§ 13-K — Care and treatment of injured employees by duly licensed podiatrists

New York § 13-K

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

Text

§ 13-k. Care and treatment of injured employees by duly licensed\npodiatrists. 1. When the term "chairman" is hereinafter used, it shall\nbe deemed to mean the chair of the workers' compensation board of the\nstate of New York.\n 2. An employee injured under circumstances which make such injury\ncompensable under this article, when care is required for an injury to\nthe foot which injury or resultant condition therefrom may lawfully be\ntreated by a duly registered and licensed podiatrist of the state of New\nYork, may select to treat him or her any podiatrist authorized by the\nchair to render podiatric medical care, as hereinafter provided. If the\ninjury or condition is one which is without the limits prescribed by the\neducation law for podiatric medical care and treatment, or the injuries\ninvolved affect other parts of the body in addition to the foot, the\nsaid podiatrist must so advise the said injured employee and instruct\nhim or her to consult a physician of said employee's choice for\nappropriate care and treatment. Such physician shall thenceforth have\noverall supervision of the treatment of said patient including the\nfuture treatment to be administered to the patient by the podiatrist. If\nfor any reason during the period when podiatric medical treatment and\ncare is required, the employee wishes to transfer his or her treatment\nand care to another authorized podiatrist he or she may do so, in\naccordance with rules prescribed by the chair, provided however that the\nemployer shall be liable for the proper fees of the original podiatrist\nfor the care and treatment he or she shall have rendered. The chair\nshall prepare and establish a schedule for the state, or schedules\nlimited to defined localities, of charges and fees for podiatric medical\ntreatment and care, to be determined in accordance with and to be\nsubject to change pursuant to rules promulgated by the chair. Before\npreparing such schedule for the state or schedules for limited\nlocalities the chair shall request the podiatric medicine practice\ncommittee to submit to him or her a report on the amount of remuneration\ndeemed by such committee to be fair and adequate for the types of\npodiatric medical care to be rendered under this chapter, but\nconsideration shall be given to the view of other interested parties.\nThe amounts payable by the employer for such treatment and services\nshall be the fees and charges established by such schedule.\n 3. (a) No claim for podiatry care or treatment shall be valid and\nenforceable as against the employer or employee unless within\nforty-eight hours following the first treatment the podiatrist giving\nsuch care or treatment furnish to the employer and directly to the chair\na preliminary notice of such injury and treatment, within fifteen days\nthereafter a more complete report and subsequent thereto progress\nreports as requested in writing by the chair, board, employer or\ninsurance carrier, at intervals of not less than three weeks apart or at\nless frequent intervals if requested on forms prescribed by the chair.\nThe board may excuse the failure to give such notices within the\ndesignated periods when it finds it to be in the interest of justice to\ndo so.\n (b) Upon receipt of the notice provided for by paragraph (a) of this\nsubdivision, the employer, the carrier and the claimant each shall be\nentitled to have the claimant examined by a qualified podiatrist\nauthorized by the chair in accordance with section thirteen-b and\nsection one hundred thirty-seven of this chapter, at a medical facility\nconvenient to the claimant and in the presence of the claimant's\npodiatrist, and refusal by the claimant to submit to such independent\nmedical examination at such time or times as may reasonably be necessary\nin the opinion of the board shall bar the claimant from recovering\ncompensation for any period during which he or she has refused to submit\nto such examination.\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 podiatrist, the employer or carrier\nshall arrange for such examination to be performed by a qualified\npodiatrist in a medical facility convenient to the claimant.\n (d) The independent podiatric examiner shall provide such reports and\nshall submit to investigation as required by the chair.\n (e) In order to qualify as admissible medical evidence, for purposes\nof adjudicating any claim under this chapter, any report submitted to\nthe board by an independent podiatric examiner licensed by the state of\nNew York shall include the following:\n (i) a signed statement certifying that the report is a full and\ntruthful representation of the independent podiatric examiner's\nprofessional opinion with respect to the claimant's condition,\n (ii) such examiner's board issued authorization number,\n (iii) the name of the individual or entity requesting the examination,\n (iv) if applicable, the registration number as required by section\nthirteen-n of this article, and\n (v) such other information as the chair may require by regulation.