N.Y. Workers Compensation Law § 13-C

Current through 2024 NY Law Chapter 457

Section 13-C - Licensing of compensation medical bureaus and laboratories

1. The chairman may, upon the recommendation of the medical society of the county or of a board as provided in section thirteen-b, authorize and license compensation medical bureaus in such counties operated by qualified physicians wholly or principally for the diagnosis and treatment of industrial injuries or illnesses in respect to which they are authorized to render medical care under this chapter. The chairman, however, shall not authorize or license more than two such bureaus operated by the same physician. The chairman may, upon the recommendation of the medical society of the county or of a board as provided in section thirteen-b, authorize and license separate laboratories and bureaus engaged in X-ray diagnosis or treatment and clinical diagnosis, or in physiotherapy or other therapeutic procedures, which participate in the diagnosis or treatment of injured workmen under this chapter. The chairman, however, shall not authorize or license more than two such laboratories or bureaus operated by the same physician. Application for such authorization shall be made on forms to be furnished by the chairman, and shall disclose in full the nature of the personnel and equipment of such bureaus. If within sixty days after such application has been filed the medical society or board refuses or fails to act or refuses to recommend to the chairman that such license be granted, the applicant may appeal to the medical appeals unit. Each such bureau or laboratory which receives such authorization shall:

(a) Make reports on its personnel and equipment in such form and at such times as may be required by the chairman; and

(b) Be subject to inspection by the chairman or the medical society of the county in which such bureau or laboratory is located; and

2. No claim for services in connection with x-ray examination, diagnosis or treatment of any claimant shall be valid or enforceable except by a laboratory or bureau of a voluntary hospital authorized and licensed under subdivision one of this section, or except by a physician duly authorized as a roentgenologist by the chairman for services performed by such physician or under his immediate supervision.

(a) The chairman may authorize a medical center, jointly operated by labor and management representatives as a non-profit corporation or as a non-profit benefit trust, approved by and under the supervision of the New York state department of health, to provide medical, surgical, dental, optometric, podiatric, or other attendance or treatment, including X-ray diagnosis or treatment, physiotherapy or other therapeutic procedures or services, laboratory services and any and all other services required to be provided for an injured employee under section thirteen of this chapter, entitled "Treatment and care of injured employees".

(b) Application for such authorization shall be made on forms to be furnished by the chairman, and shall disclose in full the nature of the personnel and equipment of such medical center. Each such medical center which receives such authorization shall:

(i) Make reports on its personnel and equipment in such form and at such times as may be required by the chairman;

(ii) Be subject to inspection by the chairman;

(c) All treatment and services provided hereunder shall be provided on an out-patient basis to employees, who are claimants for workmen's compensation, eligible to use the medical center pursuant to an agreement, plan, deed of trust or labor-management collective bargaining agreement.

(d)

(i) A physician rendering medical care at a medical center authorized hereunder must be authorized to render such care pursuant to this chapter and he shall limit his professional activities hereunder to such medical care as his experience and training qualify him to render.

(ii) When para-medical, laboratory or X-ray services or other medical care is required it shall be rendered, under the active and personal supervision of an authorized physician, by a registered nurse or other person trained in laboratory or diagnostic techniques within the scope of such person's specialized training and qualifications. This supervision shall be evidenced by signed records of instructions for treatment and signed records of the patient's condition and progress. Reports of such treatment and supervision shall be made by such physician to the chairman on such forms and at such times as the chairman may require.

(iii) When physical therapy care is required it shall be rendered by a duly licensed physical therapist upon the referral which may be directive as to treatment of an authorized physician or podiatrist within the scope of such physical therapist's specialized training and qualifications as defined in article one hundred thirty-six of the education law. Reports of such treatment and records of instruction for treatment, if any, shall be maintained by the physical therapist and referring professional and submitted to the chairman on such forms and at such times as the chairman may require.

(iv) When occupational therapy care is required it shall be rendered by a duly licensed and registered occupational therapist upon the prescription or referral of an authorized physician within the scope of such occupational therapist's specialized training and qualifications as defined in article one hundred fifty-six of the education law. Reports of such treatment and records of instruction for treatment, if any, shall be maintained by the occupational therapist and referring professional and submitted to the chairman on such forms and at such times as the chairman may require.

(v) The physician rendering the medical care hereunder shall be in charge of the care unless, in his judgment, it is necessary to refer the case to a specially trained and qualified physician, which physician shall then assume complete responsibility for and supervision of any further medical care rendered.

(e) Notwithstanding any provision of this chapter to the contrary, a medical center authorized by the chairman to render medical care and laboratory services under this section, is authorized and may charge for any and all services rendered in accordance with such schedule or schedules prepared and established by the chairman.

