12 CRR-NY 325-8.5NY-CRR

STATE COMPILATION OF CODES, RULES AND REGULATIONS OF THE STATE OF NEW YORK
TITLE 12. DEPARTMENT OF LABOR
CHAPTER V. WORKERS' COMPENSATION
SUBCHAPTER C. MEDICAL PROVIDER AUTHORIZATION
PART 325. MEDICAL AND SURGICAL CARE AND TREATMENT
SUBPART 325-8. PREFERRED PROVIDER ORGANIZATION ARRANGEMENTS
12 CRR-NY 325-8.5
12 CRR-NY 325-8.5
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.
12 CRR-NY 325-8.5
Current through August 31, 2021
End of Document

IMPORTANT NOTE REGARDING CONTENT CURRENCY: The "Current through" date indicated immediately above is the date of the most recently produced official NYCRR supplement covering this rule section. For later updates to this section, if any, please: consult editions of the NYS Register published after this date; or contact the NYS Department of State Division of Administrative Rules at [email protected]. See Help for additional information on the currency of this unofficial version of NYS Rules.