Assembly Bill A11714

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   11714
 
                           I N  A S S E M B L Y
 
                            September 16, 2026
                                ___________
 
 Introduced  by COMMITTEE ON RULES -- (at request of M. of A. Bronson) --
   read once and referred to the Committee on Labor
 
 AN ACT to amend the workers' compensation law, in relation  to  imposing
   higher  percentage  of  interest  and other civil penalties on certain
   employers or their workers' compensation insurance carriers  for  non-
   payment of a bill for medical care or supplies

   THE  PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section 1. Subdivision 1 of section 13-g of the workers'  compensation
 law,  as  amended  by  section 3 of part CC of chapter 55 of the laws of
 2019, is amended to read as follows:
   (1) (A) Within forty-five days  after  a  bill  for  medical  care  or
 supplies delivered pursuant to section thirteen of this article has been
 rendered to the employer OR SUCH EMPLOYER'S WORKER'S COMPENSATION INSUR-
 ANCE CARRIER, OR TO THE SELF-INSURED EMPLOYER RESPONSIBLE FOR PAYMENT OF
 MEDICAL  BENEFITS  UNDER  THIS  CHAPTER,  such  employer OR ITS WORKER'S
 COMPENSATION INSURANCE CARRIER, OR SUCH SELF-INSURED EMPLOYER  RESPONSI-
 BLE  FOR  PAYMENT  OF  MEDICAL BENEFITS UNDER THIS CHAPTER, must pay the
 bill or notify the medical care  provider  or  supplier  in  the  format
 prescribed  by the chair that the bill is not being paid and explain the
 reasons for non-payment. In the event that the employer OR ITS  WORKER'S
 COMPENSATION INSURANCE CARRIER, OR THE SELF-INSURED EMPLOYER RESPONSIBLE
 FOR  PAYMENT  OF  MEDICAL  BENEFITS  UNDER  THIS  CHAPTER, fails to make
 payment or notify the medical care  provider  or  supplier  within  such
 forty-five  day  period that payment is not being made, the medical care
 provider or supplier may notify the board in the  format  prescribed  by
 the  chair  that  the  bill has not been paid and request that the board
 make an award for payment of such bill. The board or the chair may  make
 an  award  not  in  excess of the established fee schedules for any such
 bill or part thereof which remains  unpaid  after  said  forty-five  day
 period  or  thirty days after all other questions duly and timely raised
 in accordance with the provisions  of  this  chapter,  relating  to  the
 employer's  liability,  SUCH  EMPLOYER'S WORKER'S COMPENSATION INSURANCE
 CARRIER'S LIABILITY, OR FOR A SELF-INSURED EMPLOYER THAT IS  RESPONSIBLE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
              

