Senate Bill S5662

2013-2014 Legislative Session

Establishes a fee schedule covering the costs of ambulance services provided to injured employees

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Archive: Last Bill Status - In Senate Committee Labor Committee

Introduced
- In Committee Assembly
- In Committee Senate
- On Floor Calendar Assembly
- On Floor Calendar Senate
- Passed Assembly
- Passed Senate
Delivered to Governor
Signed By Governor

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Date of Action	Assembly Actions - Lowercase Senate Actions - UPPERCASE
Jan 08, 2014	referred to labor
Jun 03, 2013	referred to labor

2013-S5662 (ACTIVE) - Details

See Assembly Version of this Bill:: A7151
Current Committee:: Senate Labor
Law Section:: Workers' Compensation Law
Laws Affected:: Amd §13, Work Comp L

2013-S5662 (ACTIVE) - Summary

Establishes a fee schedule covering the costs of ambulance services provided to injured employees.

2013-S5662 (ACTIVE) - Sponsor Memo

                                BILL NUMBER:S5662

TITLE OF BILL:  An act to amend the workers' compensation law, in
relation to the establishment of a fee schedule covering the costs of
ambulance services provided to injured employees

Purpose of the Bill:

The purpose of this bill is to authorize the Chair of the Workers'
Compensation Board (WCB) to adopt a fee schedule establishing maximum
fees for ambulance services.

Summary of Provisions:

Section 1 of the bill would amend subdivision (a) of section 13 of the
Workers' Compensation Law (WCL) to provide for the establishment of a
fee schedule covering fees for ambulance services including fees for
air transport and to clarify that the employer or its insurer is
liable for the payment of such services.

Section 2 of the bill would provide for an effective date of 180 days
after it becomes law.

Existing Law:

WCL § 13 provides for the establishment of fee schedules for most

types of medical treatment and care but does not include fees for
ambulance services. Fees for ambulance services including air
transport are already covered under the WCL. Under WCL § 13-f,
providers only have recourse for the payment of fees for health care
and services against the employer and its insurer.

Prior Legislative History:

This is a new bill.

Statement in Support:

Fee schedules are widely required under the WCL and apply to almost
all types of health care for injured workers. These fee schedules help
control costs by preventing exorbitant charges by providers,
permitting efficient bill handling and avoiding billing disputes.

Currently, there is no fee schedule applicable to workers'
compensation cases in New York that covers fees for ambulance
services. Without a fee schedule in place, the standard for
determining the fee for ambulance services is whether it is usual and
customary. Under this standard, workers' compensation insurers must
pay the amount billed unless they can either negotiate a lower fee
with the ambulance service or establish that the fee is unreasonable.
This ad hoc approach results in an inefficient payment process with
wide fee disparities, and in some instances, exorbitant fees.

NYSIF believes that the adoption of a fee schedule is the best way to
bring greater consistency to the workers' compensation system while
assuring that ambulance services are appropriately compensated for the
services they provide. A fee schedule would make the workers'


compensation system more efficient by precluding the need for
insurance carriers to negotiate bills with providers on an individual
basis and avoid litigation of billing disputes. Cost containment would
be achieved by standardizing fees.

This bill would also add clarifying language to the WCL to explicitly
state that ambulance services including air transport are covered
under the WCL.

Fiscal Implications:

None for the State.

Effective Date:

This bill would take effect 180 days after it becomes law.

2013-S5662 (ACTIVE) - Bill Text download pdf

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

                                  5662

                       2013-2014 Regular Sessions

                            I N  S E N A T E

                              June 3, 2013
                               ___________

Introduced by Sen. SAVINO -- (at request of the State Insurance Fund) --
  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 the estab-
  lishment of a fee schedule covering the costs  of  ambulance  services
  provided to injured employees

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

  Section 1. Subdivision (a) of section 13 of the workers'  compensation
law,  as amended by chapter 6 of the laws of 2007, is amended to read as
follows:
  (a) The employer shall promptly provide for an injured  employee  such
medical,  dental, surgical, optometric or other attendance or treatment,
nurse and hospital service,  medicine,  optometric  services,  crutches,
eye-glasses,   false   teeth,  artificial  eyes,  orthotics,  prosthetic
devices, functional assistive and adaptive  devices  and  apparatus  for
such  period  as the nature of the injury or the process of recovery may
require. The employer shall be liable for the payment of the expenses of
medical, dental, surgical, optometric or other attendance or  treatment,
AMBULANCE  SERVICES INCLUDING AIR TRANSPORT, nurse and hospital service,
medicine, optometric services, crutches, eye-glasses, false teeth, arti-
ficial eyes, orthotics, prosthetic  devices,  functional  assistive  and
adaptive  devices  and  apparatus,  as well as artificial members of the
body or other devices or appliances necessary in the first  instance  to
replace, support or relieve a portion or part of the body resulting from
and  necessitated  by  the injury of an employee, for such period as the
nature of the injury or the process of recovery  may  require,  and  the
employer  shall also be liable for replacements or repairs of such arti-
ficial members of the body or such  other  devices,  eye-glasses,  false
teeth, artificial eyes, orthotics, prosthetic devices, functional assis-
tive and adaptive devices or appliances necessitated by ordinary wear or

