§ 13-C — Licensing of compensation medical bureaus and laboratories

New York § 13-C

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

Text

§ 13-c. Licensing of compensation medical bureaus and laboratories. 1.\nThe chairman may, upon the recommendation of the medical society of the\ncounty or of a board as provided in section thirteen-b, authorize and\nlicense compensation medical bureaus in such counties operated by\nqualified physicians wholly or principally for the diagnosis and\ntreatment of industrial injuries or illnesses in respect to which they\nare authorized to render medical care under this chapter. The chairman,\nhowever, shall not authorize or license more than two such bureaus\noperated by the same physician. The chairman may, upon the\nrecommendation of the medical society of the county or of a board as\nprovided in section thirteen-b, authorize and license separate\nlaboratories and bureaus engaged in X-ray diagnosis or treatment and\nclinical diagnosis, or in physiotherapy or other therapeutic procedures,\nwhich participate in the diagnosis or treatment of injured workmen under\nthis chapter. The chairman, however, shall not authorize or license more\nthan two such laboratories or bureaus operated by the same physician.\nApplication for such authorization shall be made on forms to be\nfurnished by the chairman, and shall disclose in full the nature of the\npersonnel and equipment of such bureaus. If within sixty days after such\napplication has been filed the medical society or board refuses or fails\nto act or refuses to recommend to the chairman that such license be\ngranted, the applicant may appeal to the medical appeals unit. Each such\nbureau or laboratory which receives such authorization shall:\n (a) Make reports on its personnel and equipment in such form and at\nsuch times as may be required by the chairman; and\n (b) Be subject to inspection by the chairman or the medical society of\nthe county in which such bureau or laboratory is located; and\n 2. No claim for services in connection with x-ray examination,\ndiagnosis or treatment of any claimant shall be valid or enforceable\nexcept by a laboratory or bureau of a voluntary hospital authorized and\nlicensed under subdivision one of this section, or except by a physician\nduly authorized as a roentgenologist by the chairman for services\nperformed by such physician or under his immediate supervision.\n 3. (a) The chairman may authorize a medical center, jointly operated\nby labor and management representatives as a non-profit corporation or\nas a non-profit benefit trust, approved by and under the supervision of\nthe New York state department of health, to provide medical, surgical,\ndental, optometric, podiatric, or other attendance or treatment,\nincluding X-ray diagnosis or treatment, physiotherapy or other\ntherapeutic procedures or services, laboratory services and any and all\nother services required to be provided for an injured employee under\nsection thirteen of this chapter, entitled "Treatment and care of\ninjured employees".\n (b) Application for such authorization shall be made on forms to be\nfurnished by the chairman, and shall disclose in full the nature of the\npersonnel and equipment of such medical center. Each such medical center\nwhich receives such authorization shall:\n (i) Make reports on its personnel and equipment in such form and at\nsuch times as may be required by the chairman;\n (ii) Be subject to inspection by the chairman;\n (c) All treatment and services provided hereunder shall be provided on\nan out-patient basis to employees, who are claimants for workmen's\ncompensation, eligible to use the medical center pursuant to an\nagreement, plan, deed of trust or labor-management collective bargaining\nagreement.\n (d) (i) A physician rendering medical care at a medical center\nauthorized hereunder must be authorized to render such care pursuant to\nthis chapter and he shall limit his professional activities hereunder to\nsuch medical care as his experience and training qualify him to render.\n (ii) When para-medical, laboratory or X-ray services or other medical\ncare is required it shall be rendered, under the active and personal\nsupervision of an authorized physician, by a registered nurse or other\nperson trained in laboratory or diagnostic techniques within the scope\nof such person's specialized training and qualifications. This\nsupervision shall be evidenced by signed records of instructions for\ntreatment and signed records of the patient's condition and progress.\nReports of such treatment and supervision shall be made by such\nphysician to the chairman on such forms and at such times as the\nchairman may require.