senate Bill S3681

Requires the availability of and reimbursement for chiropractic care under the workers' compensation law to be provided on the same basis as care by a physician

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Bill Status


  • Introduced
  • In Committee
  • On Floor Calendar
    • Passed Senate
    • Passed Assembly
  • Delivered to Governor
  • Signed/Vetoed by Governor
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actions

  • 11 / Feb / 2013
    • REFERRED TO LABOR
  • 08 / Jan / 2014
    • REFERRED TO LABOR

Summary

Requires the availability of and reimbursement for chiropractic care under the workers' compensation law to be provided on the same basis as care by a physician under such law.

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Bill Details

Versions:
S3681
Legislative Cycle:
2013-2014
Current Committee:
Senate Labor
Law Section:
Workers' Compensation Law
Laws Affected:
Amd §13-l, add §356, Work Comp L
Versions Introduced in Previous Legislative Cycles:
2011-2012: S1405
2009-2010: S5233
2007-2008: S4217

Sponsor Memo

BILL NUMBER:S3681

TITLE OF BILL: An act to amend the workers' compensation law, in
relation to chiropractic care

PURPOSE OR GENERAL IDEA OF BILL: This bill would end years of the most
blatant discriminatory regulation against the consumers of chiropractic.
Doctors of chiropractor have been paid one flat fee for all treatment
services rendered to an injured worker for 31 years while all other
providers including non-doctor providers are paid for virtually every
service they perform. Doctors of Chiropractic are mandated by statute to
provide the same level of care to an injured worker as that of a private
patient but are not reimbursed for the services. Doctors of Chiropractic
are given only a flat "limited office visit" fee. No other state has a
separate and distinct Workers' Compensation fee schedule/for Doctors of
Chiropractic. Doctors of Chiropractic are not even reimbursed for a main
staple of their practice, spinal adjustments. (AKA spinal manipulation).
This policy forces health care consumers to consult additional providers
for these services. This legislation would recognize that chiropractors
provide a variety of services and to clarify that the workers' compen-
sation system must pay for the individual modalities employed by chiro-
practors in rendering primary health care services to injured workers.

SUMMARY OF SPECIFIC PROVISIONS:

Amends the Workers' Compensation Law to provide that the Workers'
Compensation Board must reimburse chiropractors for individual services
and modalities lawfully rendered by chiropractors in treatment of an
injured worker. Section 4 sets forth the effective date of this amend-
ment.

JUSTIFICATION: In rendering care, chiropractors, like all other primary
care practitioners, engage in a number of individual diagnostic and
treatment services and modalities. Most other primary care providers are
compensated by the Workers' Compensation System for each discrete
service rendered in diagnosing and treating injured workers. For exam-
ple, both the medical and physical therapy fee schedule under Workers'
Compensation is a number of pages long, listing and compensating the
full range of individual medical services employed in caring for injured
workers. Although Workers' Compensation ostensibly recognize the panoply
of chiropractic services, the fee schedule confines payment to office
visits. However, there is no recognition that a variety of individual
chiropractic modalities are routinely employed in accurately diagnosing
and treating injured workers. This bill recognizes the full scope of
chiropractic services and directs the Board to pay for individual diag-
nostic and treatment services and modalities rendered.

PRIOR LEGISLATIVE HISTORY: 2005-2012 - Died in Labor Committee.

FISCAL IMPLICATIONS: None.

EFFECTIVE DATE: January 1, 2014.

view bill text
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                  3681

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                            February 11, 2013
                               ___________

Introduced  by  Sen.  SAVINO -- 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 chiroprac-
  tic care

  THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
BLY, DO ENACT AS FOLLOWS:

  Section  1. Legislative intent. The legislature recognizes that multi-
ple health professionals are trained and licensed to diagnose and  treat
the same or similar conditions through the use of modalities, therapies,
treatments,  services  and  philosophies  that  vary  from profession to
profession. It is the specific intent of this legislature to assure that
workers' compensation policies, plans and contracts that provide  cover-
age for the diagnosis and treatment of conditions, complaints, ailments,
disorders  or injuries, that may be diagnosed and treated by a doctor of
chiropractic, must provide equivalent access, coverage and fees for  the
diagnosis and treatment of those conditions, complaints or injuries by a
duly licensed doctor of chiropractic, within the lawful scope of chirop-
ractic  practice  even  if  different terminology, philosophy, services,
treatments or modalities are used by the various health professions; and
such equivalent coverage shall not be abridged by any regulation.
  S 2. Subdivision 2 of section 13-l of the workers'  compensation  law,
as  amended  by  chapter  473 of the laws of 2000, is amended to read as
follows:
  2. (A) An employee injured under circumstances which make such  injury
compensable  under  this  article,  when  care is required for an injury
which consists solely of a condition which may lawfully be treated by  a
chiropractor  as  defined in section sixty-five hundred fifty-one of the
education law may select to treat him or her, any  duly  registered  and
licensed  chiropractor of the state of New York, authorized by the chair
to render chiropractic care as hereinafter provided. If  the  injury  or
condition is one which is outside the limits prescribed by the education

