ADVERSARIAL MEDICAL examination his OR  HER
   12  agent,  employee or the person in his OR HER custody or under his OR HER
   13  legal control. The notice may require  duly  executed  and  acknowledged
   14  written authorizations permitting all parties to obtain, and make copies
   15  of,  the records of specified hospitals relating to such mental or phys-
   16  ical condition or blood relationship; where a party obtains a copy of  a
   17  hospital record as a result of the authorization of another party, he OR
   18  SHE  shall  deliver a duplicate of the copy to such party. A copy of the
   19  notice shall be served on the person SUBJECT to [be examined] THE ADVER-
   20  SARIAL MEDICAL EXAMINATION.  It shall specify the time, which  shall  be
   21  not  less  than  twenty days after service of the notice, and the condi-
   22  tions and scope of the ADVERSARIAL MEDICAL  examination,  AND  IT  SHALL
   23  INFORM  THE  PERSON  SUBJECT  TO  THE EXAMINATION THAT HE OR SHE HAS THE
   24  RIGHT TO HAVE A REPRESENTATIVE  PRESENT  DURING  SUCH  EXAMINATION,  AND
   25  SHALL HAVE THE RIGHT TO RECORD OR TAPE SUCH EXAMINATION IN A MANNER SUCH
   26  AS  NOT  TO UNREASONABLY IMPEDE SUCH EXAMINATION.  THE PERSON SUBJECT TO
   27  THE ADVERSARIAL MEDICAL EXAMINATION SHALL NOT BE REQUIRED TO PRODUCE ANY
   28  DOCUMENTS OR SUPPLY ANY WRITTEN ANSWERS TO QUESTIONS PUT TO HIM  OR  HER
   29  AT  SUCH  EXAMINATION EXCEPT AS IN RESPONSE TO PROPERLY SERVED DISCOVERY
   30  DEMANDS MADE PURSUANT TO THE CIVIL PRACTICE LAW AND RULES.
   31    (b) Copy of report. A copy of a detailed written report of the examin-
   32  ing physician setting out [his] THE  findings  and  conclusions  OF  THE
   33  ADVERSARIAL  MEDICAL EXAMINATION shall be delivered by the party seeking
   34  the ADVERSARIAL MEDICAL examination to [any] EACH party  [requesting  to
   35  exchange therefor a copy of each report in his control of an examination
   36  made  with  respect  to the mental or physical condition in controversy]
   37  WITHIN THIRTY DAYS OF SUCH EXAMINATION.
   38    (C) FAILURE TO EXCHANGE. NOTHING CONTAINED IN THIS SECTION SHALL LIMIT
   39  THE RIGHTS OF ANY PARTY FROM MOVING TO PRECLUDE  OR  FOR  SEEKING  OTHER
   40  SANCTIONS  PURSUANT TO RULE 3124 OR SECTION 3126 FOR FAILURE TO EXCHANGE
   41  A DETAILED WRITTEN REPORT OF AN "ADVERSARIAL MEDICAL  EXAMINATION"  UPON
   42  OTHER PARTIES TO AN ACTION.
   43    S  4.    Section  5102 of the insurance law is amended by adding a new
   44  subsection (n) to read as follows:
   45    (N) "ADVERSARIAL MEDICAL EXAMINATION" MEANS ANY  PHYSICAL  EXAMINATION
   46  REQUESTED  BY  AN  INSURER  MADE IN RESPONSE TO A CLAIM MADE PURSUANT TO
   47  BENEFITS UNDER THIS ARTICLE. THE PERSON  SUBJECT  TO  EXAMINATION  SHALL
   48  HAVE  THE RIGHT TO HAVE A REPRESENTATIVE PRESENT DURING SUCH EXAMINATION
   49  AND SHALL HAVE THE RIGHT TO RECORD OR TAPE SUCH EXAMINATION IN A  MANNER
   50  SUCH  AS  NOT  TO UNREASONABLY IMPEDE SUCH EXAMINATION. THE PERSON TO BE
   51  EXAMINED SHALL BE INFORMED OF SUCH RIGHTS AT LEAST TWENTY DAYS PRIOR  TO
   52  SUCH  EXAMINATION.   IF SUCH EXAMINATION SHALL BE USED TO DENY, IN WHOLE
   53  OR IN PART, ANY BENEFITS UNDER THIS SECTION,  A  COPY  OF  THE  DETAILED
   54  WRITTEN  REPORT  OF SUCH EXAMINATION, WRITTEN BY THE EXAMINING PHYSICIAN
   55  OR HEALTH CARE PROFESSIONAL, SHALL BE PROVIDED TO THE INJURED PARTY  AND
   56  ANY  THIRD-PARTY  MEDICAL  PROVIDER  TO  WHOM THE INJURED PARTY MAY HAVE
       S. 5373                             3
    1  ASSIGNED HIS OR HER CLAIM OR CLAIMS FOR BENEFITS ALONG WITH  ANY  DENIAL
    2  OF  BENEFITS. IN THE EVENT SUCH REPORT IS NOT SO PROVIDED BY THE INSURER
    3  OR SELF-INSURER ALONG WITH THE DENIAL, THE INSURER  SHALL  BE  PRECLUDED
    4  FROM USING SUCH REPORT TO SUPPORT ANY DENIAL OF SUCH CLAIM.
    5    S  5.  Subdivision 4 of section 13-a of the workers' compensation law,
    6  as amended by chapter 473 of the laws of 2000, is  amended  to  read  as
    7  follows:
    8    (4)  (a) No claim for medical or surgical treatment shall be valid and
    9  enforceable, as  against  such  employer,  or  employee,  unless  within
   10  forty-eight  hours  following  the  first treatment the physician giving
   11  such treatment furnishes to the employer and directly  to  the  chair  a
   12  preliminary  notice  of  such  injury and treatment, within fifteen days
   13  thereafter a  more  complete  report  and  subsequent  thereto  progress
   14  reports  if requested in writing by the chair, board, employer or insur-
   15  ance carrier at intervals of not less than three weeks apart or at  less
   16  frequent  intervals  if requested on forms prescribed by the chair.  The
   17  board may excuse failure to give  such  notices  within  the  designated
   18  periods when it finds it to be in the interest of justice to do so.
   19    (b)  Upon  receipt of the notice provided for by paragraph (a) of this
   20  subdivision, the employer, the carrier, and the claimant each  shall  be
   21  entitled  to have the claimant examined by a physician authorized by the
   22  chair in accordance with sections thirteen-b and one hundred thirty-sev-
   23  en of this chapter, at a medical facility convenient to the claimant and
   24  in the presence of the claimant's physician, and refusal by the claimant
   25  to submit to such [independent] ADVERSARIAL medical examination at  such
   26  time  or  times  as  may  reasonably  be necessary in the opinion of the
   27  board, shall bar the claimant from recovering compensation for any peri-
   28  od during which he or she has refused to submit to such examination.  No
   29  hospital shall be required to produce the records of any claimant  with-
   30  out  receiving  its  customary  fees or charges for reproduction of such
   31  records.
   32    (c) Where it would place an unreasonable burden upon the  employer  or
   33  carrier  to arrange for, or for the claimant to attend, an [independent]
   34  ADVERSARIAL medical examination by an authorized physician, the employer
   35  or carrier shall arrange for such examination to be performed by a qual-
   36  ified physician in a medical facility convenient to the claimant.
