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.