(f) Nothing herein contained shall operate to prevent such employee from selecting for rendering or continuance of any medical treatment or care required, any physician authorized by the chairman to render medical care as hereinabove provided, in accordance with section thirteen-a, of this chapter.

(g) The chairman shall have full power and authority and it shall be his duty to investigate instances of misconduct, or violations of the provisions of this chapter or violations of the rules promulgated by the chairman under the provisions of this chapter, or failure to submit full and truthful medical reports directly to the chairman within the time limits provided under subdivision four of section thirteen-a of this chapter; and, after a hearing, to temporarily suspend or revoke the license of any such medical center. The chairman may also temporarily suspend or revoke the license of any such medical center upon finding, after a hearing, that such medical center has been guilty of professional or other misconduct or that the personnel of such center is not properly qualified under this chapter or the equipment of such medical center is inadequate for the proper rendering of medical care.

(h) The chairman may adopt such reasonable rules and regulations for the authorization and continued supervision of medical centers under this section, as he may deem necessary and proper.

(a) The chairman may authorize a hospital as defined in article twenty-eight of the public health law or a health maintenance organization holding a valid certificate of authority issued pursuant to article forty-four of the public health law or operating under the provisions of article forty-three of the insurance law to provide out-patient medical care under this chapter.

(b) Application for such authorization shall be made on forms to be furnished by the chairman, and shall disclose in full the nature of the personnel and equipment of such hospital or health maintenance organization. Each such hospital or health maintenance organization which receives such authorization shall:

(i) Make reports on its personnel and equipment in such form and at such times as may be required by the chairman; and

(ii) Be subject to inspection and investigation as provided hereunder.

(c) All treatment and services provided hereunder shall be provided on an out-patient basis to workers' compensation claimants.

(d)

(i) A physician rendering medical care at a hospital or health maintenance organization authorized hereunder must be authorized to render such care pursuant to this chapter and he or she shall limit his or her professional activities hereunder to such medical care as his or her experience and training qualify him or her to render. The physician rendering the medical care shall sign and submit all forms and reports as the chairman may require.

(iii) When physical therapy care is required it shall be rendered by a duly licensed physical therapist upon the referral which may be directive as to treatment of an authorized physician or podiatrist within the scope of such physical therapist's specialized training and qualifications as defined in article one hundred thirty-six of the education law. Reports of such treatment and records of instruction for treatment, if any, shall be maintained by the physical therapist and referring professional and submitted to the chairman of such forms and at such times as the chairman may require.

(v) The physician rendering the medical care hereunder shall be in charge of the care unless, in his or her judgment, it is necessary to refer the case to a specially trained and qualified authorized physician, which physician shall then assume complete responsibility for and supervision of any further medical care rendered.

(e) Notwithstanding any provision of this chapter to the contrary, a hospital or health maintenance organization authorized by the chairman to render medical care and laboratory services under this section, is authorized and may charge for any and all services rendered in accordance with such schedule or schedules prepared and established by the chairman.

(g)

(i) The department of health shall conduct inspections and investigations and make recommendations with respect to charges of professional or other misconduct or that the personnel of an authorized hospital or health maintenance organization are not properly qualified under this chapter or that the equipment of such hospital or health maintenance organization is inadequate for the proper rendering of medical care. After such inspection and investigation the department of health shall refer its report and recommendations to the chairman, who shall have full power and authority to temporarily suspend or revoke the authorization under this subdivision of any such hospital or health maintenance organization upon finding, after a hearing, that such hospital or health maintenance organization has been guilty of professional or other misconduct, or that the personnel of such hospital or health maintenance organization are not properly qualified under this chapter or the equipment of such hospital or health maintenance organization is inadequate for the proper rendering of medical care. The recommendations of the department of health shall be advisory to the chairman only and shall not be binding or conclusive upon him.

(ii) The chairman shall have full power and authority and it shall be his duty to investigate violations of the provisions of this chapter or violations of the rules promulgated by the chairman under the provisions of this chapter, or failure to submit full and truthful medical reports directly to the chairman within the time limits provided under subdivision four of section thirteen-a of this article, and, after a hearing, to temporarily suspend or revoke the authorization under this subdivision of any such hospital or health maintenance organization.

(h) The chairman may adopt such reasonable rules and regulations for the authorization and continued supervision of hospitals and health maintenance organizations under this section as he may deem necessary and proper.

N.Y. Workers Compensation Law § 13-C

Amended by New York Laws 2015, ch. 55,Sec. D-1 and Sec. D-2, eff. 4/1/2015.