New York S 6217: Relates to workers' access to treatment

Bill Text

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S06217 Summary:

BILL NOS06217 

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SAME ASSAME AS A03127

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SPONSORFERNANDEZ

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COSPNSRRHOADS, RYAN C

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MLTSPNSR

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Amd §13-a, Work Comp L

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Allows for treatment costing less than $1,500 to be done without prior approval, and more clearly defines the list of "pre-authorized procedures" as a floor on treatment as opposed to its current status as a ceiling; allows non-network providers of testing to be compensated at the provider network rate negotiated by the carrier.

Go to top S06217 Actions:

BILL NOS06217 

&nbsp

03/06/2025REFERRED TO LABOR

05/20/20251ST REPORT CAL.1196

05/21/20252ND REPORT CAL.

05/22/2025ADVANCED TO THIRD READING 

06/04/2025PASSED SENATE

06/04/2025DELIVERED TO ASSEMBLY

06/04/2025referred to labor

01/07/2026died in assembly

01/07/2026returned to senate

01/07/2026REFERRED TO LABOR

02/24/20261ST REPORT CAL.375

02/25/20262ND REPORT CAL.

02/26/2026ADVANCED TO THIRD READING 

03/04/2026PASSED SENATE

03/04/2026DELIVERED TO ASSEMBLY

03/04/2026referred to labor

Go to topS06217 Committee&nbspVotes:

Go to topS06217 Floor&nbspVotes:

There are no Assembly votes for this bill in this legislative session.

Go to topS06217 Text:

 STATE OF NEW YORK
 ________________________________________________________________________

 6217

 2025-2026 Regular Sessions

 IN SENATE

 March 6, 2025
 ___________

 Introduced by Sen. FERNANDEZ -- read twice and ordered printed, and when
 printed to be committed to the Committee on Labor

 AN ACT to amend the workers' compensation law, in relation to workers'
 access to treatment

 The People of the State of New York, represented in Senate and Assem-
 bly, do enact as follows:

 1 § 1. Subdivision 5 of section 13-a of the workers' compensation law,
 2 as amended by section 8 of part CC of chapter 55 of the laws of 2019, is
 3 amended to read as follows:
 4 (5) No claim for specialist consultations, surgical operations,
 5 physiotherapeutic or occupational therapy procedures, x-ray examinations
 6 or special diagnostic laboratory tests costing more than one thousand
 7 five hundred dollars shall be valid and enforceable, as against such
 8 employer, unless such special services shall have been authorized by the
 9 employer or by the board, or unless such authorization has been unrea-
 10 sonably withheld, or withheld for a period of more than thirty calendar
 11 days from receipt of a request for authorization, or unless such special
 12 services are required in an emergency, provided, however, that the basis
 13 for a denial of such authorization by the employer must be based on a
 14 conflicting second opinion rendered by a physician authorized by the
 15 board. The board, with the approval of the superintendent of financial
 16 services, shall issue and maintain a list of pre-authorized procedures
 17 under this section. Such list of pre-authorized procedures shall be
 18 issued and maintained solely for the purpose of expediting authorization
 19 of treatment of injured workers. Such list of pre-authorized procedures
 20 shall not prohibit varied treatment [when the treating provider demon-
 21 strates the appropriateness and medical necessity of such], nor shall
 22 the list be used as a basis to deny treatment not contained therein.
 23 Requests for varied treatment need only comply with the provisions of
 24 this subdivision.

 EXPLANATION--Matter in italics (underscored) is new; matter in brackets
 [ ] is old law to be omitted.
 LBD04384-01-5

 S. 6217 2

 1 § 2. Subdivision 7 of section 13-a of the workers' compensation law is
 2 amended by adding a new paragraph (e) to read as follows:
 3 (e) Any special diagnostic tests, x-ray examinations, magnetic reso-
 4 nance imaging or other radiological examinations or tests costing more
 5 than one thousand five hundred dollars performed by a provider who is
 6 not a member of the carrier's, self-insured's or state insurance fund's
 7 diagnostic network or networks, shall be entitled to payment at the
 8 negotiated network rate.
 9 § 3. This act shall take effect immediately.

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