Bill Text: NY S07799 | 2023-2024 | General Assembly | Introduced

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Bill Title: Simplifies the procedure by which injured workers obtain treatment for injuries covered by the workers' compensation law; provides that the list of pre-authorized procedures is to be used only as a list of treatment that does not require insurance carrier approval.

Spectrum: Partisan Bill (Republican 1-0)

Status: (Introduced) 2024-05-13 - REPORTED AND COMMITTED TO FINANCE [S07799 Detail]

Download: New_York-2023-S07799-Introduced.html

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                STATE OF NEW YORK
        ________________________________________________________________________

                                          7799

                               2023-2024 Regular Sessions

                    IN SENATE

                                    December 8, 2023
                                       ___________

        Introduced  by  Sen.  RHOADS -- read twice and ordered printed, and when
          printed to be committed to the Committee on Rules

        AN ACT to amend the workers' compensation law, in relation to  simplify-
          ing  the procedure by which injured workers obtain treatment for inju-
          ries covered by the workers' compensation law

          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 section 8 of part CC of chapter 55  of  the  laws  of
     3  2019, is amended to read as 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 financial services,
    16  shall issue and maintain a list of pre-authorized procedures under  this
    17  section.  Such  list  of  pre-authorized  procedures shall be issued and
    18  maintained solely for the purpose of expediting authorization of  treat-
    19  ment  of  injured  workers. Such list of pre-authorized procedures shall
    20  not prohibit varied treatment [when the treating  provider  demonstrates
    21  the  appropriateness and medical necessity of such treatment], nor shall
    22  the list be used as a basis to deny  treatment  not  contained  therein.
    23  Requests  for  varied  treatment need only comply with the provisions of
    24  this subdivision.
    25    § 2. This act shall take effect immediately.

         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.
                                                                   LBD13633-01-3