                                                            LBD16333-01-6
 A. 11714                            2
 
 FOR  PAYMENT  OF  MEDICAL BENEFITS UNDER THIS CHAPTER, SUCH SELF-INSURED
 EMPLOYER'S LIABILITY for the payment of such  amount,  shall  have  been
 finally  determined  adversely to [the] SUCH employer OR SUCH EMPLOYER'S
 WORKER'S  COMPENSATION  INSURANCE CARRIER, OR SUCH SELF-INSURED EMPLOYER
 RESPONSIBLE FOR PAYMENT OF MEDICAL BENEFITS UNDER THIS CHAPTER, whichev-
 er is later, in accordance with rules promulgated by the chair, and such
 award may be collected in like manner as an award of  compensation.  The
 chair  shall  assess  the  sum of fifty dollars against the employer for
 each such award made by the board, which sum  shall  be  paid  into  the
 state treasury.
   (B) In the event that the employer OR ITS WORKER'S COMPENSATION INSUR-
 ANCE  CARRIER,  OR  THE SELF-INSURED EMPLOYER RESPONSIBLE FOR PAYMENT OF
 MEDICAL BENEFITS UNDER THIS CHAPTER,  has  provided  an  explanation  in
 writing  why  the bill has not been paid, in part or in full, within the
 aforesaid time period, and the parties [can not] CANNOT agree as to  the
 value  of  medical  aid rendered under this chapter, such value shall be
 decided by arbitration as set forth in rules and regulations promulgated
 by the chair.
   (C) Where a bill for medical care or supplies has been  determined  to
 be  due  and owing in accordance with the provisions of this section the
 board shall include in the amount of the award interest of not more than
 one and one-half percent (1 1/2%) per month payable to the medical  care
 provider  or  supplier,  in  accordance  with  the rules and regulations
 promulgated by the board. Interest shall be calculated from  the  forty-
 fifth  day  after  the bill was rendered or from the thirtieth day after
 all other questions duly  and  timely  raised  in  accordance  with  the
 provisions of this chapter, relating to the employer's liability OR SUCH
 EMPLOYER'S WORKER'S COMPENSATION INSURANCE CARRIER'S LIABILITY, OR FOR A
 SELF-INSURED  EMPLOYER  THAT IS RESPONSIBLE FOR PAYMENT OF MEDICAL BENE-
 FITS UNDER THIS CHAPTER, SUCH SELF-INSURED EMPLOYER'S LIABILITY, for the
 payment of such amount, shall have been finally determined adversely  to
 the employer OR ITS WORKER'S COMPENSATION INSURANCE CARRIER, OR SELF-IN-
 SURED  EMPLOYER  RESPONSIBLE  FOR PAYMENT OF MEDICAL BENEFITS UNDER THIS
 CHAPTER, whichever is later, in accordance with rules promulgated by the
 chair.
   (D) IF THE EMPLOYER OR ITS WORKER'S COMPENSATION INSURANCE CARRIER, OR
 THE SELF-INSURED EMPLOYER RESPONSIBLE FOR PAYMENT  OF  MEDICAL  BENEFITS
 UNDER  THIS CHAPTER, FAILS TO PAY AN AWARD WITHIN FIFTEEN DAYS AFTER THE
 AWARD IS RENDERED BY THE BOARD PURSUANT TO  THIS  SUBDIVISION,  INTEREST
 SHALL  ACCRUE  ON THE UNPAID AMOUNT BEGINNING ON THE SIXTEENTH DAY AFTER
 THE AWARD IS RENDERED AND SHALL BE PAYABLE AT THE RATE OF THREE  PERCENT
 PER MONTH UNTIL THE AWARD IS PAID IN FULL.
   (E)  A  MEDICAL  CARE  PROVIDER  OR SUPPLIER THAT ALLEGES A PATTERN OR
 PRACTICE OF NON-PAYMENT BY THE EMPLOYER  OR  ITS  WORKER'S  COMPENSATION
 INSURANCE  CARRIER, OR THE SELF-INSURED EMPLOYER RESPONSIBLE FOR PAYMENT
 OF MEDICAL BENEFITS UNDER THIS CHAPTER, MAY FILE A CLAIM WITH THE BOARD,
 IN A FORM AND MANNER PRESCRIBED BY THE CHAIR, REQUESTING A DETERMINATION
 THAT SUCH EMPLOYER OR ITS WORKER'S COMPENSATION  INSURANCE  CARRIER,  OR
 SUCH  SELF-INSURED  EMPLOYER RESPONSIBLE FOR PAYMENT OF MEDICAL BENEFITS
 UNDER THIS CHAPTER, HAS ENGAGED IN A PATTERN OR PRACTICE OF  NON-PAYMENT
 AND SEEKING A SPECIAL AWARD FOR PAYMENT OF THE BILL OR BILLS AT ISSUE.
   (F)  WHERE THE BOARD DETERMINES THAT A PATTERN OR PRACTICE OF NON-PAY-
 MENT EXISTS AND THAT PAYMENT IS DUE AND OWING PURSUANT TO THIS  SUBDIVI-
 SION,  THE  BOARD  SHALL  INCLUDE IN THE AWARD INTEREST AT A RATE OF NOT
 LESS THAN THREE PERCENT AND NOT MORE THAN FIVE  PERCENT  PER  MONTH.  IN
 DETERMINING  THE  APPLICABLE  RATE OF INTEREST, THE BOARD SHALL CONSIDER
 A. 11714                            3
 
 THE SEVERITY, DURATION, AND FREQUENCY OF  THE  PATTERN  OR  PRACTICE  OF
 NON-PAYMENT, INCLUDING THE NUMBER OF VIOLATIONS, THE LENGTH OF TIME OVER
 WHICH SUCH CONDUCT OCCURRED, AND THE NUMBER OF MEDICAL CARE PROVIDERS OR
 SUPPLIERS ADVERSELY AFFECTED.
   (G) IN CASES INVOLVING EGREGIOUS OR REPEATED VIOLATIONS CONSTITUTING A
 PATTERN  OR  PRACTICE  OF NON-PAYMENT, THE BOARD MAY, IN ADDITION TO ANY
 INTEREST AWARDED PURSUANT TO THIS SUBDIVISION, IMPOSE A CIVIL PENALTY IN
 AN AMOUNT NOT TO EXCEED TWENTY-FIVE PERCENT OF THE AMOUNT DETERMINED  TO
 BE  DUE  AND OWING. SUCH PENALTY SHALL BE PAYABLE IMMEDIATELY UPON ISSU-
 ANCE OF THE BOARD'S DECISION.
   (H) FOR PURPOSES OF THIS SUBDIVISION, THE TERM "PATTERN  OR  PRACTICE"
 SHALL MEAN:
   (I)  THREE OR MORE VIOLATIONS OF THIS SUBDIVISION BY THE SAME EMPLOYER
 OR ITS INSURANCE CARRIER, OR BY THE SAME SELF-INSURED EMPLOYER RESPONSI-
 BLE FOR PAYMENT OF MEDICAL BENEFITS UNDER THIS CHAPTER, WITHIN A TWELVE-
 MONTH PERIOD WITH RESPECT TO ONE  OR  MORE  MEDICAL  CARE  PROVIDERS  OR
 SUPPLIERS; OR
   (II)  SUCH OTHER REPEATED CONDUCT AS THE CHAIR DETERMINES DEMONSTRATES
 A SYSTEMIC FAILURE TO COMPLY WITH THE REQUIREMENTS OF THIS  SUBDIVISION,
 INCLUDING REPEATED UNTIMELY PAYMENT OF CLAIMS, REPEATED UNTIMELY NOTICES
 OF DENIAL OR OBJECTION, OR OTHER RECURRING PAYMENT PRACTICES THAT UNREA-
 SONABLY DELAY REIMBURSEMENT TO MEDICAL CARE PROVIDERS OR SUPPLIERS.
   § 2. This act shall take effect immediately.