NY Work Comp L § 13-C (2021)
2021 New York Laws WKC - Workers' Compensation Article 2 - Compensation 13-C - Licensing of Compensation Medical Bureaus and Laboratories.

§ 13-c. Licensing of compensation medical bureaus and laboratories. 1. The  chairman may, upon the recommendation of the medical society of the county or of a board as provided in section  thirteen-b,  authorize  and license  compensation  medical  bureaus  in  such  counties  operated by qualified  physicians  wholly  or  principally  for  the  diagnosis  and treatment  of  industrial injuries or illnesses in respect to which they are authorized to render medical care under this chapter. The  chairman, however,  shall  not  authorize  or  license  more than two such bureaus operated  by  the  same  physician.   The   chairman   may,   upon   the recommendation  of  the  medical  society of the county or of a board as provided  in  section  thirteen-b,  authorize   and   license   separate laboratories  and  bureaus  engaged  in X-ray diagnosis or treatment and clinical diagnosis, or in physiotherapy or other therapeutic procedures, which participate in the diagnosis or treatment of injured workmen under this chapter. The chairman, however, shall not authorize or license more than two such laboratories or bureaus operated by  the  same  physician. Application  for  such  authorization  shall  be  made  on  forms  to be furnished by the chairman, and shall disclose in full the nature of  the personnel and equipment of such bureaus. If within sixty days after such application has been filed the medical society or board refuses or fails to  act  or  refuses  to  recommend to the chairman that such license be granted, the applicant may appeal to the medical appeals unit. Each such bureau or laboratory which receives such authorization shall:  (a) Make reports on its personnel and equipment in such  form  and  at such times as may be required by the chairman; and  (b) Be subject to inspection by the chairman or the medical society of the county in which such bureau or laboratory is located; and   2.  No  claim  for  services  in  connection  with  x-ray examination, diagnosis or treatment of any claimant shall  be  valid  or  enforceable except  by a laboratory or bureau of a voluntary hospital authorized and licensed under subdivision one of this section, or except by a physician duly authorized as  a  roentgenologist  by  the  chairman  for  services performed by such physician or under his immediate supervision.   3.  (a)  The chairman may authorize a medical center, jointly operated by labor and management representatives as a non-profit  corporation  or as  a non-profit benefit trust, approved by and under the supervision of the New York state department of health, to provide  medical,  surgical, dental,   optometric,  podiatric,  or  other  attendance  or  treatment, including  X-ray  diagnosis  or  treatment,   physiotherapy   or   other therapeutic  procedures or services, laboratory services and any and all other services required to be provided for  an  injured  employee  under section  thirteen  of  this  chapter,  entitled  "Treatment  and care of injured employees".  (b) Application for such authorization shall be made on  forms  to  be furnished  by the chairman, and shall disclose in full the nature of the personnel and equipment of such medical center. Each such medical center which receives such authorization shall:  (i) Make reports on its personnel and equipment in such  form  and  at such times as may be required by the chairman;  (ii) Be subject to inspection by the chairman;  (c) All treatment and services provided hereunder shall be provided on an  out-patient  basis  to  employees,  who  are claimants for workmen's compensation,  eligible  to  use  the  medical  center  pursuant  to  an agreement, plan, deed of trust or labor-management collective bargaining agreement.  (d)  (i)  A  physician  rendering  medical  care  at  a medical center authorized hereunder must be authorized to render such care pursuant  to  this chapter and he shall limit his professional activities hereunder to such medical care as his experience and training qualify him to render.  (ii)  When para-medical, laboratory or X-ray services or other medical care is required it shall be rendered, under  the  active  and  personal supervision  of  an authorized physician, by a registered nurse or other person trained in laboratory or diagnostic techniques within  the  scope of   such   person's   specialized  training  and  qualifications.  This supervision shall be evidenced by signed  records  of  instructions  for treatment  and  signed  records of the patient's condition and progress. Reports of  such  treatment  and  supervision  shall  be  made  by  such physician  to  the  chairman  on  such  forms  and  at such times as the chairman may require.  (iii) When physical therapy care is required it shall be rendered by a duly  licensed  physical  therapist  upon  the  referral  which  may  be directive  as  to  treatment  of  an  authorized physician or podiatrist within the scope of such physical therapist's specialized  training  and qualifications  as  defined  in  article  one  hundred thirty-six of the education law. Reports of such treatment and records of instruction  for treatment,  if  any,  shall  be maintained by the physical therapist and referring professional and submitted to the chairman on such  forms  and at such times as the chairman may require.  (iv)  When  occupational therapy care is required it shall be rendered by a duly  licensed  and  registered  occupational  therapist  upon  the prescription  or referral of an authorized physician within the scope of such occupational therapist's specialized training and qualifications as defined in article one hundred fifty-six of the education  law.  Reports of  such  treatment  and  records  of instruction for treatment, if any, shall  be  maintained  by  the  occupational  therapist  and   referring professional  and  submitted  to  the chairman on such forms and at such times as the chairman may require.  (v) The physician rendering the medical care  hereunder  shall  be  in charge of the care unless, in his judgment, it is necessary to refer the case  to  a  specially  trained and qualified physician, which physician shall then assume complete responsibility for  and  supervision  of  any further medical care rendered.  (e)  Notwithstanding  any provision of this chapter to the contrary, a medical center authorized by the chairman to  render  medical  care  and laboratory services under this section, is authorized and may charge for any  and  all  services  rendered  in  accordance  with such schedule or schedules prepared and established by the chairman.  (f) Nothing herein contained shall operate to  prevent  such  employee from  selecting for rendering or continuance of any medical treatment or care required, any  physician  authorized  by  the  chairman  to  render medical  care  as  hereinabove  provided,  in  accordance  with  section thirteen-a, of this chapter.  (g) The chairman shall have full power and authority and it  shall  be his  duty  to  investigate instances of misconduct, or violations of the provisions of this chapter or violations of the rules promulgated by the chairman under the provisions of this chapter, or failure to submit full and truthful medical reports directly to the chairman  within  the  time limits  provided  under  subdivision  four of section thirteen-a of this chapter; and, after a hearing, to  temporarily  suspend  or  revoke  the license  of  any  such medical center. The chairman may also temporarily suspend or revoke the license of any such medical center  upon  finding, after   a   hearing,  that  such  medical  center  has  been  guilty  of professional or other misconduct or that the personnel of such center is not properly qualified under this  chapter  or  the  equipment  of  such medical center is inadequate for the proper rendering of medical care.  (h)  The  chairman may adopt such reasonable rules and regulations for the authorization and continued supervision  of  medical  centers  under this section, as he may deem necessary and proper.   4.  (a)  The  chairman  may authorize a hospital as defined in article twenty-eight  of  the  public  health  law  or  a   health   maintenance organization holding a valid certificate of authority issued pursuant to article  forty-four  of  the  public  health  law or operating under the provisions of article  forty-three  of  the  insurance  law  to  provide out-patient medical care under this chapter.  (b)  Application  for  such authorization shall be made on forms to be furnished by the chairman, and shall disclose in full the nature of  the personnel   and   equipment  of  such  hospital  or  health  maintenance organization. Each such  hospital  or  health  maintenance  organization which receives such authorization shall:  (i)  Make  reports  on its personnel and equipment in such form and at such times as may be required by the chairman; and  (ii) Be subject to inspection and investigation as provided hereunder.  (c) All treatment and services provided hereunder shall be provided on an out-patient basis to workers' compensation claimants.  (d) (i) A physician rendering medical care at  a  hospital  or  health maintenance  organization  authorized  hereunder  must  be authorized to render such care pursuant to this chapter and he or she shall limit  his or  her professional activities hereunder to such medical care as his or her experience and training qualify him or her to render. The  physician rendering  the  medical care shall sign and submit all forms and reports as the chairman may require.  (ii) When para-medical, laboratory or X-ray services or other  medical care  is  required  it  shall be rendered, under the active and personal supervision of an authorized physician, by a registered nurse  or  other person  trained  in laboratory or diagnostic techniques within the scope of  such  person's  specialized  training   and   qualifications.   