NEW YORK STATE ASSEMBLY MEMORANDUM IN SUPPORT OF LEGISLATION submitted in accordance with Assembly Rule III, Sec 1(f)
BILL NUMBER: A7301A
SPONSOR: Paulin TITLE OF BILL: An act to amend the workers' compensation law, in
relation to diagnosis, care and treatment of injured employees by certi-
fied nurse practitioners
PURPOSE:
The bill authorizes the diagnosis, care and treatment of injured employ-
ees by certified nurse practitioners under the workers' compensation
program. The inclusion of certified nurse practitioners to conduct
healthcare services consistent with their scope and training will afford
injured workers greater access to care and more provider options across
New York State.
SUMMARY OF PROVISIONS:
Section 1 amends the workers' compensation law by adding a new section
13-q to include nurse practitioners as eligible providers of treatment
under the workers' compensation program.
Section two provides the effective date.
JUSTIFICATION:
Currently, the only providers under the Workers' Compensation Law that
may deliver healthcare services to injured workers are physicians,
psychologists, podiatrists, and chiropractors. Lack of access to quali-
fied healthcare providers can prolong an injured workers' return to
work.
Under education law, section 6902(3), nurse practitioners may diagnose
illness and physical conditions, perform therapeutic and corrective
measures, and have prescribing authority. Prior to 2015, the nurse prac-
titioners could only provide these health care services in collaboration
with a physician in accordance with a written practice agreement and
written practice protocols. Pursuant to Part D of Chapter 56 of the Laws
of 2014, a nurse practitioner with 3,600 hours of practice is not
required to maintain a written practice agreement, if the nurse practi-
tioner complies with the rest of the requirements of section 6902(3).
Under current law and in everyday actual practice, nurse practitioners
conduct physical examinations of patients, order tests, prescribe drugs,
devices and immunizing agents and, when appropriate, refer patients to
other health care providers. New York State has a long history of
providing health care consumers with the freedom of choosing from a
number of qualified health care service providers. Many New Yorkers opt
to receive healthcare services from a nurse practitioner, and more
frequently New Yorkers are relying on NPs for primary care. Individuals
in the workers' compensation system should not be denied this option.
Moreover, this bill would not result in increased costs. In fact,
including nurse practitioners in the workers' compensation program could
lead to a savings for the system.
LEGISLATIVE HISTORY:
A.10230, 2016 referred to labor.
Same as 5.5572, 2016 referred to labor.
FISCAL IMPLICATIONS:
None.
EFFECTIVE DATE:
This act shall take effect on the one hundred eightieth day after it
shall have become a law.
STATE OF NEW YORK
________________________________________________________________________
7301--A
2017-2018 Regular Sessions
IN ASSEMBLY
April 21, 2017
___________
Introduced by M. of A. PAULIN, GOTTFRIED, McDONALD, HUNTER, LIFTON --
read once and referred to the Committee on Labor -- recommitted to the
Committee on Labor in accordance with Assembly Rule 3, sec. 2 --
committee discharged, bill amended, ordered reprinted as amended and
recommitted to said committee
AN ACT to amend the workers' compensation law, in relation to diagnosis,
care and treatment of injured employees by certified nurse practition-
ers
The People of the State of New York, represented in Senate and Assem-bly, do enact as follows:
1 Section 1. The workers' compensation law is amended by adding a new
2 section 13-q to read as follows:
3 § 13-q. Diagnosis, care and treatment of injured employees by certi-
4 fied nurse practitioners. 1. Where the term "nurse practitioner" is used
5 in this section, such term shall mean a person who is duly licensed as a
6 registered professional nurse, certified as a nurse practitioner under
7 section six thousand nine hundred ten of the education law, and practic-
8 ing in compliance with the requirements of section six thousand nine
9 hundred two of the education law.
10 (a) Notwithstanding the requirements of sections thirteen and thir-
11 teen-a of this article, an injured employee, injured under circumstances
12 which make such an injury compensable under this article, may lawfully
13 be diagnosed and treated by a nurse practitioner and authorized by the
14 chair to render health care services pursuant to this section. Such
15 services shall be within the scope of the nurse practitioner as defined
16 in paragraph (a) of subdivision three of section six thousand nine
17 hundred two of the education law, and shall include performing independ-
18 ent medical examinations.
19 (b) A nurse practitioner rendering service pursuant to this section
20 shall maintain records of the patient's condition and nurse practitioner
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[] is old law to be omitted.
LBD06148-03-8
A. 7301--A 2
1 treatment, and such records or reports shall be submitted to the chair
2 on such forms and at such times as the chair may require.
