N.Y.
Workers' Compensation Law Section 13-K
Care and treatment of injured employees by duly licensed podiatrists
1.
When the term “chairman” is hereinafter used, it shall be deemed to mean the chair of the workers’ compensation board of the state of New York.2.
An employee injured under circumstances which make such injury compensable under this article, when care is required for an injury to the foot which injury or resultant condition therefrom may lawfully be treated by a duly registered and licensed podiatrist of the state of New York, may select to treat him or her any podiatrist authorized by the chair to render podiatric medical care, as hereinafter provided. If the injury or condition is one which is without the limits prescribed by the education law for podiatric medical care and treatment, or the injuries involved affect other parts of the body in addition to the foot, the said podiatrist must so advise the said injured employee and instruct him or her to consult a physician of said employee’s choice for appropriate care and treatment. Such physician shall thenceforth have overall supervision of the treatment of said patient including the future treatment to be administered to the patient by the podiatrist. If for any reason during the period when podiatric medical treatment and care is required, the employee wishes to transfer his or her treatment and care to another authorized podiatrist he or she may do so, in accordance with rules prescribed by the chair, provided however that the employer shall be liable for the proper fees of the original podiatrist for the care and treatment he or she shall have rendered. The chair shall prepare and establish a schedule for the state, or schedules limited to defined localities, of charges and fees for podiatric medical treatment and care, to be determined in accordance with and to be subject to change pursuant to rules promulgated by the chair. Before preparing such schedule for the state or schedules for limited localities the chair shall request the podiatric medicine practice committee to submit to him or her a report on the amount of remuneration deemed by such committee to be fair and adequate for the types of podiatric medical care to be rendered under this chapter, but consideration shall be given to the view of other interested parties. The amounts payable by the employer for such treatment and services shall be the fees and charges established by such schedule.3.
(a) No claim for podiatry care or treatment shall be valid and enforceable as against the employer or employee unless within forty-eight hours following the first treatment the podiatrist giving such care or treatment furnish to the employer and directly to the chair a preliminary notice of such injury and treatment, within fifteen days thereafter a more complete report and subsequent thereto progress reports as requested in writing by the chair, board, employer or insurance carrier, at intervals of not less than three weeks apart or at less frequent intervals if requested on forms prescribed by the chair. The board may excuse the failure to give such notices within the designated periods when it finds it to be in the interest of justice to do so.(b)
Upon receipt of the notice provided for by paragraph (a) of this subdivision, the employer, the carrier and the claimant each shall be entitled to have the claimant examined by a qualified podiatrist authorized by the chair in accordance with section thirteen-b and section one hundred thirty-seven of this chapter, at a medical facility convenient to the claimant and in the presence of the claimant’s podiatrist, and refusal by the claimant to submit to such independent medical examination at such time or times as may reasonably be necessary in the opinion of the board shall bar the claimant from recovering compensation for any period during which he or she has refused to submit to such examination.(c)
Where it would place an unreasonable burden upon the employer or carrier to arrange for, or for the claimant to attend, an independent medical examination by an authorized podiatrist, the employer or carrier shall arrange for such examination to be performed by a qualified podiatrist in a medical facility convenient to the claimant.(d)
The independent podiatric examiner shall provide such reports and shall submit to investigation as required by the chair.(e)
In order to qualify as admissible medical evidence, for purposes of adjudicating any claim under this chapter, any report submitted to the board by an independent podiatric examiner licensed by the state of New York shall include the following:(i)
a signed statement certifying that the report is a full and truthful representation of the independent podiatric examiner’s professional opinion with respect to the claimant’s condition, (ii) such examiner’s board issued authorization number, (iii) the name of the individual or entity requesting the examination, (iv) if applicable, the registration number as required by § 13-N (Mandatory registration of entities which derive income from independent medical examinations)section thirteen-n of this article, and(v)
such other information as the chair may require by regulation.4.