   37    (d) The [independent] ADVERSARIAL medical examiner shall provide  such
   38  reports and shall submit to investigation as required by the chair.
   39    (e)  In  order to qualify as admissible medical evidence, for purposes
   40  of adjudicating any claim under this chapter, any  report  submitted  to
   41  the  board  by an [independent] ADVERSARIAL medical examiner licensed by
   42  the state of New York shall include the following:
   43    (i) a signed statement certifying that the report is a full and truth-
   44  ful representation of the [independent] ADVERSARIAL  medical  examiner's
   45  professional opinion with respect to the claimant's condition:
   46    (ii) such examiner's board issued authorization number;
   47    (iii) the name of the individual or entity requesting the examination;
   48    (iv)  if  applicable,  the  registration number as required by section
   49  thirteen-n of this article; and
   50    (v) such other information as the chair may require by regulation.
   51    Any report by an [independent] ADVERSARIAL medical examiner who is not
   52  authorized, and who performs an [independent] ADVERSARIAL medical  exam-
   53  ination  in  accordance with paragraph (c) of this subdivision, which is
   54  to be used as medical evidence under this chapter, shall include in  the
   55  report such information as the chair may require by regulation.
       S. 5373                             4
    1    S 6. Subdivisions 1 and 2 of section 13-b of the workers' compensation
    2  law,  as amended by chapter 473 of the laws of 2000, are amended to read
    3  as follows:
    4    1.  Upon  the  recommendation  of the medical society of the county in
    5  which the physician's office is located or of a board designated by such
    6  county society or of a board representing duly  licensed  physicians  of
    7  any  other  school  of  medical  practice  in such county, the chair may
    8  authorize physicians licensed to practice medicine in the state  of  New
    9  York to render medical care under this chapter and to perform [independ-
   10  ent]  ADVERSARIAL  medical  examinations  in accordance with subdivision
   11  four of section thirteen-a of this article. If, within sixty days  after
   12  the  chair  requests  such  recommendations  the medical society of such
   13  county or board fails to act, or if there is no  such  society  in  such
   14  county,  the  chair  shall designate a board of three outstanding physi-
   15  cians, who shall make the requisite recommendations.
   16    No such authorization shall be made in the absence of a recommendation
   17  of the appropriate society or board or of a review and recommendation by
   18  the medical appeals unit. No person shall render medical care or conduct
   19  [independent] ADVERSARIAL medical examinations under this chapter  with-
   20  out such authorization by the chair, provided, that:
   21    (a)  Any  physician  licensed to practice medicine in the state of New
   22  York may render  emergency  medical  care  under  this  chapter  without
   23  authorization by the chair under this section; and
   24    (b)  A  licensed  physician  who  is a member of a constituted medical
   25  staff of any hospital may render medical care under this  chapter  while
   26  an injured employee remains a patient in such hospital; and
   27    (c)  Under the active and personal supervision of an authorized physi-
   28  cian medical care may be rendered by a registered nurse or other  person
   29  trained  in laboratory or diagnostic techniques within the scope of such
   30  person's specialized training and qualifications. This supervision shall
   31  be evidenced by signed records of instructions for treatment and  signed
   32  records  of the patient's condition and progress. Reports of such treat-
   33  ment and supervision shall be made by such physician  to  the  chair  on
   34  such forms and at such times as the chair may require.
   35    (d)  Upon  the  referral  which may be directive as to treatment of an
   36  authorized physician physical therapy care may be  rendered  by  a  duly
   37  licensed  physical  therapist.  Where  physical therapy care is rendered
   38  records of the patient's condition and progress, together  with  records
   39  of  instruction  for treatment, if any, shall be maintained by the phys-
   40  ical therapist and physician. Said records shall  be  submitted  to  the
   41  chair on such forms and at such times as the chair may require.
   42    (e) Upon the prescription or referral of an authorized physician occu-
   43  pational  therapy  care  may be rendered by a duly licensed occupational
   44  therapist. Where occupational therapy care is rendered  records  of  the
   45  patient's  condition  and progress, together with records of instruction
   46  for treatment, if any shall be maintained by the occupational  therapist
   47  and physician. Said records shall be submitted to the chair on forms and
   48  at such times as the chair may require.
   49    (f)  Where  it would place an unreasonable burden upon the employer or
   50  carrier to arrange for, or for the claimant to attend, an  [independent]
   51  ADVERSARIAL medical examination by an authorized physician, the employer
   52  or carrier shall arrange for such examination to be performed by a qual-
   53  ified physician in a medical facility convenient to the claimant.
   54    2.  A physician licensed to practice medicine in the state of New York
   55  who is desirous of being authorized to render medical  care  under  this
   56  chapter and/or to conduct [independent] ADVERSARIAL medical examinations
       S. 5373                             5
    1  in  accordance  with  paragraph (b) of subdivision four of section thir-
    2  teen-a and section one hundred thirty-seven of this chapter  shall  file
    3  an  application  for  authorization  under this chapter with the medical
    4  society  in  the county in which his or her office is located, or with a
    5  board designated by such society, or with  a  board  designated  by  the
    6  chair  as  provided  in  this section. In such application the applicant
    7  shall state his or her training and qualifications, and shall  agree  to
    8  limit  his  or  her  professional  activities under this chapter to such
    9  medical care and [independent] ADVERSARIAL medical examinations, as  his
   10  or  her experience and training qualify him or her to render. The appli-
   11  cant shall further agree  to  refrain  from  subsequently  treating  for
   12  remuneration,  as  a  private patient, any person seeking medical treat-
   13  ment, or submitting to an [independent] ADVERSARIAL medical examination,
   14  in connection with, or as a result of, any injury compensable under this
   15  chapter, if he or she has been  removed  from  the  list  of  physicians
   16  authorized  to  render  medical  care or to conduct [independent] ADVER-
   17  SARIAL medical examinations under this chapter, or if the person seeking
   18  such treatment, or submitting to an  [independent]  ADVERSARIAL  medical
   19  examination,  has  been  transferred  from his or her care in accordance
   20  with the provisions of this chapter. This agreement  shall  run  to  the
   21  benefit  of  the  injured  person  so  treated or examined, and shall be
   22  available to him or her as a defense in any action by such physician for
   23  payment for treatment rendered by a physician after he or she  has  been
   24  removed from the list of physicians authorized to render medical care or
   25  to  conduct  [independent]  ADVERSARIAL  medical examinations under this
   26  chapter, or after the injured person was transferred  from  his  or  her
   27  care  in  accordance  with  the  provisions of this chapter. The medical
   28  society or the board  designated  by  it,  or  the  board  as  otherwise
   29  provided  under  this  section, if it deems such licensed physician duly
   30  qualified, shall recommend to the chair that such physician  be  author-
   31  ized  to  render  medical  care and/or conduct [independent] ADVERSARIAL
   32  medical examinations under this chapter,  and  such  recommendation  and
   33  authorization  shall specify the character of the medical care or [inde-
   34  pendent] ADVERSARIAL medical examination which such physician is  quali-
   35  fied  and  authorized to render under this chapter. Such recommendations
   36  shall be advisory to the chair only and shall not be binding or  conclu-
   37  sive  upon him or her. The licensed physician may present to the medical
   38  society or board, evidences of additional  qualifications  at  any  time
   39  subsequent to his or her original application. If the medical society or
   40  board  fails to recommend to the chair that a physician be authorized to
   41  render medical care and/or to conduct [independent] ADVERSARIAL  medical
   42  examinations under this chapter, the physician may appeal to the medical
   43  appeals  unit. The medical society or the board designated by it, or the
   44  board as otherwise provided under this section, may upon its own  initi-
   45  ative, or shall upon request of the chair, review at any time the quali-
   46  fications  of  any  physician as to the character of the medical care or
   47  [independent] ADVERSARIAL medical examinations which such physician  has
   48  theretofore  been authorized to render under this chapter and may recom-
   49  mend to the chair that such physician be authorized  to  render  medical
   50  care or to conduct [independent] ADVERSARIAL medical examinations there-
   51  after of the character which such physician is then qualified to render.
