§ 13-M — Care and treatment of injured employees by duly licensed psychologists

§ 13-m. Care and treatment of injured employees by duly licensed\npsychologists. 1. Where the term "chairman" is hereinafter used, it\nshall be deemed to mean the chair of the workers' compensation board of\nthe state of New York.\n 2. (a) An injured employee, injured under circumstances which make\nsuch injury compensable under this article, may lawfully be treated by a\npsychologist, duly registered and licensed by the state of New York,\nauthorized by the chair to render psychological care pursuant to section\nthirteen-b of this article. Such services shall be within the scope of\nsuch psychologist's specialized training and qualifications as defined\nin article one hundred fifty-three of the education law.\n (b) Medical bureaus, medical centers jointly operated by labor and\nmanagement representatives, hospitals and health maintenance\norganizations, authorized to provide medical care pursuant to section\nthirteen-c of this article, may provide psychological services when\nrequired.\n (c) A psychologist rendering service pursuant to this section shall\nmaintain records of the patient's psychological condition and treatment,\nand such records or reports shall be submitted to the chair on such\nforms and at such times as the chair may require.\n 3. The chair shall prepare and establish a schedule for the state or\nschedules limited to defined localities of charges and fees for\npsychological treatment and care, to be determined in accordance with\nand be subject to change pursuant to rules promulgated by the chair.\nBefore preparing such schedule for the state or schedules for limited\nlocalities the chair shall request the psychology practice committee to\nsubmit to such chair a report on the amount of remuneration deemed by\nsuch committee to be fair and adequate for the types of psychological\ncare to be rendered under this chapter, but consideration shall be given\nto the view of other interested parties. The amounts payable by the\nemployer for such treatment and services shall be the fees and charges\nestablished by such schedule.\n 4. (a) No claim for psychological care or treatment shall be valid and\nenforceable as against the employer or employees unless within\nforty-eight hours following the first treatment the psychologist giving\nsuch care or treatment furnishes to the employer and directly to the\nchair a preliminary notice of such injury and treatment, and within\nfifteen days thereafter a more complete report and subsequent thereto\nprogress reports as requested in writing by the chair, board, employer\nor insurance carrier, at intervals of not less than three weeks apart or\nat less frequent intervals if requested on forms prescribed by the\nchair. The 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 psychologist,\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\npsychologist, 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\nsubmit to 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 psychologist, the employer or\ncarrier shall arrange for such examination to be performed by a\nqualified psychologist in a medical facility convenient to the claimant.\n (d) The independent psychological examiner licensed by the state of\nNew York shall provide such reports and shall submit to investigation as\nrequired 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 psychological examiner licensed by the state\nof New York shall include the following:\n (i) a signed statement certifying that the report is a full and\ntruthful representation of the independent psychological 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 5. Fees for psychological services shall be payable only to a duly\nauthorized psychologist as licensed in article one hundred fifty-three\nof the education law, or to the agent, executor or administrator of the\nestate of such psychologist. No psychologist rendering treatment to a\ncompensation claimant shall collect or receive a fee from such claimant\nwithin this state, but shall have recourse for payment of services\nrendered only to the employer under the provisions of this section.\n 6. Whenever his attendance at a hearing is required the psychologist\nof the 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 7. (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 psychologist for services rendered to an injured employee.\n (b) If the parties fail to agree as to the psychological care rendered\nunder this chapter to a claimant, and the amount of the disputed bill is\none thousand dollars or less, or where the amount of the disputed bill\nexceeds one thousand dollars and the psychologist expressly so requests,\nsuch value shall be decided by a single arbitrator process, pursuant to\nrules promulgated by the chair. The chair shall appoint a member in good\nstanding of a recognized professional association representing\npsychologists in the state of New York to determine the value of such\ndisputed bill. Decisions rendered under the single arbitrator process\nshall be conclusive upon the parties as to the value of the services in\ndispute.\n (c) If the parties fail to agree as to the psychological care rendered\nunder this chapter to a claimant, and the amount of the disputed bill\nexceeds one thousand dollars and the psychologist does not expressly\nrequest a single arbitrator process in accordance with paragraph (b) of\nthis subdivision, such value shall be decided by the psychology practice\ncommittee 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.