Fees for podiatry services shall be payable only to a duly authorized podiatrist as defined in this section or to the agent, executor or administrator of the estate of such podiatrist. No podiatrist rendering treatment to a compensation claimant, shall collect or receive a fee from such claimant within this state, but shall have recourse for payment of services rendered only to the employer under the provisions of this section.5.
Whenever his attendance at a hearing is required, the podiatrist of the injured employee shall be entitled to receive a fee from the employer in an amount to be fixed by the board, in addition to any fee payable under Civil Practice Law & Rules Law § 8001 (Persons subpoenaed)section eight thousand one of the civil practice law and rules.6.
(a) The provisions of subdivisions one and three of § 13-G (Payment of bills for medical care)section thirteen-g of this article with respect to the conditions under which a hospital, physician or self-employed physical or occupational therapist may request payment or arbitration of a bill, or under which an award may be made for payment of such bill, shall be applicable to bills rendered by a podiatrist for services rendered to an injured employee.(b)
If the parties fail to agree as to the value of podiatry care rendered under this chapter to a claimant, and the amount of the disputed bill is one thousand dollars or less, or where the amount of the disputed bill exceeds one thousand dollars and the podiatrist expressly so requests, such value shall be decided by a single arbitrator process, pursuant to rules promulgated by the chair. The chair shall appoint a member in good standing of a recognized professional association representing podiatrists in the state of New York to determine the value of such disputed bill. Decisions rendered under the single arbitrator process shall be conclusive upon the parties as to the value of the services in dispute.(c)
If the parties fail to agree as to the value of podiatry care rendered under this chapter to a claimant and the amount of the disputed bill exceeds one thousand dollars and the podiatrist does not expressly request a single arbitrator process in accordance with paragraph (b) of this subdivision, such value shall be decided by an arbitration committee consisting of three duly registered and licensed podiatrists who are members of a recognized professional association representing podiatrists in the state of New York, one to be appointed by the president of such an association, one to be appointed by the employer or carrier and one to be appointed by the chair of the workers’ compensation board and the majority decision of such committee shall be conclusive upon the parties as to the value of the services rendered.(d)
The board or the chair may make an award not in excess of the established fee schedules for any such bill or part thereof which remains unpaid in the same manner as an award for bills rendered under subdivisions one and three of § 13-G (Payment of bills for medical care)section thirteen-g of this article, and such award may be collected in like manner as an award of compensation. Where a podiatrist’s bill has been determined to be due and owing in accordance with the provisions of this section the board shall include in the amount of the award interest of not more than one and one-half percent (1 1/2%) per month payable to the podiatrist in accordance with the rules and regulations promulgated by the board. The chair shall assess the sum of fifty dollars against the employer for each such award made by the board, which sum shall be paid into the state treasury.(e)
A provider initiating an arbitration, including a single arbitration process, pursuant to this section shall not be required to pay a fee related to the conduct of such arbitration. Each member of the arbitration committee shall be entitled to receive and shall be paid a fee for each day’s attendance at an arbitration session in an amount fixed by the chair of the workers’ compensation board.7.
Within the limits prescribed by the education law for podiatry care and treatment, the report or testimony of an authorized podiatrist concerning the condition of the foot of an injured employee and the treatment thereof shall be deemed competent evidence and the professional opinion of the podiatrist as to causal relation and as to required treatment shall be deemed competent but shall not be controlling. Nothing in this section shall be deemed to deprive any employer or insurance carrier of any right to medical examination or presentation of medical testimony now conferred by law.8.
The chairman shall promulgate rules governing the procedure to be followed by those rendering podiatry care under this section, which rules so far as practicable shall conform to the rules presently in effect with reference to medical care furnished to claimants in workmen’s compensation. In connection with the promulgation of said rules the chairman may consult the podiatry practice committee hereinafter provided and may take into consideration the view of other interested parties.9.