   52  On  such  advisory recommendation the chair may review and after reason-
   53  able investigation may  revise  the  authorization  of  a  physician  in
   54  respect to the character of medical care and/or to conduct [independent]
   55  ADVERSARIAL  medical  examinations  which  he  or  she  is authorized to
   56  render. If the medical society or board recommends to the chair  that  a
       S. 5373                             6
    1  physician  be authorized to render medical care and/or to conduct [inde-
    2  pendent] ADVERSARIAL medical examinations under this chapter of a  char-
    3  acter  different  from  the  character  of medical care or [independent]
    4  ADVERSARIAL  medical examinations he or she has been theretofore author-
    5  ized to render, such physician may appeal from  such  recommendation  to
    6  the medical appeals unit.
    7    S  7. The section heading and the opening paragraph and paragraphs (b)
    8  and (g) of subdivision 2 of section 13-d of  the  workers'  compensation
    9  law,  the  section  heading,  the opening paragraph and paragraph (g) of
   10  subdivision 2, as amended by chapter 473 of the laws of 2000,  paragraph
   11  (b)  of  subdivision 2, as amended by chapter 6 of the laws of 2007, are
   12  amended to read as follows:
   13    Removal of physicians from lists of those authorized to render medical
   14  care or to conduct [independent] ADVERSARIAL medical examinations.
   15    The chair shall remove from  the  list  of  physicians  authorized  to
   16  render  medical  care  under  this  chapter, or to conduct [independent]
   17  ADVERSARIAL medical examinations in accordance  with  paragraph  (b)  of
   18  subdivision  four of section thirteen-a of this article, the name of any
   19  physician who he or she shall find  after  reasonable  investigation  is
   20  disqualified because such physician:
   21    (b)  has  exceeded the limits of his or her professional competence in
   22  rendering  medical  care  or  in  conducting  [independent]  ADVERSARIAL
   23  medical  examinations under the law, or has made materially false state-
   24  ments regarding his or her qualifications in his or her application  for
   25  the  recommendation  of  the  medical  society  or  board as provided in
   26  section thirteen-b of this article; or
   27    (g) has directly or indirectly requested, received or participated  in
   28  the division, transference, assignment, rebating, splitting or refunding
   29  of a fee for, or has directly or indirectly requested, received or prof-
   30  ited  by  means of a credit or other valuable consideration as a commis-
   31  sion, discount or gratuity in connection with the furnishing of  medical
   32  or  surgical  care,  an  [independent]  ADVERSARIAL medical examination,
   33  diagnosis or treatment  or  service,  including  X-ray  examination  and
   34  treatment,  or  for or in connection with the sale, rental, supplying or
   35  furnishing of clinical laboratory services or supplies, X-ray laboratory
   36  services or supplies, inhalation therapy service or equipment, ambulance
   37  service, hospital or medical supplies, physiotherapy or other  therapeu-
   38  tic service or equipment, artificial limbs, teeth or eyes, orthopedic or
   39  surgical  appliances or supplies, optical appliances, supplies or equip-
   40  ment, devices for aid of hearing, drugs, medication or medical supplies,
   41  or any other goods, services or supplies prescribed for medical  diagno-
   42  sis,  care  or  treatment,  under  this  chapter; except that reasonable
   43  payment, not exceeding the technical  component  fee  permitted  in  the
   44  medical  fee schedule, established under this chapter for X-ray examina-
   45  tions, diagnosis or treatment, may be made by a physician  duly  author-
   46  ized  as  a  roentgenologist  to  any hospital furnishing facilities and
   47  equipment for such examination, diagnosis or  treatment,  provided  such
   48  hospital  does  not  also submit a charge for the same services. Nothing
   49  contained in this paragraph shall prohibit such physicians who  practice
   50  as  partners, in groups or as a professional corporation or as a univer-
   51  sity faculty practice corporation from pooling fees and moneys received,
   52  either by the partnership, professional corporation, university  faculty
   53  practice  corporation  or  group  by the individual members thereof, for
   54  professional services furnished by any individual  professional  member,
   55  or  employee  of  such  partnership, corporation or group, nor shall the
   56  professionals constituting the partnerships, corporations, or groups  be
       S. 5373                             7
    1  prohibited  from  sharing,  dividing or apportioning the fees and moneys
    2  received by them or by the partnership, corporation or group in  accord-
    3  ance with a partnership or other agreement.
    4    S 8. Subdivisions 2 and 3, and the opening paragraph and paragraph (g)
    5  of  subdivision  10 of section 13-k of the workers' compensation law, as
    6  amended by chapter 473 of the laws of  2000,  are  amended  to  read  as
    7  follows:
    8    2.  An  employee  injured  under  circumstances which make such injury
    9  compensable under this article, when care is required for an  injury  to
   10  the  foot  which injury or resultant condition therefrom may lawfully be
   11  treated by a duly registered and licensed podiatrist of the state of New
   12  York, may select to treat him or her any podiatrist  authorized  by  the
   13  chair to render podiatry care, as hereinafter provided. If the injury or
   14  condition is one which is without the limits prescribed by the education
   15  law  for  podiatry  care  and treatment, or the injuries involved affect
   16  other parts of the body in addition to the  foot,  the  said  podiatrist
   17  must  so  advise  the  said  injured employee and instruct him or her to
   18  consult a physician of said employee's choice for appropriate  care  and
   19  treatment.  Such physician shall thenceforth have overall supervision of
   20  the treatment of said patient  including  the  future  treatment  to  be
   21  administered  to the patient by the podiatrist. If for any reason during
   22  the period when podiatry treatment and care is  required,  the  employee
   23  wishes  to  transfer his or her treatment and care to another authorized
   24  podiatrist he or she may do so, in accordance with rules  prescribed  by
   25  the  chair,  provided  however that the employer shall be liable for the
   26  proper fees of the original podiatrist for the care and treatment he  or
   27  she  shall  have rendered. A podiatrist licensed and registered to prac-
   28  tice podiatry in the state of New York who is desirous of being  author-
   29  ized to render podiatry care under this section and/or to conduct [inde-
   30  pendent]  ADVERSARIAL  medical examinations in accordance with paragraph
   31  (b) of subdivision three of this section shall file an  application  for
   32  authorization  under  this section with the podiatry practice committee.