3 2. A nurse practitioner who is desirous of being authorized to render
4 healthcare services under this section shall file an application for
5 authorization under this section with the nurse practitioner practice
6 committee. The applicant shall agree to refrain from subsequently treat-
7 ing for remuneration, as a private patient, any person seeking nurse
8 practitioner healthcare services, in connection with, or as a result of,
9 any injury compensable under this chapter, if he or she has been removed
10 from the list of nurse practitioners authorized to render services under
11 this chapter. This agreement shall run to the benefit of the injured
12 person so treated, and shall be available as a defense in any action by
13 such nurse practitioner for payment for treatment rendered by such nurse
14 practitioner after being removed from the list of nurse practitioners
15 authorized to render healthcare services under this section. The nurse
16 practitioner practice committee, if it deems such certified nurse prac-
17 titioner duly qualified, shall recommend to the chair that such person
18 be authorized to render healthcare services under this section. Such
19 recommendations shall be only advisory to the chair and shall not be
20 binding or conclusive. The chair shall prepare and establish a schedule
21 for the state or schedules limited to defined localities of charges and
22 fees for nurse practitioner treatment and care, to be determined in
23 accordance with and be subject to change pursuant to rules promulgated
24 by the chair. Before preparing such schedule for the state or schedules
25 for limited localities the chair shall request the nurse practitioner
26 practice committee to submit to such chair a report on the amount of
27 remuneration deemed by such committee to be fair and adequate for the
28 types of services to be rendered under this chapter, but consideration
29 shall be given to the view of other interested parties. The amounts
30 payable by the employer for such treatment and services shall be the
31 fees and charges established by such schedule.
32 3. No claim for nurse practitioner services shall be valid and
33 enforceable as against the employer or employees unless within forty-
34 eight hours following the first treatment the nurse practitioner giving
35 such care or treatment furnishes to the employer and directly to the
36 chair a preliminary notice of such injury and treatment, and within
37 fifteen days thereafter a more complete report and subsequent thereto
38 progress reports as requested in writing by the chair, board, employer
39 or insurance carrier, at intervals of not less than three weeks apart or
40 at less frequent intervals if requested on forms prescribed by the
41 chair. The board may excuse the failure to give such notices within the
42 designated periods when it finds it to be in the interest of justice to
43 do so.
44 4. Fees for nurse practitioner services shall be payable only to a
45 duly certified nurse practitioner, or to the agent, executor or adminis-
46 trator of the estate of such nurse practitioner. No nurse practitioner
47 rendering treatment to a compensation claimant shall collect or receive
48 a fee from such claimant within this state, but shall have recourse for
49 payment of services rendered only to the employer under the provisions
50 of this section.
51 5. Whenever his or her attendance at a hearing is required, the nurse
52 practitioner of the injured employee shall be entitled to receive a fee
53 from the employer in an amount to be fixed by the board, in addition to
54 any fee payable under section eight thousand one of the civil practice
55 law and rules.
A. 7301--A 3
1 6. (a) Unless within thirty days after a bill has been rendered to the
2 employer by the nurse practitioner who has treated an injured employee,
3 such employer shall have notified the chair and such nurse practitioner
4 in writing that such employer demands an impartial examination of the
5 fairness of the amount claimed by such nurse practitioner for his or her
6 services, the right to such an impartial examination shall be deemed to
7 be waived and the amount claimed by such nurse practitioner shall be
8 deemed to be the fair value of the services rendered. If the parties
9 fail to agree as to the nurse practitioner healthcare services rendered
10 under this chapter to a claimant, such value shall be decided by the
11 nurse practitioner practice committee and the majority decision of such
12 committee shall be conclusive upon the parties as to the value of the
13 services rendered. The board may make an award for any such bill or part
14 thereof which remains unpaid in the same manner as an award for bills
15 rendered under subdivisions one and three of section thirteen-g of this
16 article, and such award may be collected in like manner as an award of
17 compensation. The chair shall assess the sum of fifty dollars against
18 the employer for each such award made by the board, which sum shall be
19 paid into the state treasury.
20 (b) Where a nurse practitioner's bill has been determined to be due
21 and owing in accordance with the provisions of this section, the board
22 may impose a penalty of not more than one and one-half percent interest
23 per month payable to the licensed nurse practitioner in accordance with
24 the rules and regulations promulgated by the board.
25 (c) The parties to such proceeding shall each pay to the chair a sum
26 equal to five per centum of the amount payable under the decision of
27 such committee or a minimum of five dollars, whichever is greater. The
28 sums so collected shall be transferred to the state treasury to reim-
29 burse it on account of the expense of administering this section.
30 7. Within the limits prescribed by the education law for certified
31 nurse practitioner services, the report or testimony of an authorized
32 nurse practitioner concerning the condition of an injured employee and
33 treatment thereof shall be deemed competent evidence and the profes-
34 sional opinion of the nurse practitioner as to causal relation and as to
35 required treatment shall be deemed competent but shall not be control-
36 ling. Nothing in this section shall be deemed to deprive any employer or
37 insurance carrier of any right to a medical examination or presentation
38 of medical testimony now conferred by law.