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD08672-01-3

S. 3681                             2

law  for  chiropractic care and treatment, the said chiropractor must so
advise the said injured employee and instruct him or her  to  consult  a
physician  of said employee's choice for appropriate care and treatment.
Such  physician  shall  thenceforth have supervision of the treatment of
said condition including the future treatment to be administered to  the
patient  by  the chiropractor. A chiropractor licensed and registered to
practice chiropractic in the state of New York, who is desirous of being
authorized to render chiropractic care  under  this  section  and/or  to
conduct  independent  medical  examinations in accordance with paragraph
(b) of subdivision three of this section shall file an  application  for
authorization  under this section with the chiropractic practice commit-
tee. In such application he or she shall agree to  refrain  from  subse-
quently  treating  for  remuneration,  as  a private patient, any person
seeking chiropractic treatment, or submitting to an independent  medical
examination, in connection with, or as a result of, any injury compensa-
ble  under  this chapter, if he or she has been removed from the list of
chiropractors authorized to render chiropractic care or to conduct inde-
pendent medical examinations under this chapter, or if the person  seek-
ing  such treatment has been transferred from his or her care in accord-
ance with the provisions of this section. This agreement  shall  run  to
the  benefit of the injured person so treated, or examined, and shall be
available to him or her as a defense in any action by such  chiropractor
for  payment rendered by a chiropractor after he or she has been removed
from the list of chiropractors authorized to render chiropractic care or
to conduct independent medical examinations under this section, or after
the injured person was transferred from his or her  care  in  accordance
with the provisions of this section. The chiropractic practice committee
if it deems such licensed chiropractor duly qualified shall recommend to
the  chair that such be authorized to render chiropractic care and/or to
conduct independent medical examinations under this section. Such recom-
mendations shall be advisory to the chair only and shall not be  binding
or  conclusive  upon him or her. The chair shall prepare and establish a
schedule for the state, or schedules limited to  defined  localities  of
charges  and  fees for chiropractic treatment and care, to be determined
in accordance with and to be subject to change pursuant to rules promul-
gated by the chair.  THE CHIROPRACTIC FEE SCHEDULE PREPARED  AND  ESTAB-
LISHED  BY THE CHAIR SHALL PROVIDE FOR THE PAYMENT OF REMUNERATION WHICH
IS EQUIVALENT TO THAT APPLICABLE TO CARE OR TREATMENT PROVIDED BY PHYSI-
CIANS IN THE DIAGNOSIS, TREATMENT AND MANAGEMENT OF THE SAME OR  SIMILAR
CONDITIONS, INJURIES, COMPLAINTS, DISORDERS OR AILMENTS, EVEN IF DIFFER-
ING NOMENCLATURE IS USED TO DESCRIBE THE CONDITION, INJURY, TREATMENT OR
SERVICE.  Before  preparing such schedule for the state or schedules for
limited localities the chair shall  request  the  chiropractic  practice
committee to submit to him or her a report on the amount of remuneration
deemed  by  such  committee  to  be  fair  and adequate for the types of
chiropractic care to be rendered under this chapter,  but  consideration
shall  be  given  to  the  view of other interested parties, the amounts
payable by the employer for such treatment and  services  shall  be  the
fees  and  charges  established by such schedule.  CHIROPRACTIC CARE AND
TREATMENT MAY BE SUBJECT TO REASONABLE UTILIZATION REVIEW, PROVIDED THAT
ANY SUCH REVIEW: (I) SHALL NOT DISCRIMINATE AGAINST  CHIROPRACTIC  CARE,
AND  (II)  SHALL  BE NO MORE RESTRICTIVE THAN THAT APPLICABLE TO CARE OR
TREATMENT PROVIDED BY PHYSICIANS IN THE DIAGNOSIS, TREATMENT AND MANAGE-
MENT OF THE SAME OR SIMILAR CONDITIONS, INJURIES, COMPLAINTS,  DISORDERS
OR  AILMENTS,  EVEN  IF  DIFFERING  NOMENCLATURE IS USED TO DESCRIBE THE
CONDITION, INJURY, TREATMENT OR SERVICE.  NOTHING  IN  THIS  SUBDIVISION

