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Assembly Bill A5530B

2015-2016 Legislative Session

Requires the medical advisory committee to establish the use of comprehensive nationally recognized treatment guidelines for all body parts or conditions

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Archive: Last Bill Status - On Floor Calendar

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Bill Amendments

co-Sponsors

2015-A5530 - Details

See Senate Version of this Bill:
S4332
Law Section:
Workers' Compensation Law
Laws Affected:
Amd §13-a, Work Comp L
Versions Introduced in Other Legislative Sessions:
2013-2014: A9068, S6997
2017-2018: A5526

2015-A5530 - Summary

Requires the medical advisory committee to establish the use of comprehensive nationally recognized treatment guidelines for all body parts or conditions which have no recommendations by such advisory committee.

2015-A5530 - Bill Text download pdf 

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

                                  5530

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            February 27, 2015
                               ___________

Introduced  by M. of A. BRONSON -- read once and referred to the Commit-
  tee on Labor

AN ACT to amend the workers' compensation law, in relation to  requiring
  the  medical  advisory committee to establish the use of comprehensive
  nationally recognized treatment  guidelines  for  all  body  parts  or
  conditions which have no recommendations by such advisory committee

  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 and as further amended
by section 104 of part A of chapter 62 of the laws of 2011,  is  amended
to read as follows:
  (5)  (A)  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 financial services,
shall issue and maintain a list of pre-authorized procedures under  this
section.
  (B)(I)  THE  MEDICAL  ADVISORY COMMITTEE SHALL RECOMMEND AND THE BOARD
SHALL ADOPT THE TEMPORARY USE  OF  COMPREHENSIVE  NATIONALLY  RECOGNIZED
TREATMENT  GUIDELINES  FOR BODY PARTS OR CONDITIONS WHERE NO AGREED UPON
WORKERS' COMPENSATION TREATMENT GUIDELINE EXISTS.  UNTIL SUCH TIME  THAT
THE MEDICAL ADVISORY COMMITTEE MAKES A RECOMMENDATION FOR A BODY PART OR

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05994-01-5

co-Sponsors

2015-A5530A - Details

See Senate Version of this Bill:
S4332
Law Section:
Workers' Compensation Law
Laws Affected:
Amd §13-a, Work Comp L
Versions Introduced in Other Legislative Sessions:
2013-2014: A9068, S6997
2017-2018: A5526

2015-A5530A - Summary

Requires the medical advisory committee to establish the use of comprehensive nationally recognized treatment guidelines for all body parts or conditions which have no recommendations by such advisory committee.

2015-A5530A - Bill Text download pdf 

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

                                 5530--A

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            February 27, 2015
                               ___________

Introduced  by  M. of A. BRONSON, CROUCH, GUNTHER, RAIA -- read once and
  referred to the Committee  on  Labor  --  committee  discharged,  bill
  amended,  ordered reprinted as amended and recommitted to said commit-
  tee

AN ACT to amend the workers' compensation law, in relation to  requiring
  the  medical  advisory committee to establish the use of comprehensive
  nationally recognized treatment  guidelines  for  all  body  parts  or
  conditions which have no recommendations by such advisory committee

  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 and as further amended
by section 104 of part A of chapter 62 of the laws of 2011,  is  amended
to read as follows:
  (5)  (A)  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 financial services,
shall issue and maintain a list of pre-authorized procedures under  this
section.
  (B)(I)  THE  MEDICAL  ADVISORY COMMITTEE SHALL RECOMMEND AND THE BOARD
SHALL  ADOPT  THE  TEMPORARY  USE  OF  COMPREHENSIVE,  EVIDENCE   BASED,
NATIONALLY  RECOGNIZED TREATMENT GUIDELINES FOR BODY PARTS OR CONDITIONS

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05994-03-5

co-Sponsors

2015-A5530B (ACTIVE) - Details

See Senate Version of this Bill:
S4332
Law Section:
Workers' Compensation Law
Laws Affected:
Amd §13-a, Work Comp L
Versions Introduced in Other Legislative Sessions:
2013-2014: A9068, S6997
2017-2018: A5526

2015-A5530B (ACTIVE) - Summary

Requires the medical advisory committee to establish the use of comprehensive nationally recognized treatment guidelines for all body parts or conditions which have no recommendations by such advisory committee.

2015-A5530B (ACTIVE) - Bill Text download pdf 

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

                                 5530--B

                       2015-2016 Regular Sessions

                          I N  A S S E M B L Y

                            February 27, 2015
                               ___________

Introduced  by  M. of A. BRONSON, CROUCH, GUNTHER, RAIA -- read once and
  referred to the Committee  on  Labor  --  committee  discharged,  bill
  amended,  ordered reprinted as amended and recommitted to said commit-
  tee -- again reported from said  committee  with  amendments,  ordered
  reprinted as amended and recommitted to said committee

AN  ACT to amend the workers' compensation law, in relation to requiring
  the medical advisory committee to establish the use  of  comprehensive
  nationally  recognized  treatment  guidelines  for  all  body parts or
  conditions which have no recommendations by such advisory committee

  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 and as further  amended
by  section  104 of part A of chapter 62 of the laws of 2011, is amended
to read as follows:
  (5) (A) 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  financial  services,
shall  issue and maintain a list of pre-authorized procedures under this
section. THE LIST OF PRE-AUTHORIZED PROCEDURES, INCLUDING MEDICAL TREAT-
MENT AUTHORIZED BY ANY GUIDELINES PROMULGATED OR ADOPTED BY  THE  BOARD,

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD05994-05-5

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