39 8. The chair shall promulgate rules governing the procedure to be
40 followed by nurse practitioners rendering healthcare services under this
41 section, which rules so far as practicable shall conform to the rules
42 presently in effect with reference to medical care furnished to claim-
43 ants in workers' compensation. In connection with the promulgation of
44 such rules the chair may consult the nurse practitioner practice commit-
45 tee and may take into consideration the view of other interested
46 parties.
47 9. The chair shall appoint for and with jurisdiction in the entire
48 state of New York a single nurse practitioner practice committee
49 composed of two certified nurse practitioners, and one duly licensed
50 physician of the state of New York. Each member of such committee shall
51 receive compensation either on an annual basis or on a per diem basis to
52 be fixed by the chair within amounts appropriated therefor. One of such
53 nurse practitioners shall be designated by the chair as a chair of such
54 nurse practitioner practice committee. No member of such committee shall
55 render healthcare services under this section nor be an employer or
56 accept or participate in any fee from any insurance company authorized
A. 7301--A 4
1 to write workers' compensation insurance in this state or from any self-
2 insurer, whether such employment or fee relates to a workers' compen-
3 sation claim or otherwise. The attorney general, upon request, shall
4 advise and assist such committee.
5 10. The nurse practitioner practice committee shall investigate, hear
6 and make findings with respect to all charges as to professional or
7 other misconduct of any authorized nurse practitioner as provided in
8 this section under rules and procedures to be prescribed by the chair
9 and shall report evidence of such misconduct, with their findings and
10 recommendations with respect thereto, to the chair. The findings, deci-
11 sion and recommendation of such nurse practitioner practice committee
12 shall be advisory to the chair only, and shall not be binding or conclu-
13 sive upon him or her. The chair shall remove from the list of certified
14 nurse practitioners authorized to render healthcare services under this
15 chapter the name of any nurse practitioner who he or she shall find
16 after reasonable investigation is disqualified because such nurse prac-
17 titioner: (a) has been guilty of professional or other misconduct or
18 incompetency in connection with the rendering of healthcare services,
19 (b) has exceeded the limits of his or her professional competence in
20 rendering healthcare services under the law, or has made false state-
21 ments regarding qualifications in the application for authorization, (c)
22 has failed to submit timely, full and truthful nurse practitioner
23 healthcare services evaluation and treatment reports of all findings to
24 the employer and directly to the chair of the board within the time
25 limits provided in this section, (d) has rendered nurse practitioner
26 services under this chapter for a fee less than that fixed in the fee
27 schedule, (e) has solicited or has employed another to solicit for
28 himself or herself or for another professional treatment, examination or
29 care of an injured employee with any claim under this chapter, (f) has
30 refused to appear before or answer upon request of the chair, board,
31 nurse practitioner practice committee or any duly authorized officer of
32 the state, any legal question or produce any relevant book or paper
33 concerning conduct under an authorization granted under law, or (g) has
34 directly or indirectly requested, received or participated in the divi-
35 sion, transference, assignment, rebating, splitting or refunding of a
36 fee for, or has directly or indirectly requested, received or profited
37 by means of a credit or otherwise valuable consideration as a commis-
38 sion, discount or gratuity in connection with the treatment of a work-
39 ers' compensation claimant.
40 11. Any person who violates or attempts to violate, and any person who
41 aids another to violate or attempts to induce him or her to violate the
42 provisions of paragraph (g) of subdivision ten of this section shall be
43 guilty of a misdemeanor.
44 12. Nothing in this section shall be construed as limiting in any
45 respect the power or duty of the chair to investigate instances of
46 misconduct, either before or after investigation by the nurse practi-
47 tioner practice committee, or to temporarily suspend the authorization
48 of any nurse practitioner believed to be guilty of such misconduct. The
49 provisions of subdivision one of section thirteen-d of this article
50 which are not inconsistent with the provisions of this section shall be
51 applicable as if fully set forth in this section.
52 13. Nothing contained in this section shall prohibit nurse practition-
53 ers who practice as partners, in groups or as a professional corporation
54 from pooling fees and moneys received, either by the partnership,
55 professional corporation or group or by the individual members thereof,
56 for professional services furnished by any individual professional
A. 7301--A 5
1 member, or employee of such partnership, corporation or group, nor shall
2 the professionals constituting the partnerships, corporations, or groups
3 be prohibited from sharing, dividing or apportioning the fees and moneys
4 received by them or by the partnership, corporation or group in accord-
5 ance with a partnership or other agreement.
6 § 2. This act shall take effect on the one hundred eightieth day after
7 it shall have become a law. Effective immediately, the addition, amend-
8 ment and/or repeal of any rules and regulations necessary to implement
9 the provisions of this act on its effective date are authorized to be
10 made on or before such effective date.