S. 3681                             3

SHALL  BE  CONSTRUED  AS  IMPEDING OR PREVENTING EITHER THE PROVISION OR
COVERAGE OF CHIROPRACTIC CARE AND TREATMENT BY DULY LICENSED DOCTORS  OF
CHIROPRACTIC,  WITHIN  THE  LAWFUL  SCOPE  OF  CHIROPRACTIC PRACTICE, IN
HOSPITAL FACILITIES ON STAFF OR EMPLOYEE BASIS.
  (B)  EVERY  POLICY WHICH INCLUDES COVERAGE FOR PHYSICIAN SERVICES IN A
PHYSICIAN'S OFFICE, OTHER THAN  A  POLICY  THAT  PROVIDES  MANAGED  CARE
COVERAGE,  SHALL  PROVIDE  COVERAGE FOR CARE PROVIDED IN THE PRACTICE OF
CHIROPRACTIC, AS DEFINED IN SECTION SIXTY-FIVE HUNDRED FIFTY-ONE OF  THE
EDUCATION LAW, PROVIDED BY A DOCTOR OF CHIROPRACTIC LICENSED PURSUANT TO
ARTICLE  ONE HUNDRED THIRTY-TWO OF THE EDUCATION LAW, IN CONNECTION WITH
THE DETECTION OR CORRECTION BY MANUAL OR MECHANICAL MEANS OF  STRUCTURAL
IMBALANCE,  DISTORTION  OR SUBLUXATION IN THE HUMAN BODY FOR THE PURPOSE
OF REMOVING NERVE INTERFERENCE, AND  THE  EFFECTS  THEREOF,  WHERE  SUCH
INTERFERENCE  IS THE RESULT OF OR RELATED TO DISTORTION, MISALIGNMENT OR
SUBLUXATION OF  OR  IN  THE  VERTEBRAL  COLUMN.  CHIROPRACTIC  CARE  AND
SERVICES  MAY  BE  SUBJECT  TO  REASONABLE  FEE SCHEDULES AND REASONABLE
UTILIZATION REVIEW, PROVIDED THAT ANY SUCH  SCHEDULES  AND  REVIEW:  (I)
SHALL  NOT DISCRIMINATE AGAINST CHIROPRACTIC CARE, AND (II) INDIVIDUALLY
AND COLLECTIVELY SHALL BE NO  MORE  RESTRICTIVE  THAN  THOSE  APPLICABLE
UNDER  THE SAME POLICY TO CARE OR SERVICES PROVIDED BY PHYSICIANS IN THE
DIAGNOSIS, TREATMENT AND MANAGEMENT OF THE SAME OR  SIMILAR  CONDITIONS,
INJURIES, COMPLAINTS, DISORDERS OR AILMENTS, EVEN IF DIFFERING NOMENCLA-
TURE  IS USED TO DESCRIBE THE CONDITION, INJURY, COMPLAINT, TREATMENT OR
SERVICE. NOTHING IN THIS SUBDIVISION SHALL BE CONSTRUED AS  IMPEDING  OR
PREVENTING  EITHER  THE  PROVISION  OR COVERAGE OF CHIROPRACTIC CARE AND
SERVICES BY DULY LICENSED DOCTORS OF  CHIROPRACTIC,  WITHIN  THE  LAWFUL
SCOPE  OF  CHIROPRACTIC  PRACTICE,  IN HOSPITAL FACILITIES ON A STAFF OR
EMPLOYEE BASIS.
  (C) THE COVERAGE REQUIRED BY THIS SUBDIVISION SHALL NOT BE ABRIDGED BY
ANY REGULATION PROMULGATED BY THE CHAIR, THE BOARD OR THE SUPERINTENDENT
OF FINANCIAL SERVICES.
  S 3. The workers' compensation law is amended by adding a new  section
356 to read as follows:
  S  356.  PREFERRED PROVIDER ORGANIZATIONS; CHIROPRACTIC TREATMENT.  1.
EACH PREFERRED PROVIDER ORGANIZATION SHALL PROVIDE COVERAGE FOR CARE AND
TREATMENT PROVIDED IN THE COURSE OF THE  PRACTICE  OF  CHIROPRACTIC,  AS
DEFINED  IN  SECTION  SIXTY-FIVE HUNDRED FIFTY-ONE OF THE EDUCATION LAW,
PROVIDED BY A DOCTOR OF CHIROPRACTIC LICENSED PURSUANT  TO  ARTICLE  ONE
HUNDRED  THIRTY-TWO  OF  THE  EDUCATION  LAW,  IN  CONNECTION  WITH  THE
DETECTION OR CORRECTION BY MANUAL  OR  MECHANICAL  MEANS  OF  STRUCTURAL
IMBALANCE,  DISTORTION  OR SUBLUXATION IN THE HUMAN BODY FOR THE PURPOSE
OF REMOVING NERVE INTERFERENCE, AND  THE  EFFECTS  THEREOF,  WHERE  SUCH
INTERFERENCE  IS THE RESULT OF OR RELATED TO DISTORTION, MISALIGNMENT OR
SUBLUXATION OF OR IN THE VERTEBRAL COLUMN. CHIROPRACTIC CARE AND  TREAT-
MENT MAY BE SUBJECT TO REASONABLE FEE SCHEDULES, AND REASONABLE UTILIZA-
TION  REVIEW, PROVIDED THAT ANY SUCH SCHEDULES AND REVIEW: (A) SHALL NOT
DISCRIMINATE AGAINST CHIROPRACTIC CARE; AND (B) INDIVIDUALLY AND COLLEC-
TIVELY SHALL BE NO MORE RESTRICTIVE THAN  THOSE  APPLICABLE  WITHIN  THE
PREFERRED  PROVIDER ORGANIZATION TO CARE OR TREATMENT PROVIDED BY PHYSI-
CIANS IN THE DIAGNOSIS, TREATMENT AND MANAGEMENT OF THE SAME OR  SIMILAR
CONDITIONS,  INJURIES  OR  COMPLAINTS, EVEN IF DIFFERING NOMENCLATURE IS
USED TO DESCRIBE THE CONDITION, INJURY, COMPLAINT, TREATMENT OR SERVICE.
NOTHING IN THIS SECTION SHALL BE CONSTRUED  AS  IMPEDING  OR  PREVENTING
EITHER  THE  PROVISION OR COVERAGE OF CHIROPRACTIC CARE AND TREATMENT BY
DULY LICENSED DOCTORS  OF  CHIROPRACTIC,  WITHIN  THE  LAWFUL  SCOPE  OF