   33  In such application he or she shall agree to refrain  from  subsequently
   34  treating  for  remuneration,  as  a  private patient, any person seeking
   35  podiatry  treatment,  or  submitting  to  an  [independent]  ADVERSARIAL
   36  medical  examination,  in connection with, or as a result of, any injury
   37  compensable under this chapter, if he or she has been removed  from  the
   38  list  of  podiatrists  authorized  to render podiatry care or to conduct
   39  [independent] ADVERSARIAL medical examinations under this chapter, or if
   40  the person seeking such treatment has been transferred from his  or  her
   41  care  in  accordance with the provisions of this section. This agreement
   42  shall run to the benefit of the injured person so treated  or  examined,
   43  and  shall be available to him or her as a defense in any action by such
   44  podiatrist for payment for treatment rendered by a podiatrist  after  he
   45  or  she  has  been  removed  from  the list of podiatrists authorized to
   46  render podiatry care or to  conduct  [independent]  ADVERSARIAL  medical
   47  examinations  under this section, or after the injured person was trans-
   48  ferred from his or her care in accordance with the  provisions  of  this
   49  section.  The  podiatry  practice  committee  if  it deems such licensed
   50  podiatrist duly qualified shall recommend to the chair that such  podia-
   51  trist be authorized to render podiatry care and/or to conduct [independ-
   52  ent] ADVERSARIAL medical examinations under this section. Such recommen-
   53  dation  shall  be advisory to the chair only and shall not be binding or
   54  conclusive upon him or her. The chair  shall  prepare  and  establish  a
   55  schedule  for  the state, or schedules limited to defined localities, of
   56  charges and fees for podiatry treatment and care, to  be  determined  in
       S. 5373                             8
    1  accordance with and to be subject to change pursuant to rules promulgat-
    2  ed  by the chair. Before preparing such schedule for the state or sched-
    3  ules for limited localities the chair shall request the  podiatry  prac-
    4  tice  committee  to  submit  to  him  or  her  a report on the amount of
    5  remuneration deemed by such committee to be fair and  adequate  for  the
    6  types  of podiatry care to be rendered under this chapter, but consider-
    7  ation shall be given to the view  of  other  interested  parties.    The
    8  amounts payable by the employer for such treatment and services shall be
    9  the fees and charges established by such schedule.
   10    3.  (a)  No  claim  for  podiatry care or treatment shall be valid and
   11  enforceable as against the employer or  employee  unless  within  forty-
   12  eight  hours  following  the  first treatment the podiatrist giving such
   13  care or treatment furnish to the employer and directly to  the  chair  a
   14  preliminary  notice  of  such  injury and treatment, within fifteen days
   15  thereafter a  more  complete  report  and  subsequent  thereto  progress
   16  reports  as requested in writing by the chair, board, employer or insur-
   17  ance carrier, at intervals of not less than three weeks apart or at less
   18  frequent intervals if requested on forms prescribed by the chair.    The
   19  board  may excuse the failure to give such notices within the designated
   20  periods when it finds it to be in the interest of justice to do so.
   21    (b) Upon receipt of the notice provided for by paragraph (a)  of  this
   22  subdivision,  the  employer,  the carrier and the claimant each shall be
   23  entitled to have the claimant examined by a qualified podiatrist author-
   24  ized by the chair in accordance with subdivision two of this section and
   25  section one hundred thirty-seven of this chapter, at a medical  facility
   26  convenient  to the claimant and in the presence of the claimant's podia-
   27  trist, and refusal by the  claimant  to  submit  to  such  [independent]
   28  ADVERSARIAL  medical examination at such time or times as may reasonably
   29  be necessary in the opinion of the board shall  bar  the  claimant  from
   30  recovering  compensation  for  any  period  during  which  he or she has
   31  refused to submit to such examination.
   32    (c) Where it would place an unreasonable burden upon the  employer  or
   33  carrier  to arrange for, or for the claimant to attend, an [independent]
   34  ADVERSARIAL medical examination by an authorized podiatrist, the employ-
   35  er or carrier shall arrange for such examination to be  performed  by  a
   36  qualified podiatrist in a medical facility convenient to the claimant.
   37    (d)  The  [independent]  ADVERSARIAL  podiatric examiner shall provide
   38  such reports and shall submit to investigation as required by the chair.
   39    (e) In order to qualify as admissible medical evidence,  for  purposes
   40  of  adjudicating  any  claim under this chapter, any report submitted to
   41  the board by an [independent] ADVERSARIAL podiatric examiner licensed by
   42  the state of New York shall include the following:
   43    (i) a signed statement certifying that the report is a full and truth-
   44  ful representation of the [independent] ADVERSARIAL podiatric examiner's
   45  professional opinion with respect to the claimant's condition,
   46    (ii) such examiner's board issued authorization number,
   47    (iii) the name of the individual or entity requesting the examination,
   48    (iv) if applicable, the registration number  as  required  by  section
   49  thirteen-n of this article, and
   50    (v) such other information as the chair may require by regulation.
   51    The podiatry practice committee shall investigate, hear and make find-
   52  ings  with respect to all charges as to professional or other misconduct
   53  of any authorized podiatrist as herein provided under rules  and  proce-
   54  dures  to  be  prescribed by the chair and shall report evidence of such
   55  misconduct, with their findings and recommendation with respect thereto,
   56  to the chair. The findings, decision and recommendation of such podiatry
       S. 5373                             9
    1  practice committee shall be advisory to the chair only, and shall not be
    2  binding or conclusive upon him or her. The chair shall remove  from  the
    3  list  of podiatrists authorized to render podiatry care under this chap-
    4  ter  or  to  conduct  [independent]  ADVERSARIAL medical examinations in
    5  accordance with paragraph (b) of subdivision three of this  section  the
    6  name  of any podiatrist who he or she shall find after reasonable inves-
    7  tigation is disqualified because such podiatrist
    8    (g) has directly or indirectly requested, received or participated  in
    9  the division, transference, assignment, rebating, splitting or refunding
   10  of a fee for, or has directly or indirectly requested, received or prof-
   11  ited  by  means of a credit or other valuable consideration as a commis-
   12  sion, discount or gratuity in connection with the treatment,  or  [inde-
   13  pendent]  ADVERSARIAL  medical  examination,  of a workers' compensation
   14  claimant.   Nothing contained in  this  paragraph  shall  prohibit  such
   15  podiatrists  who  practice  as  partners, in groups or as a professional
   16  corporation from pooling fees and moneys received, either by  the  part-
   17  nership,  professional  corporation  or  group by the individual members
   18  thereof, for professional services furnished by any  individual  profes-
   19  sional  member,  or  employee of such partnership, corporation or group,
   20  nor shall the professionals constituting the  partnership,  corporation,
   21  or  group  be prohibited from sharing, dividing or apportioning the fees
   22  and moneys received by them or by the partnership, corporation or  group
   23  in accordance with a partnership or other agreement.
   24    S 9. Subdivisions 2 and 3, and the opening paragraph and paragraph (g)
   25  of  subdivision  10 of section 13-l of the workers' compensation law, as
   26  amended by chapter 473 of the laws of  2000,  are  amended  to  read  as
   27  follows:
   28    2.  An  employee  injured  under  circumstances which make such injury
   29  compensable under this article, when care  is  required  for  an  injury
   30  which  consists solely of a condition which may lawfully be treated by a
   31  chiropractor as defined in section sixty-five hundred fifty-one  of  the
   32  education  law  may  select to treat him or her, any duly registered and
   33  licensed chiropractor of the state of New York, authorized by the  chair
   34  to  render  chiropractic  care as hereinafter provided. If the injury or
   35  condition is one which is outside the limits prescribed by the education
   36  law for chiropractic care and treatment, the said chiropractor  must  so
   37  advise  the  said  injured employee and instruct him or her to consult a
   38  physician of said employee's choice for appropriate care and  treatment.
