S T A T E O F N E W Y O R K
________________________________________________________________________
2066
2021-2022 Regular Sessions
I N A S S E M B L Y
January 14, 2021
___________
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 section 8 of part CC of chapter 55 of the laws of
2019, 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 prohibit varied treatment when the treating provider demon-
strates the appropriateness and medical necessity of such treatment.
SUCH LIST OF PRE-AUTHORIZED PROCEDURES SHALL NOT BE CONSTRUED OR RELIED
UPON TO SUPPORT THE PREMISE THAT PROCEDURES NOT INCLUDED ON THE PRE-AU-
THORIZED LIST SHOULD BE DENIED. PRE-AUTHORIZED PROCEDURES SHALL NOT BE
GIVEN PREFERENCE OVER ALTERNATIVE FORMS OF TREATMENT THAT ARE NOT ON THE
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD06941-01-1
A. 2066 2
PRE-AUTHORIZED PROCEDURES LIST. SUCH LIST SHALL INCLUDE CONCURRENT
ENROLLMENT IN AN ADDICTION AND/OR DEPENDENCY 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.