Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
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---|---|
Apr 10, 2025 |
referred to labor |
Senate Bill S7361
2025-2026 Legislative Session
Sponsored By
(R, C) 5th Senate District
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
Actions
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
BILL NUMBER: S7361 SPONSOR: RHOADS TITLE OF BILL: An act to amend the workers' compensation law, in relation to medical treatment for workers' compensation claimants when the workers' compen- sation claim has been controverted PURPOSE: Relates to medical treatment for certain workers' compensation claim- ants. SUMMARY OF PROVISIONS: 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 the injury, such employer or insurance carrier shall provide
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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