   39  Such  physician  shall  thenceforth have supervision of the treatment of
   40  said condition including the future treatment to be administered to  the
   41  patient  by  the chiropractor. A chiropractor licensed and registered to
   42  practice chiropractic in the state of New York, who is desirous of being
   43  authorized to render chiropractic care  under  this  section  and/or  to
   44  conduct  [independent]  ADVERSARIAL  medical  examinations in accordance
   45  with paragraph (b) of subdivision three of this section  shall  file  an
   46  application  for  authorization under this section with the chiropractic
   47  practice committee. In such application he or she shall agree to refrain
   48  from subsequently treating for remuneration, as a private  patient,  any
   49  person seeking chiropractic treatment, or submitting to an [independent]
   50  ADVERSARIAL  medical examination, in connection with, or as a result of,
   51  any injury compensable under this chapter, if he or she has been removed
   52  from the list of chiropractors authorized to render chiropractic care or
   53  to conduct [independent] ADVERSARIAL  medical  examinations  under  this
   54  chapter,  or  if  the person seeking such treatment has been transferred
   55  from his or her care in accordance with the provisions of this  section.
   56  This  agreement shall run to the benefit of the injured person so treat-
       S. 5373                            10
    1  ed, or examined, and shall be available to him or her as  a  defense  in
    2  any  action  by such chiropractor for payment rendered by a chiropractor
    3  after he or she has been removed from the list of chiropractors  author-
    4  ized to render chiropractic care or to conduct [independent] ADVERSARIAL
    5  medical examinations under this section, or after the injured person was
    6  transferred  from  his  or her care in accordance with the provisions of
    7  this section. The chiropractic  practice  committee  if  it  deems  such
    8  licensed  chiropractor  duly qualified shall recommend to the chair that
    9  such be authorized to render chiropractic care and/or to conduct  [inde-
   10  pendent]  ADVERSARIAL  medical  examinations  under  this  section. Such
   11  recommendations shall be advisory to the chair only  and  shall  not  be
   12  binding  or  conclusive  upon  him  or  her. The chair shall prepare and
   13  establish a schedule for the state,  or  schedules  limited  to  defined
   14  localities  of  charges and fees for chiropractic treatment and care, to
   15  be determined in accordance with and to be subject to change pursuant to
   16  rules promulgated by the chair.  Before preparing such schedule for  the
   17  state  or  schedules  for limited localities the chair shall request the
   18  chiropractic practice committee to submit to him or her a report on  the
   19  amount  of remuneration deemed by such committee to be fair and adequate
   20  for the types of chiropractic care to be rendered  under  this  chapter,
   21  but  consideration  shall  be  given  to  the  view  of other interested
   22  parties, the amounts payable by the  employer  for  such  treatment  and
   23  services shall be the fees and charges established by such schedule.
   24    3.  (a) No claim for chiropractic care or treatment shall be valid and
   25  enforceable as against the employer or employees  unless  within  forty-
   26  eight  hours  following the first treatment the chiropractor giving such
   27  care or treatment furnishes to the employer and directly to the chair  a
   28  preliminary notice of such injury and treatment, and within fifteen days
   29  thereafter  a  more  complete  report  and  subsequent  thereto progress
   30  reports as requested in writing by the chair, board, employer or  insur-
   31  ance carrier, at intervals of not less than three weeks apart or at less
   32  frequent  intervals  if  requested on forms prescribed by the chair. The
   33  board may excuse the failure to give such notices within the  designated
   34  periods when it finds it to be in the interest of justice to do so.
   35    (b)  Upon  receipt of the notice provided for by paragraph (a) of this
   36  subdivision, the employer, the carrier, and the claimant each  shall  be
   37  entitled  to  have  the  claimant  examined  by a qualified chiropractor
   38  authorized by the chair in  accordance  with  subdivision  two  of  this
   39  section  and  section  one  hundred  thirty-seven  of  this chapter at a
   40  medical facility convenient to the claimant and in the presence  of  the
   41  claimant's  chiropractor,  and refusal by the claimant to submit to such
   42  [independent] ADVERSARIAL medical examination at such time or  times  as
   43  may  reasonably  be  necessary in the opinion of the board shall bar the
   44  claimant from recovering compensation, for any period during which he or
   45  she has refused to submit to such examination.
   46    (c) Where it would place an unreasonable burden upon the  employer  or
   47  carrier  to arrange for, or for the claimant to attend, an [independent]
   48  ADVERSARIAL medical  examination  by  an  authorized  chiropractor,  the
   49  employer  or  carrier shall arrange for such examination to be performed
   50  by a qualified chiropractor in a  medical  facility  convenient  to  the
   51  claimant.
   52    (d)  The [independent] ADVERSARIAL chiropractic examiner shall provide
   53  such reports and shall submit to investigation as required by the chair.
   54    (e) In order to  qualify  as  admissible  chiropractic  evidence,  for
   55  purposes  of  adjudicating  any  claim  under  this  chapter, any report
       S. 5373                            11
    1  submitted to the board by an [independent] ADVERSARIAL medical  examiner
    2  licensed by the state of New York shall include the following:
    3    (i) a signed statement certifying that the report is a full and truth-
    4  ful representation of the [independent] ADVERSARIAL chiropractic examin-
    5  er's professional opinion with respect to the claimant's condition,
    6    (ii) such examiner's board issued authorization number,
    7    (iii) the name of the individual or entity requesting the examination,
    8    (iv)  if  applicable,  the  registration number as required by section
    9  thirteen-n of this article, and
   10    (v) such other information as the chair may require by regulation.
   11    The chiropractic practice committee shall investigate, hear  and  make
   12  findings with respect to all charges as to professional or other miscon-
   13  duct  of  any authorized chiropractor as herein provided under rules and
   14  procedure to be prescribed by the chair and  shall  report  evidence  of
   15  such  misconduct,  with  their findings and recommendations with respect
   16  thereto, to the chair. The findings, decision and recommendation of such
   17  chiropractic practice committee shall be advisory to the chair only, and
   18  shall not be binding or conclusive upon him  or  her.  The  chair  shall
   19  remove  from the list of chiropractors authorized to render chiropractic
   20  care under this chapter or to conduct [independent] ADVERSARIAL  medical
   21  examinations  in  accordance  with paragraph (b) of subdivision three of
   22  this section the name of any chiropractor who he or she shall find after
   23  reasonable investigation is disqualified because such chiropractor,
   24    (g) has directly or indirectly requested, received or participated  in
   25  the division, transference, assignment, rebating, splitting or refunding
   26  of a fee for, or has directly or indirectly requested, received or prof-
   27  ited  by  means  of  a  credit  or otherwise valuable consideration as a
   28  commission, discount or gratuity, in connection with the  treatment,  or
   29  [independent]  ADVERSARIAL  medical  examination,  of a workers' compen-
   30  sation claimant.   Nothing contained in this  paragraph  shall  prohibit
   31  such  chiropractors  who practice as partners, in groups or as a profes-
   32  sional corporation, or as a university faculty practice corporation from
   33  pooling fees and moneys received, either  by  the  partnership,  profes-
   34  sional  corporation, university faculty practice corporation or group by
   35  the individual members thereof, for professional services  furnished  by
   36  any  individual  professional  member,  or employee of such partnership,
   37  corporation or group, nor shall the professionals constituting the part-
   38  nership, corporation, or group be prohibited from sharing,  dividing  or
   39  apportioning the fees and moneys received by them or by the partnership,
   40  corporation  or  group  in accordance with a partnership or other agree-
   41  ment.