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD08921-01-3

S. 5662                             2

loss  or  damage  to  a prosthesis, with or without bodily injury to the
employee. Damage to or loss of a prosthetic device shall  be  deemed  an
injury  except that no disability benefits shall be payable with respect
to such injury under section fifteen of this article. Such a replacement
or  repair of artificial members of the body or such other devices, eye-
glasses, false teeth, artificial eyes,  orthotics,  prosthetic  devices,
functional assistive and adaptive devices or appliances or the providing
of medical treatment and care as defined herein shall not constitute the
payment of compensation under section twenty-five-a of this article. All
fees  and other charges for such treatment and services shall be limited
to such charges as prevail in the same community for  similar  treatment
of injured persons of a like standard of living.
  The  chair  shall  prepare  and establish a schedule for the state, or
schedules limited to defined localities, of charges and  fees  for  such
medical treatment and care, and including all medical, dental, surgical,
optometric or other attendance or treatment, nurse and hospital service,
medicine, optometric services, crutches, eye-glasses, false teeth, arti-
ficial  eyes,  orthotics,  prosthetic  devices, functional assistive and
adaptive devices and apparatus AND AMBULANCE SERVICES  INCLUDING  TRANS-
PORT  BY  AIR in accordance with and to be subject to change pursuant to
rules promulgated by the chair. Before preparing such schedule  for  the
state  or  schedules  for limited localities the chair shall request the
president of the medical society of the state of New York and the presi-
dent of the New York state osteopathic medical society to submit to  him
or  her a report on the amount of remuneration deemed by such society to
be fair and adequate for the types of medical care to be rendered  under
this  chapter,  but  consideration  shall  be given to the view of other
interested parties. In the case of physical therapy fees  schedules  the
chair  shall  request the president of a recognized professional associ-
ation representing physical therapists in  the  state  of  New  York  to
submit  to  him  or her a report on the amount of remuneration deemed by
such association to be fair and reasonable  for  the  type  of  physical
therapy services rendered under this chapter, but consideration shall be
given  to  the  views of other interested parties.  The chair shall also
prepare and establish a schedule for the state, or schedules limited  to
defined localities, of charges and fees for outpatient hospital services
not  covered  under  the  medical fee schedule previously referred to in
this subdivision, to be determined in accordance with and to be  subject
to  change  pursuant to rules promulgated by the chair. Before preparing
such schedule for the state or  schedules  for  limited  localities  the
chair  shall  request  the  president of the hospital association of New
York state to submit to him or her a report on the amount  of  remunera-
tion deemed by such association to be fair and adequate for the types of
hospital  outpatient care to be rendered under this chapter, but consid-
eration shall be given to the views of other interested parties. In  the
case  of occupational therapy fees schedules the chair shall request the
president of a recognized professional association representing  occupa-
tional  therapists  in  the  state of New York to submit to him or her a
report on the amount of remuneration deemed by such  association  to  be
fair  and  reasonable  for  the  type  of  occupational therapy services
rendered under this chapter, but consideration shall  be  given  to  the
views  of  other interested parties. The amounts payable by the employer
for such treatment and services shall be the  fees  and  charges  estab-
lished  by  such  schedule.    Nothing  in this schedule, however, shall
prevent voluntary payment of amounts higher or lower than the  fees  and
charges  fixed  therein, but no physician rendering medical treatment or

S. 5662                             3

care, and no physical or occupational therapist rendering their  respec-
tive  physical  or  occupational therapy services may receive payment in
any higher amount unless such increased amount has  been  authorized  by
the  employer,  or by decision as provided in section thirteen-g of this
article. Nothing in this section shall be construed  as  preventing  the
employment  of  a  duly  authorized  physician  on  a salary basis by an
authorized compensation medical bureau or laboratory.
  S 2. This act shall take effect on the one hundred eightieth day after
it shall have become a law.

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Senate Bill S5662

Sponsored By

Archive: Last Bill Status - In Senate Committee Labor Committee

Actions

2013-S5662 (ACTIVE) - Details

2013-S5662 (ACTIVE) - Summary

2013-S5662 (ACTIVE) - Sponsor Memo

2013-S5662 (ACTIVE) - Bill Text download pdf

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Sponsored By

Diane J. Savino

Archive: Last Bill Status - In Senate Committee Labor Committee

Actions

2013-S5662 (ACTIVE) - Details

2013-S5662 (ACTIVE) - Summary

2013-S5662 (ACTIVE) - Sponsor Memo

2013-S5662 (ACTIVE) - Bill Text download pdf

Comments