What's happening
This bill requires the Workers' Compensation Board to update medical fee schedules every two years and clarifies consultation procedures.
Why it matters
More frequent medical fee updates. By requiring the Workers' Compensation Board to update medical fee schedules every two years, the bill helps ensure payment rates better reflect current healthcare costs and practices, potentially improving provider participation and access to care for injured workers.
Greater medical oversight and input. The chair must now consult with the board’s medical director when setting or adjusting fee schedules. This could lead to more clinically informed decisions, aligning payment rates more closely with medical realities and standards of care.
Formalized consultation with professional associations. The bill clarifies and strengthens the process for soliciting input from relevant medical, therapy, and hospital associations before fee schedules are set. This may help ensure that provider perspectives and fair compensation are considered, potentially improving provider satisfaction and willingness to treat workers’ compensation patients.
Immediate impact and ongoing flexibility. The bill mandates an initial fee schedule update within one year of enactment and sets a predictable, biennial update schedule (every January 15th of odd-numbered years). However, it also preserves the Board’s authority to make interim adjustments if needed, allowing for timely responses to unforeseen changes in healthcare costs or practices.
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Who cares
Workers’ Compensation Board
The chair would have to consult the board’s medical director on fee schedules, publish an initial revision within one year and publish subsequent schedules every other January 15.
Medical providers treating injured workers
Physicians, podiatrists, chiropractors and psychologists would have their workers’ compensation fee schedules established every two years, without barring adjustments between scheduled publications.
New York Physical Therapy Association
The bill would specifically name its president as the person asked to submit a report on fair and reasonable physical therapy fees.
Employers
Revised fee schedules would set the amounts they owe for covered workers’ compensation treatment and services.
Headline styles
Set Health Payment Rates
Plain English, a few words. Used as the page title.
Sponsors
No co-sponsors yet.
History
- Referred to labor
- Referred to labor
Full text
4 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
530
2025-2026 Regular Sessions
IN ASSEMBLY (Prefiled)
January 8, 2025
Introduced by M. of A. MAGNARELLI -- read once and referred to the Committee on Labor
AN ACT to amend the workers' compensation law, in relation to the establishment of rates of payment and delivery of health care services
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. The closing paragraph of subdivision (a) of section 13 of the workers' compensation law, as amended by chapter 6 of the laws of 2007, is amended to read as follows:
The chair, in consultation with the board's medical director, shall biennially prepare and establish a schedule for the state, or schedules limited to defined localities, of charges and fees for such medical treatment and care, and including all medical, dental, surgical, optometric or other attendance or treatment, nurse and hospital service, medicine, optometric services, crutches, eye-glasses, false teeth, artificial eyes, orthotics, prosthetic devices, functional assistive and adaptive devices and apparatus 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 president of the medical society of the state of New York and the president of the New York state osteopathic medical society [to] submit [to him or her] a report on the amount of remuneration deemed by such society to be fair and adequate for the types of medical care to be rendered under this chapter, but consideration shall be given to the view of other interested parties. In the case of physical therapy fees schedules the chair shall request the president of [a recognized professional association representing physical therapists in the state of New York to] the New York physical therapy association submit [to him or her] a report on the amount of remuneration deemed by such association to be fair and reasonable for the type of physical therapy
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD00867-01-5
services rendered under this chapter, but consideration shall be given to the views of other interested parties. The chair shall also prepare and establish a schedule for the state, or schedules limited to defined localities, of charges and fees for outpatient hospital services not covered under the medical fee schedule previously referred to in this subdivision, 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 president of the hospital association of New York state [to] submit [to him or her] a report on the amount of remuneration deemed by such association to be fair and adequate for the types of hospital outpatient care to be rendered under this chapter, but consideration shall be given to the views of other interested parties. In the case of occupational therapy fees schedules the chair shall request the president of a recognized professional association representing occupational therapists in the state of New York [to] submit [to him or her] a report on the amount of remuneration deemed by such association to be fair and reasonable for the type of occupational therapy services rendered under this chapter, but consideration shall be given to the views 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. Nothing in this schedule, however, shall prevent voluntary payment of amounts higher or lower than the fees and charges fixed therein, but no physician rendering medical treatment or care, and no physical or occupational therapist rendering their respective physical or occupational therapy services may receive payment in any higher amount unless such increased amount has been authorized by the employer, or by decision as provided in section thirteen-g of this article. Nothing in this section shall be construed as preventing the employment of a duly authorized physician on a salary basis by an authorized compensation medical bureau or laboratory.
§ 2. Subdivision 2 of section 13-k of the workers' compensation law, as amended by section 4 of part CC of chapter 55 of the laws of 2019, is amended to read as follows:
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] such employee 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] such podiatrist must so advise [the said injured employee] and instruct [him or her to] such injured employee 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] may 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, in consultation with the board's medical director, shall biennially 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. Subdivision 2 of section 13-l of the workers' compensation law, as amended by section 5 of part CC of chapter 55 of the laws of 2019, is amended to read as follows:
2. An employee injured under circumstances which make such injury compensable under this article, when care is required for an injury which consists solely of a condition which may lawfully be treated by a chiropractor as defined in section sixty-five hundred fifty-one of the education law may select to treat [him or her] such employee, any duly registered and licensed chiropractor of the state of New York, authorized by the chair to render chiropractic care as hereinafter provided. If the injury or condition is one which is outside the limits prescribed by the education law for chiropractic care and treatment, the said chiropractor must so advise [the said injured employee] and instruct [him or her to] such injured employee consult a physician of said employee's choice for appropriate care and treatment. Such physician shall thenceforth have supervision of the treatment of said condition including the future treatment to be administered to the patient by the chiropractor. The chair, in consultation with the board's medical director, shall biennially prepare and establish a schedule for the state, or schedules limited to defined localities of charges and fees for chiropractic 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 chiropractic 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 chiropractic 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.
§ 4. Subdivision 3 of section 13-m of the workers' compensation law, as amended by section 6 of part CC of chapter 55 of the laws of 2019, is amended to read as follows:
3. The chair, in consultation with the board's medical director, shall biennially prepare and establish a schedule for the state or schedules limited to defined localities of charges and fees for psychological treatment and care, to be determined in accordance with and 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 psychology practice committee to submit to such chair a report on the amount of remuneration deemed by such committee to be fair and adequate for the types of psychological 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.
§ 5. Notwithstanding the provisions of section one of this act or of any other law, rule or regulation to the contrary, a revision to the fee schedules established pursuant to sections 13, 13-k, 13-l and 13-m of the workers' compensation law existing as of the effective date of this act shall be published by the chair of the workers' compensation board on behalf of such board no later than one year following the effective date of this act. Subsequent biennial schedules shall be published in final form on January fifteenth every other year. Nothing in this section shall limit the authority of the chair of the workers' compensation board to make adjustments in the fee schedule other than at the biennial publication.
§ 6. This act shall take effect immediately.
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