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A07301 Summary:

COSPNSRGottfried, McDonald, Hunter, Lifton, Taylor, Williams, Skoufis, D'Urso, Steck, Thiele
Add 13-q, Work Comp L
Relates to diagnosis, care and treatment of injured employees by certified nurse practitioners.
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A07301 Actions:

04/21/2017referred to labor
01/03/2018referred to labor
02/02/2018amend and recommit to labor
02/02/2018print number 7301a
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A07301 Memo:

submitted in accordance with Assembly Rule III, Sec 1(f)
  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.
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A07301 Text:

                STATE OF NEW YORK
                               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-
          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.

        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.
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