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A07301 Summary:

COSPNSRGottfried, McDonald, Hunter, Lifton
Add 13-p, 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
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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 certified 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-p 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 S.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 -- read once and referred to
          the Committee on Labor
        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-p to read as follows:
     3    § 13-p. 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
    21  treatment, and such records or reports shall be submitted to  the  chair
    22  on such forms and at such times as the chair may require.
    23    2.  A nurse practitioner who is desirous of being authorized to render
    24  healthcare services under this section shall  file  an  application  for
         EXPLANATION--Matter in italics (underscored) is new; matter in brackets
                              [ ] is old law to be omitted.

        A. 7301                             2
     1  authorization  under  this  section with the nurse practitioner practice
     2  committee. The applicant shall agree to refrain from subsequently treat-
     3  ing for remuneration, as a private patient,  any  person  seeking  nurse
     4  practitioner healthcare services, in connection with, or as a result of,
     5  any injury compensable under this chapter, if he or she has been removed
     6  from the list of nurse practitioners authorized to render services under
     7  this  chapter.  This  agreement  shall run to the benefit of the injured
     8  person so treated, and shall be available as a defense in any action  by
     9  such nurse practitioner for payment for treatment rendered by such nurse
    10  practitioner  after  being  removed from the list of nurse practitioners
    11  authorized to render healthcare services under this section.  The  nurse
    12  practitioner  practice committee, if it deems such certified nurse prac-
    13  titioner duly qualified, shall recommend to the chair that  such  person
    14  be  authorized  to  render  healthcare services under this section. Such
    15  recommendations shall be only advisory to the chair  and  shall  not  be
    16  binding  or conclusive. The chair shall prepare and establish a schedule
    17  for the state or schedules limited to defined localities of charges  and
    18  fees  for  nurse  practitioner  treatment  and care, to be determined in
    19  accordance with and be subject to change pursuant to  rules  promulgated
    20  by  the chair. Before preparing such schedule for the state or schedules
    21  for limited localities the chair shall request  the  nurse  practitioner
    22  practice  committee  to  submit  to such chair a report on the amount of
    23  remuneration deemed by such committee to be fair and  adequate  for  the
    24  types  of  services to be rendered under this chapter, but consideration
    25  shall be given to the view of other interested  parties.    The  amounts
    26  payable  by  the  employer  for such treatment and services shall be the
    27  fees and charges established by such schedule.
    28    3. No claim  for  nurse  practitioner  services  shall  be  valid  and
    29  enforceable  as  against  the employer or employees unless within forty-
    30  eight hours following the first treatment the nurse practitioner  giving
    31  such  care  or  treatment  furnishes to the employer and directly to the
    32  chair a preliminary notice of such  injury  and  treatment,  and  within
    33  fifteen  days  thereafter  a more complete report and subsequent thereto
    34  progress reports as requested in writing by the chair,  board,  employer
    35  or insurance carrier, at intervals of not less than three weeks apart or
    36  at  less  frequent  intervals  if  requested  on forms prescribed by the
    37  chair.  The board may excuse the failure to give such notices within the
    38  designated periods when it finds it to be in the interest of justice  to
    39  do so.
    40    4.  Fees  for  nurse  practitioner services shall be payable only to a
    41  duly certified nurse practitioner, or to the agent, executor or adminis-
    42  trator of the estate of such nurse practitioner. No  nurse  practitioner
    43  rendering  treatment to a compensation claimant shall collect or receive
    44  a fee from such claimant within this state, but shall have recourse  for
    45  payment  of  services rendered only to the employer under the provisions
    46  of this section.
    47    5. Whenever his or her attendance at a hearing is required, the  nurse
    48  practitioner  of the injured employee shall be entitled to receive a fee
    49  from the employer in an amount to be fixed by the board, in addition  to
    50  any  fee  payable under section eight thousand one of the civil practice
    51  law and rules.
    52    6. (a) Unless within thirty days after a bill has been rendered to the
    53  employer by the nurse practitioner who has treated an injured  employee,
    54  such  employer shall have notified the chair and such nurse practitioner
    55  in writing that such employer demands an impartial  examination  of  the
    56  fairness of the amount claimed by such nurse practitioner for his or her

