§ 13-B — Authorization of providers, medical bureaus and laboratories by the chair

New York § 13-B

• Jurisdiction: New York
• Law WKC: Workers' Compensation
• Art. 2: Compensation

Text

§ 13-b. Authorization of providers, medical bureaus and laboratories\nby the chair. 1. No person shall render medical care or conduct\nindependent medical examinations under this chapter without such\nauthorization by the chair. As used in this title, the following\ndefinitions shall have the following meanings unless their context\nrequires otherwise:\n (a) "Acupuncturist" shall mean licensed as having completed a formal\ncourse of study and having passed an examination in accordance with the\neducation law, the regulations of the commissioner of education, and the\nrequirements of the board of regents. Acupuncturists are required by the\neducation law to advise, in writing, each patient of the importance of\nconsulting with a physician for the condition or conditions\nnecessitating acupuncture care, as prescribed by the education law.\n (b) "Chair" of the board shall mean either the chair or the chair's\ndesignee.\n (c) "Chiropractor" shall mean licensed and having completed two years\nof preprofessional college study and a four-year resident program in\nchiropractic in accordance with the education law, and consistent with\nthe licensing requirements of the commissioner of education.\n (d) "Dentist" shall mean licensed and having completed a four-year\ncourse of study leading to a D.D.S. or D.D.M. degree, or an equivalent\ndegree, in accordance with the education law and the licensing\nrequirements of the commissioner of education.\n (e) "Employer" shall mean a self-insured employer or, if insured, the\ninsurance carrier.\n (f) "Independent medical examination" shall mean an examination\nperformed by a physician, podiatrist, chiropractor or psychologist,\nauthorized under this section to perform such examination, for the\npurpose of examining or evaluating injury or illness pursuant to\nparagraph (b) of subdivision four of section thirteen-a and section one\nhundred thirty-seven of this chapter and as more fully set forth in\nregulation.\n (g) "Nurse practitioner" shall mean a licensed registered professional\nnurse certified pursuant to section sixty-nine hundred ten of the\neducation law acting within their lawful scope of practice.\n (h) "Occupational therapist" shall mean licensed as having at least a\nbachelor's or master's degree in occupational therapy from a registered\nprogram with the education department or receipt of a diploma or degree\nresulting from completion of not less than four years of postsecondary\nstudy, which includes the professional study of occupational therapy in\naccordance with the education law and the regulations of the\ncommissioner of education.\n (i) "Physical therapist" shall mean licensed in accordance with the\neducation law and the licensing requirements of the commissioner of\neducation.\n (j) "Physician" shall mean licensed with a degree of doctor of\nmedicine, M.D., or doctor of osteopathic medicine, D.O., or an\nequivalent degree in accordance with the education law and the licensing\nrequirements of the state board of medicine and the regulations of the\ncommissioner of education.\n (k) "Physician assistant" shall mean a licensed provider who is\nlicensed as a physician assistant pursuant to section sixty-five hundred\nforty-one of the education law.\n (l) "Podiatrist" shall mean a doctor of podiatric medicine licensed as\nhaving received a doctoral degree in podiatric medicine in accordance\nwith the regulations of the commissioner of education and the education\nlaw, and must satisfactorily meet all other requirements of the state\nboard for podiatric medicine.\n (m) "Provider" shall mean a duly licensed acupuncturist, chiropractor,\nnurse practitioner, occupational therapist, physical therapist,\nphysician, physician assistant, podiatrist, psychologist, or social\nworker authorized by the chair.\n (n) "Psychologist" shall mean licensed as having received a doctoral\ndegree in psychology from a program of psychology registered with the\nstate education department or the substantial equivalent thereof in\naccordance with the education law, the requirements of the state board\nfor psychology, and the regulations of the commissioner of education.\n (o) "Social worker" shall mean a licensed clinical social worker. A\nlicensed clinical social worker has completed a master's degree of\nsocial work that includes completion of a core curriculum of at least\ntwelve credit hours of clinical courses or the equivalent post-graduate\nclinical coursework, in accordance with the education law and the\nregulations of the commissioner of education.\n (p) "Physical therapist assistant" shall mean licensed in accordance\nwith the education law and the licensing requirements of the\ncommissioner of education.\n (q) "Occupational therapy assistant" shall mean licensed in accordance\nwith the education law and the licensing requirements of the\ncommissioner of education.\n 2. Any provider licensed pursuant to the education law to provide\nmedical care and treatment in the state of New York may render emergency\ncare and treatment in an emergency hospital or urgent care setting\nproviding emergency treatment under this chapter without authorization\nby the chair under this section; (a) Such licensed provider as\nidentified in this subdivision who is on staff at any hospital or urgent\ncare center providing emergency treatment may continue such medical care\nunder this chapter while an injured employee remains a patient in such\nhospital or urgent care setting; and\n (b) Under the direct supervision of an authorized provider, medical\ncare may be rendered by a registered nurse or other person trained in\nlaboratory or diagnostic techniques within the scope of such person's\nspecialized training and qualifications. This supervision shall be\nevidenced by signed records of instructions for treatment and signed\nrecords of the patient's condition and progress. Reports of such\ntreatment and supervision shall be made by such provider to the chair in\nthe format prescribed by the chair at such times as the chair may\nrequire.