\nThe chair shall assess the sum of fifty dollars against the employer for\neach such award made by the board, which sum shall be paid into the\nstate treasury. Where a psychologist's bill has been determined to be\ndue and owing in accordance with the provisions of this section the\nboard shall include in the amount of the award interest of not more than\none and one-half percent per month payable to the psychologist in\naccordance with the rules and regulations promulgated by the board.\n (e) A provider initiating an arbitration, including a single\narbitrator process, pursuant to this section shall not be required to\npay a fee to cover the costs related to the conduct of such arbitration.\n 8. Within the limits prescribed by the education law for psychological\ncare and treatment, the report or testimony of an authorized\npsychologist concerning the condition of an injured employee and\ntreatment thereof shall be deemed competent evidence and the\nprofessional opinion of the psychologist 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 a medical examination or\npresentation of medical testimony now conferred by law.\n 9. The chairman shall promulgate rules governing the procedure to be\nfollowed by those rendering psychological 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 workers'\ncompensation. In connection with the promulgation of said rules the\nchairman may consult the psychology practice committee hereinafter\nprovided and may take into consideration the view of other interested\nparties.\n 10. The chair shall appoint for and with jurisdiction in the entire\nstate of New York a single psychology practice committee composed of\nthree duly registered and licensed psychologists, at least one of whom\nshall be a member in good standing of the New York state psychological\nassociation recommended by the president of such organization. Each\nmember of said committee shall receive compensation either on an annual\nbasis or on a per diem basis to be fixed by the chair within amounts\nappropriated therefor. One of said psychologists shall be designated by\nthe chair as a chair of said psychology practice committee. No member of\nsaid committee shall render psychological treatment under this section\nnor be an employer or accept or participate in any fee from any\ninsurance company authorized to write workers' compensation insurance in\nthis state or from any self-insurer, whether such employment or fee\nrelates to a workers' compensation claim or otherwise. The attorney\ngeneral, upon request, shall advise and assist such committee.\n 11. The psychology practice committee shall investigate, hear and make\nfindings with respect to all charges as to professional or other\nmisconduct of any authorized psychologist as herein provided under rules\nand procedures to be prescribed by the chair and shall report evidence\nof such misconduct, with their findings and recommendations with respect\nthereto, to the chair. The findings, decision and recommendation of such\npsychology 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 psychologists authorized to render psychological\ncare under this chapter or to conduct independent medical examinations\nin accordance with paragraph (b) of subdivision four of this section the\nname of any psychologist who he or she shall find after reasonable\ninvestigation is disqualified because such psychologist:\n (a) has been guilty of professional or other misconduct or\nincompetency in connection with the rendering of psychological services,\nor\n (b) has exceeded the limits of his or her professional competence in\nrendering psychological services under the law, or has made false\nstatements regarding qualifications in the application for\nauthorization, or\n (c) has failed to submit timely, full and truthful psychological\nreports of all findings to the employer and directly to the chair of the\nboard within the time limits provided in this section, or\n (d) has knowingly made a false statement or representation 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\nhimself/herself or for another professional treatment, examination or\ncare of an injured employee with any claim under this chapter, or\n (f) has refused to appear before, to testify, to submit to a\ndeposition, or answer upon request of the chair, board, psychology\npractice committee or any duly authorized officer of the state, any\nlegal question or produce any relevant book or paper concerning conduct\nunder an authorization granted under law, or\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 otherwise valuable consideration as a\ncommission, discount or gratuity in connection with the treatment of a\nworkers' compensation claimant.\n 12. 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 eleven of this section shall\nbe guilty of a misdemeanor.\n 13. 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 psychology\npractice committee, or to temporarily suspend the authorization of any\npsychologist believed to be guilty of such misconduct. The provisions of\nsubdivision one of section thirteen-d of this article which are not\ninconsistent with the provisions of this section shall be applicable as\nif fully set forth herein.\n 14. Nothing contained in this section shall prohibit psychologists 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 or by the individual members thereof,\nfor professional services furnished by any individual professional\nmember, or employee of such partnership, corporation or group, nor shall\nthe professionals constituting the partnerships, corporations, or groups\nbe prohibited 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