S T A T E O F N E W Y O R K
________________________________________________________________________
S. 5476 A. 7934
2011-2012 Regular Sessions
S E N A T E - A S S E M B L Y
May 25, 2011
___________
IN SENATE -- Introduced by Sen. RITCHIE -- read twice and ordered print-
ed, and when printed to be committed to the Committee on Labor
IN ASSEMBLY -- 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:
Section 1. Subdivision 5 of section 13-a of the workers' compensation
law, as amended by chapter 6 of the laws of 2007, is amended to read as
follows:
(5) No claim for specialist consultations, surgical operations,
physiotherapeutic or occupational therapy procedures, x-ray examinations
or special diagnostic laboratory tests costing more than one thousand
dollars shall be valid and enforceable, as against such employer, unless
such special services shall have been authorized by the employer or by
the board, or unless such authorization has been unreasonably withheld,
or withheld for a period of more than thirty calendar days from receipt
of a request for authorization, or unless such special services are
required in an emergency, provided, however, that the basis for a denial
of such authorization by the employer must be based on a conflicting
second opinion rendered by a physician authorized by the board. The
board, with the approval of the superintendent of insurance, shall issue
and maintain a list of pre-authorized procedures under this section.
SUCH LIST OF PRE-AUTHORIZED PROCEDURES SHALL BE ISSUED AND MAINTAINED
FOR THE SOLE PURPOSE OF EXPEDITING AUTHORIZATION OF PATIENT TREATMENT.
SUCH LIST OF PRE-AUTHORIZED PROCEDURES SHALL NOT BE UTILIZED AS MEDICAL
GUIDELINES OR TO DIRECT PATIENT CARE IN ANY WAY NOR SHALL ANY PRE-AU-
THORIZED PROCEDURE BE GIVEN PREFERENCE OVER AN ALTERNATIVE FORM OF
TREATMENT THAT HAS NOT BEEN PLACED ON THE PRE-AUTHORIZED PROCEDURES
LIST.
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