\n (iii) When physical therapy care is required it shall be rendered by a\nduly licensed physical therapist upon the referral which may be\ndirective as to treatment of an authorized physician or podiatrist\nwithin the scope of such physical therapist's specialized training and\nqualifications as defined in article one hundred thirty-six of the\neducation law. Reports of such treatment and records of instruction for\ntreatment, if any, shall be maintained by the physical therapist and\nreferring professional and submitted to the chairman on such forms and\nat such times as the chairman may require.\n (iv) When occupational therapy care is required it shall be rendered\nby a duly licensed and registered occupational therapist upon the\nprescription or referral of an authorized physician within the scope of\nsuch occupational therapist's specialized training and qualifications as\ndefined in article one hundred fifty-six of the education law. Reports\nof such treatment and records of instruction for treatment, if any,\nshall be maintained by the occupational therapist and referring\nprofessional and submitted to the chairman on such forms and at such\ntimes as the chairman may require.\n (v) The physician rendering the medical care hereunder shall be in\ncharge of the care unless, in his judgment, it is necessary to refer the\ncase to a specially trained and qualified physician, which physician\nshall then assume complete responsibility for and supervision of any\nfurther medical care rendered.\n (e) Notwithstanding any provision of this chapter to the contrary, a\nmedical center authorized by the chairman to render medical care and\nlaboratory services under this section, is authorized and may charge for\nany and all services rendered in accordance with such schedule or\nschedules prepared and established by the chairman.\n (f) Nothing herein contained shall operate to prevent such employee\nfrom selecting for rendering or continuance of any medical treatment or\ncare required, any physician authorized by the chairman to render\nmedical care as hereinabove provided, in accordance with section\nthirteen-a, of this chapter.\n (g) The chairman shall have full power and authority and it shall be\nhis duty to investigate instances of misconduct, or violations of the\nprovisions of this chapter or violations of the rules promulgated by the\nchairman under the provisions of this chapter, or failure to submit full\nand truthful medical reports directly to the chairman within the time\nlimits provided under subdivision four of section thirteen-a of this\nchapter; and, after a hearing, to temporarily suspend or revoke the\nlicense of any such medical center. The chairman may also temporarily\nsuspend or revoke the license of any such medical center upon finding,\nafter a hearing, that such medical center has been guilty of\nprofessional or other misconduct or that the personnel of such center is\nnot properly qualified under this chapter or the equipment of such\nmedical center is inadequate for the proper rendering of medical care.\n (h) The chairman may adopt such reasonable rules and regulations for\nthe authorization and continued supervision of medical centers under\nthis section, as he may deem necessary and proper.\n 4. (a) The chairman may authorize a hospital as defined in article\ntwenty-eight of the public health law or a health maintenance\norganization holding a valid certificate of authority issued pursuant to\narticle forty-four of the public health law or operating under the\nprovisions of article forty-three of the insurance law to provide\nout-patient medical care under this chapter.\n (b) Application for such authorization shall be made on forms to be\nfurnished by the chairman, and shall disclose in full the nature of the\npersonnel and equipment of such hospital or health maintenance\norganization. Each such hospital or health maintenance organization\nwhich receives such authorization shall:\n (i) Make reports on its personnel and equipment in such form and at\nsuch times as may be required by the chairman; and\n (ii) Be subject to inspection and investigation as provided hereunder.\n (c) All treatment and services provided hereunder shall be provided on\nan out-patient basis to workers' compensation claimants.\n (d) (i) A physician rendering medical care at a hospital or health\nmaintenance organization authorized hereunder must be authorized to\nrender such care pursuant to this chapter and he or she shall limit his\nor her professional activities hereunder to such medical care as his or\nher experience and training qualify him or her to render. The physician\nrendering the medical care shall sign and submit all forms and reports\nas the chairman may require.