   42    S 10. Subdivisions 3 and 4 and the opening paragraph of subdivision 11
   43  of section 13-m of the workers' compensation law, as amended by  chapter
   44  473 of the laws of 2000, are amended to read as follows:
   45    3.  A  psychologist, licensed and registered to practice psychology in
   46  the state of New York, who is desirous of  being  authorized  to  render
   47  psychological  care  under  this section and/or to conduct [independent]
   48  ADVERSARIAL medical examinations in accordance  with  paragraph  (b)  of
   49  subdivision  four of this section shall file an application for authori-
   50  zation under this section with the psychology  practice  committee.  The
   51  applicant shall agree to refrain from subsequently treating for remuner-
   52  ation, as a private patient, any person seeking psychological treatment,
   53  or  submitting  to  an [independent] ADVERSARIAL medical examination, in
   54  connection with, or as a result of, any injury  compensable  under  this
   55  chapter,  if  he  or she has been removed from the list of psychologists
   56  authorized to render psychological care under this chapter. This  agree-
       S. 5373                            12
    1  ment  shall  run  to  the  benefit of the injured person so treated, and
    2  shall be available as a defense in any action by such  psychologist  for
    3  payment  for treatment rendered by such psychologist after being removed
    4  from  the  list of psychologists authorized to render psychological care
    5  or to conduct [independent] ADVERSARIAL medical examinations under  this
    6  section.  The  psychology  practice  committee if it deems such licensed
    7  psychologist duly qualified shall  recommend  to  the  chair  that  such
    8  person  be  authorized  to  render  psychological care and/or to conduct
    9  [independent] ADVERSARIAL medical examinations under this section.  Such
   10  recommendations  shall  be  only  advisory to the chair and shall not be
   11  binding or conclusive. The chair shall prepare and establish a  schedule
   12  for  the state or schedules limited to defined localities of charges and
   13  fees for psychological treatment and care, to be determined  in  accord-
   14  ance  with and be subject to change pursuant to rules promulgated by the
   15  chair. Before preparing such schedule for the  state  or  schedules  for
   16  limited  localities  the  chair  shall  request  the psychology practice
   17  committee to submit to such chair a report on the amount of remuneration
   18  deemed by such committee to be  fair  and  adequate  for  the  types  of
   19  psychological  care to be rendered under this chapter, but consideration
   20  shall be given to the view of  other  interested  parties.  The  amounts
   21  payable  by  the  employer  for such treatment and services shall be the
   22  fees and charges established by such schedule.
   23    4. (a) No claim for psychological care or treatment shall be valid and
   24  enforceable as against the employer or employees  unless  within  forty-
   25  eight  hours  following the first treatment the psychologist giving such
   26  care or treatment furnishes to the employer and directly to the chair  a
   27  preliminary notice of such injury and treatment, and within fifteen days
   28  thereafter  a  more  complete  report  and  subsequent  thereto progress
   29  reports as requested in writing by the chair, board, employer or  insur-
   30  ance carrier, at intervals of not less than three weeks apart or at less
   31  frequent  intervals  if  requested on forms prescribed by the chair. The
   32  board may excuse the failure to give such notices within the  designated
   33  periods when it finds it to be in the interest of justice to do so.
   34    (b)  Upon  receipt of the notice provided for by paragraph (a) of this
   35  subdivision, the employer, the carrier, and the claimant each  shall  be
   36  entitled  to  have  the  claimant  examined by a qualified psychologist,
   37  authorized by the chair in accordance with  subdivision  three  of  this
   38  section  and  section  one  hundred  thirty-seven  of this chapter, at a
   39  medical facility convenient to the claimant and in the presence  of  the
   40  claimant's  psychologist,  and refusal by the claimant to submit to such
   41  [independent] ADVERSARIAL medical examination at such time or  times  as
   42  may  reasonably  be  necessary in the opinion of the board shall bar the
   43  claimant from recovering compensation, for any period during which he or
   44  she has refused to submit to such examination.
   45    (c) Where it would place an unreasonable burden upon the  employer  or
   46  carrier  to arrange for, or for the claimant to attend, an [independent]
   47  ADVERSARIAL medical  examination  by  an  authorized  psychologist,  the
   48  employer  or  carrier shall arrange for such examination to be performed
   49  by a qualified psychologist in a  medical  facility  convenient  to  the
   50  claimant.
   51    (d)  The  [independent] ADVERSARIAL psychological examiner licensed by
   52  the state of New York shall provide such reports  and  shall  submit  to
   53  investigation as required by the chair.
   54    (e)  In  order to qualify as admissible medical evidence, for purposes
   55  of adjudicating any claim under this chapter, any  report  submitted  to
       S. 5373                            13
    1  the   board  by  an  [independent]  ADVERSARIAL  psychological  examiner
    2  licensed by the state of New York shall include the following:
    3    (i) a signed statement certifying that the report is a full and truth-
    4  ful  representation of the [independent] ADVERSARIAL psychological exam-
    5  iner's professional opinion with respect to the claimant's condition,
    6    (ii) such examiner's board issued authorization number,
    7    (iii) the name of the individual or entity requesting the examination,
    8    (iv) if applicable, the registration number  as  required  by  section
    9  thirteen-n of this article, and
   10    (v) such other information as the chair may require by regulation.
   11    The  psychology  practice  committee  shall investigate, hear and make
   12  findings with respect to all charges as to professional or other miscon-
   13  duct of any authorized psychologist as herein provided under  rules  and
   14  procedures  to  be  prescribed by the chair and shall report evidence of
   15  such misconduct, with their findings and  recommendations  with  respect
   16  thereto, to the chair. The findings, decision and recommendation of such
   17  psychology  practice  committee shall be advisory to the chair only, and
   18  shall not be binding or conclusive upon him  or  her.  The  chair  shall
   19  remove from the list of psychologists authorized to render psychological
   20  care  under this chapter or to conduct [independent] ADVERSARIAL medical
   21  examinations in accordance with paragraph (b)  of  subdivision  four  of
   22  this section the name of any psychologist who he or she shall find after
   23  reasonable investigation is disqualified because such psychologist:
   24    S 11. Section 13-n of the workers' compensation law, as added by chap-
   25  ter  473  of the laws of 2000 and subdivision 3 as added by chapter 6 of
   26  the laws of 2007, is amended to read as follows:
   27    S 13-n. Mandatory registration of entities which  derive  income  from
   28  [independent]  ADVERSARIAL  medical  examinations.  1.  Any entity which
   29  derives  income  from  [independent]  ADVERSARIAL  medical  examinations
   30  performed  in  accordance  with  subdivision four of section thirteen-a,
   31  subdivision three of section thirteen-k, subdivision  three  of  section
   32  thirteen-1  and  subdivision four of section thirteen-m of this article,
   33  whether by employing or contracting with [independent] ADVERSARIAL exam-
   34  iners to conduct such [independent] ADVERSARIAL medical examinations  or
   35  by  acting as a referral service or otherwise facilitating such examina-
   36  tions, shall register with the chair by filing a statement of  registra-
   37  tion  containing such information prescribed by the chair in regulation.
