N.Y. Comp. Codes R. & Regs. Tit. 12 § 323.1 - Application for New York Workers' Compensation Authorization
(a) Providers who can apply to become
authorized. A duly New York State licensed acupuncturist, chiropractor, nurse
practitioner, occupational therapist, physical therapist, physician, physician
assistant, podiatrist, psychologist or social worker as defined in section 13-b
of the Workers' Compensation Law may apply to become an authorized provider
under the Workers' Compensation Law by complying with the provisions of this
section.
(b) Providers listed in
subdivision (a) of this section who wish to be authorized by the Chair shall
submit their application in the electronic format prescribed by the Chair. A
hospital, as that term is defined in Article 28 of the Public Health Law, may
submit a single collective application for each provider type employed by such
hospital when such employer hospital affirms that the providers listed in the
collective application are currently employed and meet the qualifications
required to become Board authorized,
(c) Affirmations. Such application shall
contain an affirmation that the information provided by the applicant(s) is
correct and complete, and that all bills, variances, medical reports, requests
for prior authorization, and requests for review of billing disputes will be
submitted in the electronic format prescribed by the Chair.
(d) Required license and certification
information. An application for authorization under this section must also
provide the provider's license information and certification of completion of
the required training, including:
(1) For
acupuncturists, New York State licensed and having completed a formal course of
study and having passed an examination in accordance with the education law,
the regulations of the commissioner of education, and the requirements of the
Board of regents.
(2) For
chiropractors, New York State licensed and having completed two years of
preprofessional college study and a four-year resident program in chiropractic
in accordance with the education law, and consistent with the licensing
requirements of the commissioner of education.
(3) For nurse practitioners, certification of
licensure as a registered professional nurse (certified pursuant to section sixty-nine hundred ten of the education law) acting within their lawful scope
of practice.
(4) For occupational
therapists, New York State licensed and having at least a bachelor's or
master's degree in occupational therapy from a registered program with the
education department or receipt of a diploma or degree resulting from
completion of not less than four years of postsecondary study, which includes
the professional study of occupational therapy in accordance with the education
law and the regulations of the commissioner of education.
(5) For physical therapists, New York State
licensed in accordance with the education law and licensing requirements of the
commissioner of education.
(6) For
physicians, New York State licensed with a degree of doctor of medicine, M.D.,
or doctor of osteopathic medicine, D.O., or an equivalent degree in accordance
with the education law and the licensing requirements of the state board of
medicine and the regulations of the commissioner of education.
(7) For physician assistants, New York State
licensed as a physician assistant pursuant to section sixty-five hundred forty-one of the education law. In order to become authorized to practice under
the Workers' Compensation Law, such physician assistants' supervising physician
must have an active Board authorization to treat injured workers.
(8) For podiatrists, New York State licensed
and having received a doctoral degree in podiatric medicine in accordance with
the regulations of the commissioner of education and the education law, and
satisfactorily meeting all other requirements of the state board for podiatric
medicine.
(9) For psychologists,
New York State licensed and having received a doctoral degree in psychology
from a program of psychology.
(10)
For social workers, New York State licensed as a clinical social worker having
completed a master's degree of social work that includes completion of a core
curriculum of at least twelve credit hours of clinical courses or the
equivalent post-graduate clinical coursework, in accordance with the education
law and the regulations of the commissioner of education.
(e) Receipt of application. The date and time
of an application shall be the time a completed and electronically signed
application is received by the Board. For the purposes of this section,
electronically signed shall mean submitted using a valid NY.gov ID business
account in the applicant's name. Receipt of the completed application by the
Board does not indicate that a provider has been authorized.
(1) An applicant, if approved for
authorization, shall receive a separate notification informing them of their
authorization.
(2) Pursuant to
section thirteen-b of the Workers' Compensation Law, a physician applicant must
submit an authorization application to the medical society of the county in
which the physician's office is located or to a board designated by such county
society or to a board representing duly licensed physicians of any other school
of medical practice in such county together with submission of his or her
application to the Board. Such simultaneous submission to the applicable county
medical society and the Board shall be done in a single transaction using the
electronic method and format prescribed by the Chair and available to all
parties. Every county medical society shall individually or through a delegate
provide the Board with the email address for application submission. Following
review of the application, a county medical society shall submit their
recommendation to the Board. In the event such county society or board fails to
take action upon a physician's completed and electronically signed application
within forty-five days, the chair may complete review of the application
without such approval.
(f) The Board may reject applications for
authorization or remove a provider from the list of authorized providers if
information in the application is omitted, inaccurate or false.
(g) Every authorized provider, regardless of
their date of authorization, shall renew their authorization with the Board
within thirty days of their license renewal with the New York State Education
Department. Such renewal of authorization shall include updated professional
information and certification that any mandatory training required by the Chair
has been completed. The Board may remove a provider from the list of authorized
providers if the renewal of authorization is not filed, or is incomplete,
inaccurate, or falsifies any information. A provider whose New York State
license is not timely renewed may not renew their authorization.
(h) Upon approval of an authorization
application, the provider may treat injured workers within the scope of their
practice and as set forth in section thirteen-b of the Workers' Compensation
Law. Authorized providers billing for workers' compensation injuries, including
treatment rendered after a case is closed, must bill at the provider's
appropriate New York State Workers' Compensation medical fee schedule
rate.
(i) Unless otherwise
permitted by law, a provider permitted to seek authorization, must obtain such
authorization prior to treating injured workers under the workers' compensation
law.
(1) Such provider may not treat an
injured worker under subdivision (2)(b) of section thirteen-b of the workers'
compensation law.
(2) A provider
permitted to treat injured workers upon prescription or referral of an
authorized provider or under the supervision of an authorized provider prior to
January 1, 2020, may continue to treat in such capacity when such provider has
submitted an application for authorization on or before January 1, 2020, but
such application has not yet been acted upon by the chair or chair's
designee.
Notes
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