\n 4. Fees for podiatry services shall be payable only to a duly\nauthorized podiatrist as defined in this section or to the agent,\nexecutor or administrator of the estate of such podiatrist. No\npodiatrist rendering treatment to a compensation claimant, shall collect\nor receive a fee from such claimant within this state, but shall have\nrecourse for payment of services rendered only to the employer under the\nprovisions of this section.\n 5. Whenever his attendance at a hearing is required, the podiatrist of\nthe injured employee shall be entitled to receive a fee from the\nemployer in an amount to be fixed by the board, in addition to any fee\npayable under section eight thousand one of the civil practice law and\nrules.\n 6. (a) The provisions of subdivisions one and three of section\nthirteen-g of this article with respect to the conditions under which a\nhospital, physician or self-employed physical or occupational therapist\nmay request payment or arbitration of a bill, or under which an award\nmay be made for payment of such bill, shall be applicable to bills\nrendered by a podiatrist for services rendered to an injured employee.\n (b) If the parties fail to agree as to the value of podiatry care\nrendered under this chapter to a claimant, and the amount of the\ndisputed bill is one thousand dollars or less, or where the amount of\nthe disputed bill exceeds one thousand dollars and the podiatrist\nexpressly so requests, such value shall be decided by a single\narbitrator process, pursuant to rules promulgated by the chair. The\nchair shall appoint a member in good standing of a recognized\nprofessional association representing podiatrists in the state of New\nYork to determine the value of such disputed bill. Decisions rendered\nunder the single arbitrator process shall be conclusive upon the parties\nas to the value of the services in dispute.\n (c) If the parties fail to agree as to the value of podiatry care\nrendered under this chapter to a claimant and the amount of the disputed\nbill exceeds one thousand dollars and the podiatrist does not expressly\nrequest a single arbitrator process in accordance with paragraph (b) of\nthis subdivision, such value shall be decided by an arbitration\ncommittee consisting of three duly registered and licensed podiatrists\nwho are members of a recognized professional association representing\npodiatrists in the state of New York, one to be appointed by the\npresident of such an association, one to be appointed by the employer or\ncarrier and one to be appointed by the chair of the workers'\ncompensation board and the majority decision of such committee shall be\nconclusive upon the parties as to the value of the services rendered.\n (d) The board or the chair may make an award not in excess of the\nestablished fee schedules for any such bill or part thereof which\nremains unpaid in the same manner as an award for bills rendered under\nsubdivisions one and three of section thirteen-g of this article, and\nsuch award may be collected in like manner as an award of compensation.\nWhere a podiatrist's bill has been determined to be due and owing in\naccordance with the provisions of this section the board shall include\nin the amount of the award interest of not more than one and one-half\npercent (1 1/2%) per month payable to the podiatrist in accordance with\nthe rules and regulations promulgated by the board. The chair shall\nassess the sum of fifty dollars against the employer for each such award\nmade by the board, which sum shall be paid into the state treasury.\n (e) A provider initiating an arbitration, including a single\narbitration process, pursuant to this section shall not be required to\npay a fee related to the conduct of such arbitration. Each member of the\narbitration committee shall be entitled to receive and shall be paid a\nfee for each day's attendance at an arbitration session in an amount\nfixed by the chair of the workers' compensation board.\n 7. Within the limits prescribed by the education law for podiatry care\nand treatment, the report or testimony of an authorized podiatrist\nconcerning the condition of the foot of an injured employee and the\ntreatment thereof shall be deemed competent evidence and the\nprofessional opinion of the podiatrist as to causal relation and as to\nrequired treatment shall be deemed competent but shall not be\ncontrolling. Nothing in this section shall be deemed to deprive any\nemployer or insurance carrier of any right to medical examination or\npresentation of medical testimony now conferred by law.\n 8. The chairman shall promulgate rules governing the procedure to be\nfollowed by those rendering podiatry care under this section, which\nrules so far as practicable shall conform to the rules presently in\neffect with reference to medical care furnished to claimants in\nworkmen's compensation. In connection with the promulgation of said\nrules the chairman may consult the podiatry practice committee\nhereinafter provided and may take into consideration the view of other\ninterested parties.