S. 3681                             4

CHIROPRACTIC  PRACTICE,  IN  HOSPITAL  FACILITIES ON A STAFF OR EMPLOYEE
BASIS.
  2.  EACH  PREFERRED  PROVIDER  ORGANIZATION SHALL INCLUDE A SUFFICIENT
NUMBER OF CHIROPRACTORS WITHIN EACH GEOGRAPHIC AREA TO ASSURE ACCESS  TO
CHIROPRACTIC TREATMENT THAT IS EQUAL TO THAT AVAILABLE TO MEDICAL TREAT-
MENT WITHIN THE SAME PREFERRED PROVIDER ORGANIZATION.
  3.  AN  EMPLOYEE  MAY  SEEK  CHIROPRACTIC  TREATMENT  FROM OUTSIDE THE
PREFERRED PROVIDER ORGANIZATION THIRTY DAYS AFTER HIS OR HER VISIT TO  A
PREFERRED PROVIDER ORGANIZATION PROVIDER. IN THE EVENT THAT SUCH EMPLOY-
EE SEEKS CHIROPRACTIC TREATMENT OUTSIDE THE PREFERRED PROVIDER ORGANIZA-
TION,  THE  EMPLOYER MAY REQUIRE A SECOND OPINION FROM A PROVIDER WITHIN
THE PREFERRED PROVIDER ORGANIZATION.
  4. AN EMPLOYEE MAY SEEK A SECOND OPINION WITH RESPECT TO SUCH  CHIROP-
RACTIC  TREATMENT  FROM  ANOTHER  PROVIDER WITHIN THE PREFERRED PROVIDER
ORGANIZATION AT ANY TIME.
  5. THE COVERAGE REQUIRED BY THIS SECTION SHALL NOT BE ABRIDGED BY  ANY
REGULATION PROMULGATED BY THE CHAIR OR THE BOARD.
  S  4.  This  act  shall take effect January 1, 2014 and shall apply to
policies and contracts issued, renewed, modified, altered or amended  on
or after such effective date.

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