\n (b-1) Under the direction and supervision of an authorized\noccupational therapist, occupational therapy services may be rendered by\nan occupational therapy assistant. Under the direction and supervision\nof an authorized physical therapist, physical therapy services may be\nrendered by a physical therapist assistant. Where any such care or\ntreatment is rendered, records of the patient's condition and progress,\ntogether with records of instruction for treatment, if any, shall be\nmaintained by the physical therapist or occupational therapist and by\nthe referring physician, physician assistant, podiatrist, or nurse\npractitioner. Said records shall be submitted to the chair on forms and\nat such times as the chair may require.\n (b-2) Under the supervision of any authorized provider, any resident\nor fellow who may practice medicine as an exempt person as provided for\nin title eight of the education law, may render medical care under this\nchapter so long as the supervisory requirements of the education law are\nmet and neither the supervising provider nor resident or fellow have\nbeen prohibited from treating workers' compensation claimants pursuant\nto section thirteen-d of this article.\n (c) Where it would place an unreasonable burden upon the employer or\ncarrier to arrange for, or for the claimant to attend, an independent\nmedical examination by an authorized provider, the employer or carrier\nshall arrange for such examination to be performed by a qualified\nprovider in a medical facility convenient to the claimant.\n (d) Upon the prescription or referral of an authorized physician,\nphysician assistant, podiatrist, or nurse practitioner acting within the\nscope of his or her practice, care or treatment may be rendered to an\ninjured employee by an authorized physical therapist, occupational\ntherapist or acupuncturist provided the conditions and the treatment\nperformed are among the conditions that the physical therapist,\noccupational therapist or acupuncturist is authorized to treat pursuant\nto the education law or the regulations of the commissioner of\neducation. Where any such care or treatment is rendered, records of the\npatient's condition and progress, together with records of instruction\nfor treatment, if any, shall be maintained by the physical therapist,\noccupational therapist or acupuncturist rendering treatment and by the\nreferring physician, physician assistant, podiatrist, or nurse\npractitioner. Said records shall be submitted to the chair on forms and\nat such times as the chair may require.\n (e) A record, report or opinion of a physical therapist, occupational\ntherapist, acupuncturist or physician assistant shall not be considered\nas evidence of the causal relationship of any condition to a work\nrelated accident or occupational disease under this chapter. Nor may a\nrecord, report or opinion of a physical therapist, occupational\ntherapist or acupuncturist be considered evidence of disability. Nor may\na record, report or opinion of a physician assistant be considered\nevidence of the presence of a permanent or initial disability or the\ndegree thereof.\n (f) An independent medical examination performed in accordance with\nsection one hundred thirty-seven of this chapter, may only be performed\nby a physician, podiatrist, chiropractor or psychologist authorized to\nperform such examinations by the chair, or as specified in regulation,\nwhen qualified by the board.\n 3. A provider properly licensed or certified pursuant to the\nregulations of the commissioner of education and the requirements of the\neducation law desirous of being authorized to render medical care under\nthis chapter and/or to conduct independent medical examinations in\naccordance with paragraph (b) of subdivision four of section thirteen-a\nand section one hundred thirty-seven of this chapter shall file an\napplication for authorization under this chapter with the chair or\nchair's designee. Prior to receiving authorization, a physician must,\ntogether with submission of an application to the chair, submit such\napplication to the medical society of the county in which the\nphysician's office is located or of a board designated by such county\nsociety or of a board representing duly licensed physicians of any other\nschool of medical practice in such county, and such medical society\nshall submit the recommendation to the board. In the event such county\nsociety or board fails to take action upon a physician's completed and\nsigned application within forty-five days, the chair may complete review\nof the application without such approval. Upon approval of the\napplication by the chair or the chair's designee, the applicant shall\nfurther agree to refrain from subsequently treating for remuneration, as\na private patient, any person seeking medical treatment, or submitting\nto an independent medical examination, in connection with, or as a\nresult of, any injury compensable under this chapter, if he or she has\nbeen removed from the list of providers authorized to render medical\ncare or to conduct independent medical examinations under this chapter,\nor if the person seeking such treatment, or submitting to an independent\nmedical examination, has been transferred from his or her care in\naccordance with the provisions of this chapter. This agreement shall run\nto the benefit of the injured person so treated or examined, and shall\nbe available to him or her as a defense in any action by such provider\nfor payment for treatment rendered by a provider after he or she has\nbeen removed from the list of providers authorized to render medical\ncare or to conduct independent medical examinations under this chapter,\nor after the injured person was transferred from his or her care in\naccordance with the provisions of this chapter.\n 4. Laboratories and bureaus engaged in x-ray diagnosis or treatment or\nin physiotherapy or other therapeutic procedures and which participate\nin the diagnosis or treatment of injured workers under this chapter\nshall be operated or supervised by providers authorized under this\nchapter and shall be subject to the provisions of section thirteen-c of\nthis article. The person in charge of diagnostic clinical laboratories\nduly authorized under this chapter shall possess the qualifications\nestablished by the public health and health planning council for\napproval by the state commissioner of health or, in the city of New\nYork, the qualifications approved by the board of health of said city\nand shall maintain the standards of work required for such approval.\n