\n 9. The chairman shall appoint for and with jurisdiction in the entire\nstate of New York a single podiatry practice committee composed of one\nduly licensed physician and two duly registered and licensed podiatrists\nof the state of New York. Each podiatry member of said committee shall\nhave been engaged in the practice of podiatry as a duly registered and\nlicensed podiatrist of the state of New York at least ten years prior to\nthe time of his appointment and shall receive compensation either on an\nannual basis or on a per diem basis to be fixed by the chairman within\namounts appropriated therefor. One of said members shall be designated\nby the chairman as chairman of said podiatry practice committee. No\nmember of said committee shall render podiatry treatment under this\nsection nor be employed by or accept or participate in any fee from any\ninsurance company authorized to write workmen's compensation insurance\nin this state or from any self-insurer, whether such employment or fee\nrelates to a workmen's compensation claim or otherwise. The attorney\ngeneral, upon request, shall advise and assist such committee.\n 10. The podiatry practice committee shall investigate, hear and make\nfindings with respect to all charges as to professional or other\nmisconduct of any authorized podiatrist as herein provided under rules\nand procedures to be prescribed by the chair and shall report evidence\nof such misconduct, with their findings and recommendation with respect\nthereto, to the chair. The findings, decision and recommendation of such\npodiatry practice committee shall be advisory to the chair only, and\nshall not be binding or conclusive upon him or her. The chair shall\nremove from the list of podiatrists authorized to render podiatry care\nunder this chapter or to conduct independent medical examinations in\naccordance with paragraph (b) of subdivision three of this section the\nname of any podiatrist who he or she shall find after reasonable\ninvestigation is disqualified because such podiatrist\n (a) has been guilty of professional or other misconduct or\nincompetency in connection with podiatry services rendered under the\nlaw; or\n (b) has exceeded the limits of his or her professional competence in\nrendering podiatry care under the law, or has made materially false\nstatements regarding his or her qualifications in his or her application\nfor authorization; or\n (c) has failed to submit timely, full and truthful podiatry reports of\nall his or her findings to the employer and directly to the chair or the\nboard within the time limits provided in this section; or\n (d) has knowingly made a false statement or presentation as to a\nmaterial fact in any medical report made pursuant to this chapter or in\ntestifying or otherwise providing information for the purposes of this\nchapter; or\n (e) has solicited or has employed another to solicit for himself or\nherself or for another professional treatment, examination or care of an\ninjured employee with any claim under this chapter; or\n (f) has refused to appear before, to testify, to submit to a\ndeposition, or to answer upon request of, the chair, board, podiatry\npractice committee or any duly authorized officer of the state, any\nlegal question or produce any relevant book or paper concerning his or\nher conduct under an authorization granted to him or her under the law,\nor\n (g) has directly or indirectly requested, received or participated in\nthe division, transference, assignment, rebating, splitting or refunding\nof a fee for, or has directly or indirectly requested, received or\nprofited by means of a credit or other valuable consideration as a\ncommission, discount or gratuity in connection with the treatment, or\nindependent medical examination, of a workers' compensation claimant.\nNothing contained in this paragraph shall prohibit such podiatrists who\npractice as partners, in groups or as a professional corporation from\npooling fees and moneys received, either by the partnership,\nprofessional corporation or group by the individual members thereof, for\nprofessional services furnished by any individual professional member,\nor employee of such partnership, corporation or group, nor shall the\nprofessionals constituting the partnership, corporation, or group be\nprohibited from sharing, dividing or apportioning the fees and moneys\nreceived by them or by the partnership, corporation or group in\naccordance with a partnership or other agreement.\n 11. Any person who violates or attempts to violate, and any person who\naids another to violate or attempts to induce him to violate the\nprovisions of paragraph g of subdivision ten of this section shall be\nguilty of a misdemeanor.\n 12. Nothing in this section shall be construed as limiting in any\nrespect the power or duty of the chairman to investigate instances of\nmisconduct, either before or after investigation by the podiatry\npractice committee or to temporarily suspend the authorization of any\npodiatrist that he may believe to be guilty of such misconduct. The\nprovisions of subdivision one of section thirteen-d of this article\nwhich are not inconsistent with the provisions of this section shall be\napplicable as fully as if set forth herein.\n 13. Upon the referral which may be directive as to treatment of an\nauthorized podiatrist physical therapy care may be rendered by a duly\nlicensed physical therapist.\n