   38  A fee may be imposed in accordance with regulations promulgated  by  the
   39  chair. Any such fees collected shall be used for the purpose of adminis-
   40  tering this section.
   41    2.  The  chair  shall  assign a registration number to the entity upon
   42  registration. If an entity operates under more than one name, or in more
   43  than one location, the chair may assign a series of registration numbers
   44  which would differentiate each such sub-entity. In order to  qualify  as
   45  admissible  medical  evidence,  for  purposes  of adjudicating any claim
   46  under this chapter, any report submitted to the board by  an  [independ-
   47  ent]  ADVERSARIAL medical examiner who is employed by, or has contracted
   48  with, an entity as described in subdivision one of this section for  the
   49  purpose  of  performing  [independent] ADVERSARIAL medical examinations,
   50  must include the registration number of such entity.
   51    3. The chair, upon finding that an entity  that  derives  income  from
   52  [independent] ADVERSARIAL medical examinations has materially altered an
   53  [independent]  ADVERSARIAL  medical examination report, or caused such a
   54  report to be materially altered, may revoke  the  registration  of  such
   55  entity,  impose  a  penalty not exceeding ten thousand dollars and refer
   56  the matter to the attorney general for prosecution.
       S. 5373                            14
    1    S 12. Section 137 of the workers' compensation law, as added by  chap-
    2  ter 473 of the laws of 2000, is amended to read as follows:
    3    S  137.  [Independent] ADVERSARIAL medical examinations. 1. (a) A copy
    4  of each report of [independent] ADVERSARIAL medical examination shall be
    5  submitted by the practitioner on the same day and in the same manner  to
    6  the  board, the insurance carrier, the claimant's attending physician or
    7  other attending practitioner,  the  claimant's  representative  and  the
    8  claimant.
    9    (b)  If  a  practitioner  who  has  performed or will be performing an
   10  [independent] ADVERSARIAL medical examination of a claimant  receives  a
   11  request for information regarding the claimant, including faxed or elec-
   12  tronically transmitted requests, the practitioner shall submit a copy of
   13  the  request  for information to the board within ten days of receipt of
   14  the request. Nothing in this subdivision shall be construed to  abrogate
   15  the attorney-client privilege.
   16    (c)  Copies  of  all responses to such requests for information as are
   17  described in paragraph (b) of this subdivision, including all  materials
   18  which  are provided in response to such a request, shall be submitted by
   19  the responding practitioner to the board within ten days  of  submission
   20  of  the  response to the requestor. Nothing in this subdivision shall be
   21  construed to abrogate the attorney-client privilege.
   22    2. In any open case where an award has been directed by the board  for
   23  temporary or permanent disability at an established rate of compensation
   24  and  there  is a direction by the board for continuation of payments, or
   25  any closed case where an award for compensation has been made for perma-
   26  nent total or permanent partial disability, a report of an [independent]
   27  ADVERSARIAL medical examination shall not be the basis for suspending or
   28  reducing payments unless and until the  rules  and  regulations  of  the
   29  board  regarding suspending or reducing payments have been met and there
   30  is a  determination  by  the  board  finding  that  such  suspension  or
   31  reduction is justified.
   32    3.  (a)  Only a New York state licensed and board certified physician,
   33  surgeon, podiatrist or any other person authorized to examine or  evalu-
   34  ate  injury  or  illness  by  the board shall perform such [independent]
   35  ADVERSARIAL medical examination. Where a claimant resides out of state a
   36  practitioner qualified to examine or evaluate injury or illness  by  the
   37  board shall perform such [independent] ADVERSARIAL medical examination.
   38    (b)  Any practitioner performing the [independent] ADVERSARIAL medical
   39  examinations shall be paid according to  the  fee  schedule  established
   40  pursuant to section thirteen of this chapter.
   41    4.   All  [independent]  ADVERSARIAL  medical  examinations  shall  be
   42  performed in medical facilities suitable for such exam, with due  regard
   43  and respect for the privacy and dignity of the injured worker as well as
   44  the  access and safety of the claimant. Such facilities must be provided
   45  in a convenient and accessible location  within  a  reasonable  distance
   46  from the claimant's residence.
   47    5.   All  [independent]  ADVERSARIAL  medical  examinations  shall  be
   48  performed by a practitioner competent to evaluate or examine the  injury
   49  or disease from which the injured worker suffers. Such examination shall
   50  be  performed  by  a practitioner who is licensed and board certified in
   51  the state of New York or any other person authorized to examine or eval-
   52  uate injury or illness by the board.
   53    6. No practitioner examining or evaluating a claimant under this chap-
   54  ter nor any supervising authority or proprietor nor insurance carrier or
   55  employer may cause, direct or encourage a  report  to  be  submitted  as
   56  evidence  in  workers'  compensation  claim  adjudication  which differs
       S. 5373                            15
    1  substantially from the professional opinion of the examining practition-
    2  er. Such an action shall be considered within the  jurisdiction  of  the
    3  workers'  compensation  fraud inspector general and may be referred as a
    4  fraudulent practice.
    5    7.  The  claimant shall receive notice by mail of the scheduled [inde-
    6  pendent] ADVERSARIAL medical examination at least  seven  business  days
    7  prior  to such examination. Such notice shall advise the claimant if the
    8  practitioner intends to record or video tape the examination, and  shall
    9  advise the claimant of their right to video tape or otherwise record the
   10  examination. Claimants shall be advised of their right to be accompanied
   11  during the exam by an individual or individuals of their choosing.
   12    8.  [Independent]  ADVERSARIAL medical examinations shall be performed
   13  during regular business hours  except  with  the  consent  and  for  the
   14  convenience of the claimant. Claimants subject to such examination shall
   15  be  notified  at the time of the exam in writing of the available travel
   16  reimbursement under law.
   17    9. A practitioner is not eligible to perform an  [independent]  ADVER-
   18  SARIAL medical examination of a claimant if the practitioner has treated
   19  or  examined  the claimant for the condition for which the [independent]
   20  ADVERSARIAL medical examination is being requested or if another  member
   21  of  a  preferred provider organization or managed care provider to which
   22  the practitioner belongs has treated or examined the  claimant  for  the
   23  condition for which the [independent] ADVERSARIAL medical examination is
   24  being requested.
   25    10.  The  ability of a claimant to appear for an exam or hearing shall
   26  not be dispositive in the determination of disability, extent  of  disa-
   27  bility or eligibility for benefits.
   28    11.  At  the time of the [independent] ADVERSARIAL medical examination
   29  the claimant shall receive a  notice  from  the  entity  performing  the
   30  [independent]  ADVERSARIAL medical examination, on a form which shall be
   31  approved and promulgated by the chair,  stating  the  rights  and  obli-
   32  gations  of the claimant and the practitioner with respect to such exam,
   33  and such notice shall include but not be limited to a statement that the
   34  claimant's receipt of benefits could be denied, terminated,  or  reduced
   35  as a result of a determination which may be based upon the medical eval-
   36  uation  made  after  such [independent] ADVERSARIAL medical examination,
   37  and the claimant's rights to challenge or appeal such a determination.
