N.Y. WKC Law § 13-G — New York Code / Act WKC / Article 2 / Section 13-G
Payment of bills for medical care
Status: in_force

§ 13-g. Payment of bills for medical care. (1) Within forty-five days\nafter a bill for medical care or supplies delivered pursuant to section\nthirteen of this article has been rendered to the employer, such\nemployer must pay the bill or notify the medical care provider or\nsupplier in the format prescribed by the chair that the bill is not\nbeing paid and explain the reasons for non-payment. In the event that\nthe employer fails to make payment or notify the medical care provider\nor supplier within such forty-five day period that payment is not being\nmade, the medical care provider or supplier may notify the board in the\nformat prescribed by the chair that the bill has not been paid and\nrequest that the board make an award for payment of such bill. The board\nor the chair may make an award not in excess of the established fee\nschedules for any such bill or part thereof which remains unpaid after\nsaid forty-five day period or thirty days after all other questions duly\nand timely raised in accordance with the provisions of this chapter,\nrelating to the employer's liability for the payment of such amount,\nshall have been finally determined adversely to the employer, whichever\nis later, in accordance with rules promulgated by the chair, and such\naward may be collected in like manner as an award of compensation. The\nchair 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.\n  In the event that the employer has provided an explanation in writing\nwhy the bill has not been paid, in part or in full, within the aforesaid\ntime period, and the parties can not agree as to the value of medical\naid rendered under this chapter, such value shall be decided by\narbitration as set forth in rules and regulations promulgated by the\nchair.\n  Where a bill for medical care or supplies 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 (1 1/2%) per month payable to the medical care\nprovider or supplier, in accordance with the rules and regulations\npromulgated by the board. Interest shall be calculated from the\nforty-fifth day after the bill was rendered or from the thirtieth day\nafter all other questions duly and timely raised in accordance with the\nprovisions of this chapter, relating to the employer's liability for the\npayment of such amount, shall have been finally determined adversely to\nthe employer, whichever is later, in accordance with rules promulgated\nby the chair.\n  (2) If the parties fail to agree to the value of medical aid rendered\nunder this chapter, such value shall be decided by a single arbitrator\nprocess, pursuant to rules promulgated by the chair. The chair shall\nappoint a physician who is a member in good standing of the medical\nsociety of the state of New York to determine the value of such disputed\nmedical bill. Where the physician whose charges are being arbitrated is\na member in good standing of the New York osteopathic society, the value\nof such disputed bill shall be determined by a member in good standing\nof the New York osteopathic society appointed by the chair. Where the\nphysician whose charges are being arbitrated is a member in good\nstanding of the New York homeopathic society, the value of such disputed\nbill shall be determined by a member in good standing of the New York\nhomeopathic society appointed by the chair. Where the value of any other\nauthorized provider's services are at issue, such value shall be\ndetermined by a member in good standing of one or more recognized\nprofessional associations representing its respective profession in the\nstate of New York appointed by the chair. Decisions rendered under the\nsingle arbitrator process shall be conclusive upon the parties as to the\nvalue of the services in dispute.\n  (3) A provider or supplier initiating a single arbitrator process,\npursuant to this section shall not pay a fee to cover the costs related\nto the conduct of such arbitration. (4) In claims where the employer has\nfailed to secure compensation to his employees as required by section\nfifty of this chapter, the board may make an award for the value of\nmedical services, supplies or treatment rendered to such employees, in\naccordance with the schedules of fees and charges prepared and\nestablished under the provisions of this chapter. Such award shall be\nmade to the medical care provider or supplier entitled thereto. A\ndefault in the payment of such award may be enforced in the manner\nprovided for the enforcement of compensation awards as set forth in\nsection twenty-six of this article.\n  In all cases coming under this subdivision the payment of the claim\nfor medical care or supplies shall be subordinate to that of the\nclaimant or his or her beneficiaries.\n