Senate Bill S7361

2025-2026 Legislative Session

Relates to medical treatment for certain workers' compensation claimants

download bill text pdf

Sponsored By

Current Bill Status - In Senate Committee Labor Committee


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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2025-S7361 (ACTIVE) - Details

Current Committee:
Senate Labor
Law Section:
Workers' Compensation Law
Laws Affected:
Amd §25, Work Comp L

2025-S7361 (ACTIVE) - Summary

Provides that where an employer or insurance carrier elects to controvert the right to compensation and such claimant holds a valid insurance policy, the employer or insurance carrier shall provide medical treatment to the injured claimant and payment to health care providers without regard to such controversy.

2025-S7361 (ACTIVE) - Sponsor Memo

2025-S7361 (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   7361
 
                        2025-2026 Regular Sessions
 
                             I N  S E N A T E
 
                              April 10, 2025
                                ___________
 
 Introduced  by  Sen.  RHOADS -- read twice and ordered printed, and when
   printed to be committed to the Committee on Labor
 
 AN ACT to amend the workers' compensation law, in  relation  to  medical
   treatment  for  workers'  compensation  claimants  when  the  workers'
   compensation claim has been controverted

   THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND  ASSEM-
 BLY, DO ENACT AS FOLLOWS:
 
   Section  1.  Subdivision  2 of section 25 of the workers' compensation
 law is amended by adding a new paragraph (d) to read as follows:
   (D) (I) IN THE EVENT THE  EMPLOYER  OR  INSURANCE  CARRIER  ELECTS  TO
 CONTROVERT  THE  RIGHT  TO  COMPENSATION,  AND  IT IS CONFIRMED THAT THE
 CLAIMANT HOLDS A VALID POLICY  OF  INSURANCE  FROM  A  HEALTH  INSURANCE
 PROVIDER  IN  EFFECT  ON  THE DATE OF INJURY, SUCH EMPLOYER OR INSURANCE
 CARRIER SHALL PROVIDE MEDICAL TREATMENT TO THE INJURED  WORKER  PURSUANT
 TO  THE  PROVISIONS  OF SECTION THIRTEEN OF THIS CHAPTER, AND PAYMENT TO
 HEALTH CARE PROVIDERS PURSUANT TO PROCEDURES ESTABLISHED  BY  THE  BOARD
 WITHOUT REGARD TO SUCH CONTROVERSY.
   (II) IN THE EVENT THE BOARD MAKES A FINAL DETERMINATION THAT THE CLAIM
 IS   NOT  COMPENSABLE,  THE  EMPLOYER  OR  INSURANCE  CARRIER  MAY  SEEK
 REIMBURSEMENT FOR MEDICAL BILLS FROM  THE  CLAIMANT'S  HEALTH  INSURANCE
 PROVIDER  IN  AN  AMOUNT  NOT  TO EXCEED THE ACTUAL PAYMENTS MADE BY THE
 EMPLOYER OR INSURANCE CARRIER ON BEHALF OF THE CLAIMANT FOR SUCH MEDICAL
 TREATMENT. WITHIN THIRTY DAYS OF RECEIPT BY THE HEALTH INSURANCE PROVID-
 ER OF THE MEDICAL REPORTS, BILLS  AND  PROOF  OF  PAYMENT,  SUCH  HEALTH
 INSURANCE PROVIDER SHALL REIMBURSE THE EMPLOYER OR INSURANCE CARRIER FOR
 THE  FULL  AMOUNT  OF  THE  ACTUAL  PAYMENTS  MADE.  BILLS SUBMITTED FOR
 REIMBURSEMENT UNDER THIS SECTION MAY NOT BE CHALLENGED ON THE GROUNDS OF
 MEDICAL NECESSITY; UTILIZATION OF AN OUT OF NETWORK PROVIDER OR  IF  THE
 ESTABLISHED REIMBURSEMENT RATE FOR THE HEALTH INSURANCE PROVIDER IS LESS
 THAN  WHAT  IS  PROVIDED  UNDER  THE WORKERS' COMPENSATION FEE SCHEDULE.
 SHOULD THE HEALTH INSURANCE PROVIDER FAIL TO MAKE  TIMELY  PAYMENT,  THE
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD11581-01-5
              

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