S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1179
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 14, 2019
                                ___________
 
 Introduced  by M. of A. ASHBY -- read once and referred to the Committee
   on Higher Education
 
 AN ACT to amend the education law and the insurance law, in relation  to
   allowing  patients  up to twelve visits with an occupational therapist
   without a referral from  a  physician,  nurse  practitioner  or  other
   health care provider

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Section 7901 of the education law, as  amended  by  chapter
 460 of the laws of 2011, is amended to read as follows:
   § 7901. Definition.  1. The practice of the profession of occupational
 therapy is defined as the functional evaluation of the client, the plan-
 ning and utilization of a program of purposeful activities, the develop-
 ment and utilization of a treatment program,  and/or  consultation  with
 the  client,  family,  caregiver  or  organization  in order to restore,
 develop  or  maintain  adaptive  skills,  and/or  performance  abilities
 designed  to  achieve maximal physical, cognitive and mental functioning
 of the client associated with his or her activities of daily living  and
 daily  life  tasks.  A  treatment  program designed to restore function,
 shall be rendered on the prescription or referral of a physician,  nurse
 practitioner  or  other  health  care  provider acting within his or her
 scope of practice pursuant to this title,  EXCEPT  AS  PROVIDED  FOR  IN
 SUBDIVISION  TWO  OF  THIS  SECTION.  However, nothing contained in this
 article shall be construed to permit any licensee hereunder to  practice
 medicine  or  psychology, including psychotherapy or to otherwise expand
 such licensee's scope of practice beyond  what  is  authorized  by  this
 chapter.
   2.  TREATMENT MAY BE RENDERED BY A LICENSED OCCUPATIONAL THERAPIST FOR
 TWELVE VISITS WITHOUT A REFERRAL FROM A PHYSICIAN, NURSE PRACTITIONER OR
 OTHER HEALTH CARE PROVIDER PROVIDED THAT:

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02032-01-9
              

 A. 1179                             2
 
   (A) THE LICENSED OCCUPATIONAL  THERAPIST  HAS  PRACTICED  OCCUPATIONAL
 THERAPY  ON  A  FULL TIME BASIS EQUIVALENT TO NOT LESS THAN THREE YEARS;
 AND
   (B)  EACH  OCCUPATIONAL  THERAPIST  LICENSED  PURSUANT TO THIS ARTICLE
 SHALL PROVIDE WRITTEN NOTICE TO EACH PATIENT RECEIVING TREATMENT  ABSENT
 A  REFERRAL  FROM  A  PHYSICIAN, NURSE PRACTITIONER OR OTHER HEALTH CARE
 PROVIDER THAT OCCUPATIONAL THERAPY MAY NOT BE COVERED BY  THE  PATIENT'S
 HEALTH CARE PLAN OR INSURER WITHOUT SUCH A REFERRAL AND THAT SUCH TREAT-
 MENT  MAY  BE A COVERED EXPENSE IF RENDERED PURSUANT TO A REFERRAL.  THE
 OCCUPATIONAL THERAPIST SHALL KEEP ON FILE WITH THE PATIENT'S  RECORDS  A
 FORM  ATTESTING  TO THE PATIENT'S NOTICE OF SUCH ADVICE. SUCH FORM SHALL
 BE IN DUPLICATE, WITH ONE COPY TO BE RETAINED BY THE PATIENT, SIGNED AND
 DATED BY BOTH THE OCCUPATIONAL THERAPIST AND THE PATIENT IN SUCH FORM AS
 PRESCRIBED PURSUANT TO REGULATIONS PROMULGATED BY THE COMMISSIONER.
   § 2. Paragraph 1 of subsection (a) of section 5102  of  the  insurance
 law,  as  amended by chapter 298 of the laws of 2006, is amended to read
 as follows:
   (1)  All  necessary  expenses  incurred  for:  (i)  medical,  hospital
 (including services rendered in compliance with article forty-one of the
 public health law, whether or not such services are rendered directly by
 a  hospital),  surgical, nursing, dental, ambulance, x-ray, prescription
 drug  and  prosthetic  services;  (ii)  psychiatric,  physical   therapy
 (provided that treatment is rendered pursuant to a referral) and occupa-
 tional  therapy  and rehabilitation (PROVIDED THAT TREATMENT IS RENDERED
 PURSUANT TO A REFERRAL); (iii) any non-medical remedial care and  treat-
 ment  rendered  in  accordance with a religious method of healing recog-
 nized by the laws of this state; and (iv) any other professional  health
 services;  all  without  limitation as to time, provided that within one
 year after the date of the accident causing the injury it is ascertaina-
 ble that further expenses may be incurred as a result of the injury. For
 the purpose of determining basic economic loss,  the  expenses  incurred
 under  this  paragraph  shall  be  in accordance with the limitations of
 section five thousand one hundred eight of this article.
   § 3. This act shall take effect on the one hundred twentieth day after
 it shall have become a law, provided, however, that effective immediate-
 ly the department of education is  authorized  to  take  such  steps  in
 advance of such effective date, including the addition, amendment and/or
 repeal  of  any  rule  or  regulation as may be necessary, to ensure the
 timely implementation of the provisions of this act  on  such  effective
 date.