   38    S 13. Subdivisions 1, 2 and 3 of section 50-h of the general municipal
   39  law, subdivision 1 as amended by chapter 24 of the laws of 1988,  subdi-
   40  vision 2 as amended by chapter 254 of the laws of 1990 and subdivision 3
   41  as  added  by  chapter  393  of the laws of 1958, are amended to read as
   42  follows:
   43    1. Wherever a notice of claim is filed against a city,  county,  town,
   44  village,  fire  district,  ambulance  district  [or], school district OR
   45  PUBLIC AUTHORITY the city, county, town, village, fire  district,  ambu-
   46  lance  district [or], school district OR PUBLIC AUTHORITY shall have the
   47  right to demand an examination of the claimant relative  to  the  occur-
   48  rence  and  extent  of  the injuries or damages for which claim is made,
   49  which examination shall be upon oral questions unless the parties other-
   50  wise stipulate and may include [a physical] AN ADVERSARIAL MEDICAL exam-
   51  ination of the claimant by a duly qualified physician. If the  party  to
   52  be  examined  desires, he or she is entitled to have such examination in
   53  the presence of his or her own personal physician and such  relative  or
   54  other  person  as he or she may elect.  THE PERSON SUBJECT TO THE ADVER-
   55  SARIAL MEDICAL EXAMINATION SHALL NOT BE REQUIRED TO  PRODUCE  ANY  DOCU-
   56  MENTS  OR  SUPPLY  ANY WRITTEN ANSWERS TO QUESTIONS PUT TO HIM OR HER AT
       S. 5373                            16
    1  SUCH ADVERSARIAL MEDICAL EXAMINATION. Exercise of the right to demand  a
    2  physical  examination  of the claimant as provided in this section shall
    3  in no way affect the right  of  a  city,  county,  town,  village,  fire
    4  district,  ambulance  district [or], school district OR PUBLIC AUTHORITY
    5  in a subsequent action brought upon the claim to demand [a physical]  AN
    6  ADVERSARIAL  MEDICAL examination of the plaintiff pursuant to statute or
    7  court rule.
    8    2. The demand for examination as provided in subdivision one  of  this
    9  section  shall be made by the chief executive officer or, where there is
   10  no such officer, by the chairman of the  governing  body  of  the  city,
   11  county,  town,  village,  fire  district [or], school district OR PUBLIC
   12  AUTHORITY or by such officer, agent or employee as may be designated  by
   13  him  OR  HER for that purpose.  The demand shall be in writing and shall
   14  be served personally or by registered or certified mail upon the  claim-
   15  ant  unless the claimant is represented by an attorney, when it shall be
   16  served personally or by mail upon his OR HER attorney. The demand  shall
   17  give  reasonable  notice  of  the examination. It shall state the person
   18  before whom the examination is to be held, the time, place  and  subject
   19  matter  thereof  and, if [a physical] AN ADVERSARIAL MEDICAL examination
   20  is to be required, it shall so state. If the  place  of  examination  is
   21  located  outside  the  municipality against which the claim is made, the
   22  claimant may demand, within ten days of such service, that the  examina-
   23  tion be held at a location within such municipality. Such location shall
   24  be  determined  by  the  municipality.    If [a physical] AN ADVERSARIAL
   25  MEDICAL examination is to be required and there is no appropriate  place
   26  for  such an examination within the municipality, such examination shall
   27  be given at a location as close to such municipality as practicable.  No
   28  demand  for  examination shall be effective against the claimant for any
   29  purpose unless it shall be served as provided in this subdivision within
   30  ninety days from the date of filing of the notice of claim.
   31    3. In any examination required pursuant  to  the  provisions  of  this
   32  section  the claimant shall have the right to be represented by counsel.
   33  The examination shall be conducted upon oath or affirmation. The officer
   34  or person before whom the examination is had shall take down or cause to
   35  be taken down every question and answer unless the parties consent  that
   36  only the substance of the testimony be inserted. The testimony so taken,
   37  together  with  the report of the examining physician where [a physical]
   38  AN ADVERSARIAL MEDICAL examination is  required,  shall  constitute  the
   39  record  of the examination.  The transcript of the record of an examina-
   40  tion shall not be subject to or available for public inspection,  except
   41  upon  court  order  upon good cause shown, but shall be furnished to the
   42  claimant or his OR HER attorney upon request.
   43    S 14. Subdivisions 1, 2 and 3 of section 17-a of the court  of  claims
   44  act, as added by chapter 189 of the laws of 1990, are amended to read as
   45  follows:
   46    1.  Wherever  a  notice  of  intention  to file a claim is served, the
   47  defendant shall have the right to demand an examination of the  claimant
   48  relative  to  the  occurrence  and extent of the injuries or damages for
   49  which claim is made, which examination  shall  be  upon  oral  questions
   50  unless  the  parties otherwise stipulate and may include [a physical] AN
   51  ADVERSARIAL MEDICAL examination of the  claimant  by  a  duly  qualified
   52  physician. If the party to be examined desires, he or she is entitled to
   53  have  such [physical] AN ADVERSARIAL MEDICAL examination in the presence
   54  of his or her own personal physician and such relative or  other  person
   55  as  he or she may elect. Exercise of the right to demand [a physical] AN
   56  ADVERSARIAL MEDICAL examination of the  claimant  as  provided  in  this
       S. 5373                            17
    1  section  shall in no way affect the right of a defendant in a subsequent
    2  claim brought upon the notice of intention to file a claim to demand  [a
    3  physical] AN ADVERSARIAL MEDICAL examination of the claimant pursuant to
    4  statute or court rule.
    5    2.  The  demand for examination as provided in subdivision one of this
    6  section shall be made by the attorney for the defendant or by such offi-
    7  cer, agent or employee as may be designated by him for that purpose. The
    8  demand shall be in writing and shall be served personally or  by  regis-
    9  tered or certified mail upon the claimant unless the claimant is repres-
   10  ented by an attorney, when it shall be served personally or by mail upon
   11  his  or  her  attorney.  The  demand shall give reasonable notice of the
   12  examination. It shall state the person before whom the examination is to
   13  be held, the time, place and subject matter thereof and, if [a physical]
   14  AN ADVERSARIAL MEDICAL examination is to be required, it shall so state.
   15  No demand for examination shall be effective against  the  claimant  for
   16  any  purpose  unless  it shall be served as provided in this subdivision
   17  within ninety days from the date of service of the notice  of  intention
   18  to file a claim.
   19    3.  In  any  examination  required  pursuant to the provisions of this
   20  section the claimant shall have the right to be represented by  counsel.
   21  The examination shall be conducted upon oath or affirmation. The officer
   22  or  person  before whom the examination is held shall take down or cause
   23  to be taken down every question and answer unless  the  parties  consent
   24  that  only  the substance of the testimony be inserted. The testimony so
   25  taken, together with the report of  the  examining  physician  where  [a
   26  physical]  AN ADVERSARIAL MEDICAL examination is required, shall consti-
   27  tute the record of the examination.  The transcript of the record of  an
   28  examination,  including  a copy of the report of the examining physician
   29  shall not be subject to or available for public inspection, except  upon
   30  court  order upon good cause shown, but shall be furnished to the claim-
   31  ant or his or her attorney upon request.
   32    S 15. This act shall take effect immediately and shall  apply  to  all
   33  currently  pending actions and proceedings, and to proceedings commenced
   34  subsequent to such date.
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