S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   2679
 
                        2019-2020 Regular Sessions
 
                           I N  A S S E M B L Y
 
                             January 24, 2019
                                ___________
 
 Introduced by M. of A. BARNWELL -- read once and referred to the Commit-
   tee on Labor
 
 AN  ACT  to amend the workers' compensation law, in relation to ensuring
   timely access to high-quality medical care
 
   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)  No  claim  for  specialist  consultations,  surgical  operations,
 physiotherapeutic or occupational therapy procedures, x-ray examinations
 or special diagnostic laboratory tests costing more than [one] TWO thou-
 sand  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] SEVEN  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.  SUCH  LIST  OF PRE-AUTHORIZED PROCEDURES SHALL BE
 ISSUED AND MAINTAINED FOR THE PURPOSE  OF  EXPEDITING  AUTHORIZATION  OF
 TREATMENT  OF  INJURED  WORKERS.  SUCH LIST OF PRE-AUTHORIZED PROCEDURES
 SHALL NOT BE CONSTRUED OR RELIED UPON TO SUPPORT THE PREMISE THAT PROCE-
 DURES NOT INCLUDED ON THE PRE-AUTHORIZED LIST SHOULD BE DENIED.  PRE-AU-
 THORIZED PROCEDURES SHALL NOT BE GIVEN PREFERENCE OVER ALTERNATIVE FORMS
 OF  TREATMENT  THAT  ARE NOT ON THE PRE-AUTHORIZED PROCEDURES LIST. SUCH
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD02237-01-9
              

 A. 2679                             2
 
 LIST MUST INCLUDE CONCURRENT ENROLLMENT IN AN ADDICTION AND/OR DEPENDEN-
 CY TREATMENT PROGRAM FOR ALL INJURED WORKERS SUBJECT TO OPIOID WEANING.
   §  2.  Paragraph  (c) of subdivision 7 of section 13-a of the workers'
 compensation law, as added by chapter 6 of the laws of 2007, is  amended
 to read as follows:
   (c)  At  the  time  a request for authorization for special diagnostic
 tests, x-ray examinations, magnetic resonance imaging or other radiolog-
 ical examinations or tests costing more than [one] TWO thousand  dollars
 as  required by subdivision five of this section is approved, the insur-
 ance carrier, self-insurer or state insurance fund, or if  so  delegated
 the  network  with  which  the  insurance carrier, self-insurer or state
 insurance fund has contracted, shall  notify  the  physician  requesting
 authorization of the requirement that the claimant obtain or undergo the
 special  diagnostic  test, x-ray examination, magnetic resonance imaging
 or other radiological examination or test with a provider or at a facil-
 ity  affiliated  with  the  network  or  networks  with  which  it   has
 contracted,  the  contact  information for the network and a list of the
 providers and facilities within the claimant's geographic  location,  as
 defined  by  regulation of the board. The claimant, in consultation with
 the provider who requested the special diagnostic test,  x-ray  examina-
 tion,  magnetic  resonance  imaging  or other radiological test or exam,
 will determine the provider or facility from within  the  network  which
 will perform such diagnostic test, x-ray examination, magnetic resonance
 imaging or other radiological examination or test.
   § 3. This act shall take effect immediately.