This supervision  shall  be  evidenced  by signed records of instructions for treatment and signed records of the patient's  condition  and  progress. Reports  of  such  treatment  and  supervision  shall  be  made  by such physician to the chairman on  such  forms  and  at  such  times  as  the chairman may require.  (iii) When physical therapy care is required it shall be rendered by a duly  licensed  physical  therapist  upon  the  referral  which  may  be directive as to treatment  of  an  authorized  physician  or  podiatrist within  the  scope of such physical therapist's specialized training and qualifications as defined in  article  one  hundred  thirty-six  of  the education  law. Reports of such treatment and records of instruction for treatment, if any, shall be maintained by  the  physical  therapist  and referring  professional  and submitted to the chairman of such forms and at such times as the chairman may require.  (iv) When occupational therapy care is required it shall  be  rendered by  a  duly  licensed  and  registered  occupational  therapist upon the prescription or referral of an authorized physician within the scope  of such occupational therapist's specialized training and qualifications as defined  in  article one hundred fifty-six of the education law. Reports of such treatment and records of  instruction  for  treatment,  if  any, shall   be  maintained  by  the  occupational  therapist  and  referring professional and submitted to the chairman on such  forms  and  at  such times as the chairman may require. Reports  of  such  treatment  and  supervision  shall  be  made  by such physician to the chairman on  such  forms  and  at  such  times  as  the chairman may require.  (v)  The  physician  rendering  the medical care hereunder shall be in charge of the care unless, in his or her judgment, it  is  necessary  to refer   the  case  to  a  specially  trained  and  qualified  authorized physician, which physician shall then assume complete responsibility for and supervision of any further medical care rendered.  (e)  Notwithstanding  any provision of this chapter to the contrary, a hospital or health maintenance organization authorized by  the  chairman to  render  medical  care and laboratory services under this section, is authorized  and  may  charge  for  any  and  all  services  rendered  in accordance  with  such schedule or schedules prepared and established by the chairman.  (f) Nothing herein contained shall operate to  prevent  such  employee from  selecting for rendering or continuance of any medical treatment or care required, any  physician  authorized  by  the  chairman  to  render medical  care  as  hereinabove  provided,  in  accordance  with  section thirteen-a of this chapter.  (g) (i)  The  department  of  health  shall  conduct  inspections  and investigations  and  make  recommendations  with  respect  to charges of professional or other misconduct or that the personnel of an  authorized hospital  or  health maintenance organization are not properly qualified under this chapter or that the equipment  of  such  hospital  or  health maintenance  organization  is  inadequate  for  the  proper rendering of medical care. After such inspection and investigation the department  of health  shall  refer its report and recommendations to the chairman, who shall have full power and authority to temporarily suspend or revoke the authorization under this subdivision of  any  such  hospital  or  health maintenance  organization  upon  finding,  after  a  hearing,  that such hospital  or  health  maintenance  organization  has  been   guilty   of professional or other misconduct, or that the personnel of such hospital or health maintenance organization are not properly qualified under this chapter  or  the  equipment  of  such  hospital  or  health  maintenance organization is inadequate for the proper rendering of medical care. The recommendations of the department of health shall  be  advisory  to  the chairman only and shall not be binding or conclusive upon him.  (ii)  The chairman shall have full power and authority and it shall be his duty to investigate violations of the provisions of this chapter  or violations of the rules promulgated by the chairman under the provisions of  this chapter, or failure to submit full and truthful medical reports directly  to  the  chairman  within  the  time  limits  provided   under subdivision  four  of  section  thirteen-a of this article, and, after a hearing, to temporarily suspend or revoke the authorization  under  this subdivision of any such hospital or health maintenance organization.  (h)  The  chairman may adopt such reasonable rules and regulations for the authorization and continued  supervision  of  hospitals  and  health maintenance  organizations  under  this section as he may deem necessary and proper.