        A. 7301                             3
     1  services,  the right to such an impartial examination shall be deemed to
     2  be waived and the amount claimed by such  nurse  practitioner  shall  be
     3  deemed  to  be  the  fair value of the services rendered. If the parties
     4  fail  to agree as to the nurse practitioner healthcare services rendered
     5  under this chapter to a claimant, such value shall  be  decided  by  the
     6  nurse  practitioner practice committee and the majority decision of such
     7  committee shall be conclusive upon the parties as to the  value  of  the
     8  services rendered. The board may make an award for any such bill or part
     9  thereof  which  remains  unpaid in the same manner as an award for bills
    10  rendered under subdivisions one and three of section thirteen-g of  this
    11  article,  and  such award may be collected in like manner as an award of
    12  compensation. The chair shall assess the sum of  fifty  dollars  against
    13  the  employer  for each such award made by the board, which sum shall be
    14  paid into the state treasury.
    15    (b) Where a nurse practitioner's bill has been determined  to  be  due
    16  and  owing  in accordance with the provisions of this section, the board
    17  may impose a penalty of not more than one and one-half percent  interest
    18  per  month payable to the licensed nurse practitioner in accordance with
    19  the rules and regulations promulgated by the board.
    20    (c) The parties to such proceeding shall each pay to the chair  a  sum
    21  equal  to  five  per  centum of the amount payable under the decision of
    22  such committee or a minimum of five dollars, whichever is greater.   The
    23  sums  so  collected  shall be transferred to the state treasury to reim-
    24  burse it on account of the expense of administering this section.
    25    7. Within the limits prescribed by the  education  law  for  certified
    26  nurse  practitioner  services,  the report or testimony of an authorized
    27  nurse practitioner concerning the condition of an injured  employee  and
    28  treatment  thereof  shall  be  deemed competent evidence and the profes-
    29  sional opinion of the nurse practitioner as to causal relation and as to
    30  required treatment shall be deemed competent but shall not  be  control-
    31  ling. Nothing in this section shall be deemed to deprive any employer or
    32  insurance  carrier of any right to a medical examination or presentation
    33  of medical testimony now conferred by law.
    34    8. The chair shall promulgate rules  governing  the  procedure  to  be
    35  followed by nurse practitioners rendering healthcare services under this
    36  section,  which  rules  so far as practicable shall conform to the rules
    37  presently in effect with reference to medical care furnished  to  claim-
    38  ants  in  workers'  compensation. In connection with the promulgation of
    39  such rules the chair may consult the nurse practitioner practice commit-
    40  tee and may  take  into  consideration  the  view  of  other  interested
    41  parties.
    42    9.  The  chair  shall  appoint for and with jurisdiction in the entire
    43  state of  New  York  a  single  nurse  practitioner  practice  committee
    44  composed  of  two  certified  nurse practitioners, and one duly licensed
    45  physician of the state of New York. Each member of such committee  shall
    46  receive compensation either on an annual basis or on a per diem basis to
    47  be  fixed by the chair within amounts appropriated therefor. One of such
    48  nurse practitioners shall be designated by the chair as a chair of  such
    49  nurse practitioner practice committee. No member of such committee shall
    50  render  healthcare  services  under  this  section nor be an employer or
    51  accept or participate in any fee from any insurance  company  authorized
    52  to write workers' compensation insurance in this state or from any self-
    53  insurer,  whether  such  employment or fee relates to a workers' compen-
    54  sation claim or otherwise. The attorney  general,  upon  request,  shall
    55  advise and assist such committee.