\n (ii) When para-medical, laboratory or X-ray services or other medical\ncare is required it shall be rendered, under the active and personal\nsupervision of an authorized physician, by a registered nurse or other\nperson trained in laboratory or diagnostic techniques within the scope\nof such person's specialized training and qualifications. This\nsupervision shall be evidenced by signed records of instructions for\ntreatment and signed records of the patient's condition and progress.\nReports of such treatment and supervision shall be made by such\nphysician to the chairman on such forms and at such times as the\nchairman may require.\n (iii) When physical therapy care is required it shall be rendered by a\nduly licensed physical therapist upon the referral which may be\ndirective as to treatment of an authorized physician or podiatrist\nwithin the scope of such physical therapist's specialized training and\nqualifications as defined in article one hundred thirty-six of the\neducation law. Reports of such treatment and records of instruction for\ntreatment, if any, shall be maintained by the physical therapist and\nreferring professional and submitted to the chairman of such forms and\nat such times as the chairman may require.\n (iv) When occupational therapy care is required it shall be rendered\nby a duly licensed and registered occupational therapist upon the\nprescription or referral of an authorized physician within the scope of\nsuch occupational therapist's specialized training and qualifications as\ndefined in article one hundred fifty-six of the education law. Reports\nof such treatment and records of instruction for treatment, if any,\nshall be maintained by the occupational therapist and referring\nprofessional and submitted to the chairman on such forms and at such\ntimes as the chairman may require.\nReports of such treatment and supervision shall be made by such\nphysician to the chairman on such forms and at such times as the\nchairman may require.\n (v) The physician rendering the medical care hereunder shall be in\ncharge of the care unless, in his or her judgment, it is necessary to\nrefer the case to a specially trained and qualified authorized\nphysician, which physician shall then assume complete responsibility for\nand supervision of any further medical care rendered.\n (e) Notwithstanding any provision of this chapter to the contrary, a\nhospital or health maintenance organization authorized by the chairman\nto render medical care and laboratory services under this section, is\nauthorized and may charge for any and all services rendered in\naccordance with such schedule or schedules prepared and established by\nthe chairman.\n (f) Nothing herein contained shall operate to prevent such employee\nfrom selecting for rendering or continuance of any medical treatment or\ncare required, any physician authorized by the chairman to render\nmedical care as hereinabove provided, in accordance with section\nthirteen-a of this chapter.\n (g) (i) The department of health shall conduct inspections and\ninvestigations and make recommendations with respect to charges of\nprofessional or other misconduct or that the personnel of an authorized\nhospital or health maintenance organization are not properly qualified\nunder this chapter or that the equipment of such hospital or health\nmaintenance organization is inadequate for the proper rendering of\nmedical care. After such inspection and investigation the department of\nhealth shall refer its report and recommendations to the chairman, who\nshall have full power and authority to temporarily suspend or revoke the\nauthorization under this subdivision of any such hospital or health\nmaintenance organization upon finding, after a hearing, that such\nhospital or health maintenance organization has been guilty of\nprofessional or other misconduct, or that the personnel of such hospital\nor health maintenance organization are not properly qualified under this\nchapter or the equipment of such hospital or health maintenance\norganization is inadequate for the proper rendering of medical care. The\nrecommendations of the department of health shall be advisory to the\nchairman only and shall not be binding or conclusive upon him.\n (ii) The chairman shall have full power and authority and it shall be\nhis duty to investigate violations of the provisions of this chapter or\nviolations of the rules promulgated by the chairman under the provisions\nof this chapter, or failure to submit full and truthful medical reports\ndirectly to the chairman within the time limits provided under\nsubdivision four of section thirteen-a of this article, and, after a\nhearing, to temporarily suspend or revoke the authorization under this\nsubdivision of any such hospital or health maintenance organization.\n (h) The chairman may adopt such reasonable rules and regulations for\nthe authorization and continued supervision of hospitals and health\nmaintenance organizations under this section as he may deem necessary\nand proper.\n