N.Y. Comp. Codes R. & Regs. Tit. 12 § 325-8.5 - Improper influence or involvement in medical treatment
(a) No person, including but not limited to
the employer, insurer, carrier, self-insured employer or any of their agents
shall interfere with the selection by an injured employee of an authorized
physician for treatment except as authorized by article 10-A, section 354 of
the Workers' Compensation Law nor shall any insurer, carrier or self-insured
employer improperly influence or attempt to improperly influence the medical
opinion of any physician who has treated or examined an injured employee within
the meaning of section 13-a (6) of the Workers' Compensation Law.
(b) No insurer, carrier or self-insured
employer shall participate in the treatment of an injured employee within the
meaning of section 13-j (1) of the Workers' Compensation Law.
(c) All functional activities which are
subcontracted by a PPO through a management contract arrangement in accordance
with section
732-2.5(b)
of Title 10 NYCRR, including case management services, as defined by the
parties to the management contract, shall conform to the provisions of section 13-a (6) and 13-j (1) of the Workers' Compensation Law. Copies of all management
contracts shall be provided to the chair as well as the Commissioner of Health
for compliance purposes. Where necessary, the chair or the Commissioner of
Health shall seek additional information from insurers, carriers and
self-insured employers who enter into such arrangements with PPOs to ensure
compliance with this Part.
Notes
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