        A. 7301                             4
     1    10.  The nurse practitioner practice committee shall investigate, hear
     2  and make findings with respect to all  charges  as  to  professional  or
     3  other  misconduct  of  any  authorized nurse practitioner as provided in
     4  this section under rules and procedures to be prescribed  by  the  chair
     5  and  shall  report  evidence of such misconduct, with their findings and
     6  recommendations with respect thereto, to the chair. The findings,  deci-
     7  sion  and  recommendation  of such nurse practitioner practice committee
     8  shall be advisory to the chair only, and shall not be binding or conclu-
     9  sive upon him or her. The chair shall remove from the list of  certified
    10  nurse  practitioners authorized to render healthcare services under this
    11  chapter the name of any nurse practitioner who  he  or  she  shall  find
    12  after  reasonable investigation is disqualified because such nurse prac-
    13  titioner: (a) has been guilty of professional  or  other  misconduct  or
    14  incompetency  in  connection  with the rendering of healthcare services,
    15  (b) has exceeded the limits of his or  her  professional  competence  in
    16  rendering  healthcare  services  under the law, or has made false state-
    17  ments regarding qualifications in the application for authorization, (c)
    18  has failed to  submit  timely,  full  and  truthful  nurse  practitioner
    19  healthcare  services evaluation and treatment reports of all findings to
    20  the employer and directly to the chair of  the  board  within  the  time
    21  limits  provided  in  this  section, (d) has rendered nurse practitioner
    22  services under this chapter for a fee less than that fixed  in  the  fee
    23  schedule,  (e)  has  solicited  or  has  employed another to solicit for
    24  himself or herself or for another professional treatment, examination or
    25  care of an injured employee with any claim under this chapter,  (f)  has
    26  refused  to  appear  before  or answer upon request of the chair, board,
    27  nurse practitioner practice committee or any duly authorized officer  of
    28  the  state,  any  legal  question  or produce any relevant book or paper
    29  concerning conduct under an authorization granted under law, or (g)  has
    30  directly  or indirectly requested, received or participated in the divi-
    31  sion, transference, assignment, rebating, splitting or  refunding  of  a
    32  fee  for,  or has directly or indirectly requested, received or profited
    33  by means of a credit or otherwise valuable consideration  as  a  commis-
    34  sion,  discount  or gratuity in connection with the treatment of a work-
    35  ers' compensation claimant.
    36    11. Any person who violates or attempts to violate, and any person who
    37  aids another to violate or attempts to induce him or her to violate  the
    38  provisions  of paragraph (g) of subdivision ten of this section shall be
    39  guilty of a misdemeanor.
    40    12. Nothing in this section shall be  construed  as  limiting  in  any
    41  respect  the  power  or  duty  of  the chair to investigate instances of
    42  misconduct, either before or after investigation by  the  nurse  practi-
    43  tioner  practice  committee, or to temporarily suspend the authorization
    44  of any nurse practitioner believed to be guilty of such misconduct.  The
    45  provisions  of  subdivision  one  of  section thirteen-d of this article
    46  which are not inconsistent with the provisions of this section shall  be
    47  applicable as if fully set forth in this section.
    48    13. Nothing contained in this section shall prohibit nurse practition-
    49  ers who practice as partners, in groups or as a professional corporation
    50  from  pooling  fees  and  moneys  received,  either  by the partnership,
    51  professional corporation or group or by the individual members  thereof,
    52  for  professional  services  furnished  by  any  individual professional
    53  member, or employee of such partnership, corporation or group, nor shall
    54  the professionals constituting the partnerships, corporations, or groups
    55  be prohibited from sharing, dividing or apportioning the fees and moneys

        A. 7301                             5
     1  received by them or by the partnership, corporation or group in  accord-
     2  ance with a partnership or other agreement.
     3    § 2. This act shall take effect on the one hundred eightieth day after
     4  it  shall have become a law. Effective immediately, the addition, amend-
     5  ment and/or repeal of any rules and regulations necessary  to  implement
     6  the  provisions  of  this act on its effective date are authorized to be
     7  made on or before such effective date.
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