The chairman shall appoint for and with jurisdiction in the entire state of New York a single podiatry practice committee composed of one duly licensed physician and two duly registered and licensed podiatrists of the state of New York. Each podiatry member of said committee shall have been engaged in the practice of podiatry as a duly registered and licensed podiatrist of the state of New York at least ten years prior to the time of his appointment and shall receive compensation either on an annual basis or on a per diem basis to be fixed by the chairman within amounts appropriated therefor. One of said members shall be designated by the chairman as chairman of said podiatry practice committee. No member of said committee shall render podiatry treatment under this section nor be employed by or accept or participate in any fee from any insurance company authorized to write workmen’s compensation insurance in this state or from any self-insurer, whether such employment or fee relates to a workmen’s compensation claim or otherwise. The attorney general, upon request, shall advise and assist such committee.10.
The podiatry practice committee shall investigate, hear and make findings with respect to all charges as to professional or other misconduct of any authorized podiatrist as herein provided under rules and procedures to be prescribed by the chair and shall report evidence of such misconduct, with their findings and recommendation with respect thereto, to the chair. The findings, decision and recommendation of such podiatry practice committee shall be advisory to the chair only, and shall not be binding or conclusive upon him or her. The chair shall remove from the list of podiatrists authorized to render podiatry care under this chapter or to conduct independent medical examinations in accordance with paragraph (b) of subdivision three of this section the name of any podiatrist who he or she shall find after reasonable investigation is disqualified because such podiatrist (a) has been guilty of professional or other misconduct or incompetency in connection with podiatry services rendered under the law; or(b)
has exceeded the limits of his or her professional competence in rendering podiatry care under the law, or has made materially false statements regarding his or her qualifications in his or her application for authorization; or(c)
has failed to submit timely, full and truthful podiatry reports of all his or her findings to the employer and directly to the chair or the board within the time limits provided in this section; or(d)
has knowingly made a false statement or presentation as to a material fact in any medical report made pursuant to this chapter or in testifying or otherwise providing information for the purposes of this chapter; or(e)
has solicited or has employed another to solicit for himself or herself or for another professional treatment, examination or care of an injured employee with any claim under this chapter; or(f)
has refused to appear before, to testify, to submit to a deposition, or to answer upon request of, the chair, board, podiatry practice committee or any duly authorized officer of the state, any legal question or produce any relevant book or paper concerning his or her conduct under an authorization granted to him or her under the law, or(g)
has directly or indirectly requested, received or participated in the division, transference, assignment, rebating, splitting or refunding of a fee for, or has directly or indirectly requested, received or profited by means of a credit or other valuable consideration as a commission, discount or gratuity in connection with the treatment, or independent medical examination, of a workers’ compensation claimant. Nothing contained in this paragraph shall prohibit such podiatrists who practice as partners, in groups or as a professional corporation from pooling fees and moneys received, either by the partnership, professional corporation or group by the individual members thereof, for professional services furnished by any individual professional member, or employee of such partnership, corporation or group, nor shall the professionals constituting the partnership, corporation, or group be prohibited from sharing, dividing or apportioning the fees and moneys received by them or by the partnership, corporation or group in accordance with a partnership or other agreement.11.
Any person who violates or attempts to violate, and any person who aids another to violate or attempts to induce him to violate the provisions of paragraph g of subdivision ten of this section shall be guilty of a misdemeanor.12.
Nothing in this section shall be construed as limiting in any respect the power or duty of the chairman to investigate instances of misconduct, either before or after investigation by the podiatry practice committee or to temporarily suspend the authorization of any podiatrist that he may believe to be guilty of such misconduct. The provisions of subdivision one of § 13-D (Removal of providers from lists of those authorized to render medical care or to conduct independent medical examinations)section thirteen-d of this article which are not inconsistent with the provisions of this section shall be applicable as fully as if set forth herein.13.
Upon the referral which may be directive as to treatment of an authorized podiatrist physical therapy care may be rendered by a duly licensed physical therapist.
Source:
Section 13-K — Care and treatment of injured employees by duly licensed podiatrists, https://www.nysenate.gov/legislation/laws/WKC/13-K (updated Jan. 10, 2020; accessed Oct. 26, 2024).
