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New York Workers' Compensation Law Section 13-d - Removal Of Physicians From Lists Of Those Authorized To Render Medical Care Or To Conduct Independent Medical Examinations.Legal Research Home > New York Lawyer > Workers' Compensation > New York Workers' Compensation Law Section 13-d - Removal Of Physicians From Lists Of Those Authorized To Render Medical Care Or To Conduct Independent Medical Examinations.
§ 13-d. Removal of physicians from lists of those authorized to render
medical care or to conduct independent medical examinations. 1. The
medical society of the county in which the physician's office is located
at the time or a board designated by such county society or a board
representing duly licensed physicians of any other school of medical
practice in such county shall investigate, hear and make findings with
respect to all charges as to professional or other misconduct of any
authorized physician as herein provided under rules and procedure to be
prescribed by the medical appeals unit, and shall report evidence of
such misconduct, with their findings and recommendation with respect
thereto, to the chair. Failure to commence such investigation within
sixty days from the date the charges are referred to the society by the
chair or submit findings and recommendations relating to the charges
within one hundred eighty days from the date the charges are referred
shall empower the chair to appoint, as a hearing officer, a member of
the board, employee, or other qualified hearing officer to hear and
report on the charges to the chair. A qualified hearing officer, who is
neither a member of the board, or employee thereof shall be paid at a
reasonable per diem rate to be fixed by the chair.
Such investigation, hearing, findings, recommendation and report may
be made by the society or board of an adjoining county upon the request
of the medical society of the county in which the alleged misconduct or
infraction of this chapter occurred, subject to the time limit and
conditions set forth herein. The medical appeals unit shall review the
findings and recommendation of such medical society or board, or hearing
officer appointed by the chair upon application of the accused physician
and may reopen the matter and receive further evidence. The findings,
decision and recommendation of such society, board or hearing officer
appointed by the chair or medical appeals unit shall be advisory to the
chair only, and shall not be binding or conclusive upon him or her.
2. The chair shall remove from the list of physicians authorized to
render medical care under this chapter, or to conduct independent
medical examinations in accordance with paragraph (b) of subdivision
four of section thirteen-a of this article, the name of any physician
who he or she shall find after reasonable investigation is disqualified
because such physician:
(a) has been guilty of professional or other misconduct or
incompetency in connection with medical services rendered under this
chapter; or
(b) has exceeded the limits of his or her professional competence in
rendering medical care or in conducting independent medical examinations
under this chapter, or has made materially false statements regarding
his or her qualifications in his or her application for the
recommendation of the medical society or board as provided in section
thirteen-b of this article; or
(c) has failed to transmit copies of medical reports to claimant's
attorney or licensed representative as provided in subdivision (f) of
section thirteen of this article; or has failed to submit full and
truthful medical reports of all his or her findings to the employer, and
directly to the chair or the board within the time limits provided in
subdivision four of section thirteen-a of this article with the
exception of injuries which do not require (1) more than ordinary first
aid or more than two treatments by a physician or person rendering first
aid, or (2) loss of time from regular duties of one day beyond the
working day or shift; or
(d) knowingly made a false statement or representation as to a
material fact in any medical report made pursuant to this chapter or in
testifying or otherwise providing information for the purposes of this
chapter; or
(e) has solicited, or has employed another to solicit for himself or
herself or for another, professional treatment, examination or care of
an injured employee in connection with any claim under this chapter; or
(f) has refused to appear before, to testify, to submit to a
deposition, or to answer upon request of, the chair, board, medical
appeals unit or any duly authorized officer of the state, any legal
question, or to produce any relevant book or paper concerning his or her
conduct under any authorization granted to him or her under this
chapter; or
(g) has directly or indirectly requested, received or participated in
the division, transference, assignment, rebating, splitting or refunding
of a fee for, or has directly or indirectly requested, received or
profited by means of a credit or other valuable consideration as a
commission, discount or gratuity in connection with the furnishing of
medical or surgical care, an independent medical examination, diagnosis
or treatment or service, including X-ray examination and treatment, or
for or in connection with the sale, rental, supplying or furnishing of
clinical laboratory services or supplies, X-ray laboratory services or
supplies, inhalation therapy service or equipment, ambulance service,
hospital or medical supplies, physiotherapy or other therapeutic service
or equipment, artificial limbs, teeth or eyes, orthopedic or surgical
appliances or supplies, optical appliances, supplies or equipment,
devices for aid of hearing, drugs, medication or medical supplies, or
any other goods, services or supplies prescribed for medical diagnosis,
care or treatment, under this chapter; except that reasonable payment,
not exceeding the technical component fee permitted in the medical fee
schedule, established under this chapter for X-ray examinations,
diagnosis or treatment, may be made by a physician duly authorized as a
roentgenologist to any hospital furnishing facilities and equipment for
such examination, diagnosis or treatment, provided such hospital does
not also submit a charge for the same services. Nothing contained in
this paragraph shall prohibit such physicians who practice as partners,
in groups or as a professional corporation or as a university faculty
practice corporation from pooling fees and moneys received, either by
the partnership, professional corporation, university faculty practice
corporation or group by the individual members thereof, for professional
services furnished by any individual professional member, or employee of
such partnership, corporation or group, nor shall the professionals
constituting the partnerships, corporations, or groups be prohibited
from sharing, dividing or apportioning the fees and moneys received by
them or by the partnership, corporation or group in accordance with a
partnership or other agreement.
3. Any person who violates or attempts to violate, and any person who
aids another to violate or attempts to induce him to violate the
provisions of paragraph (g) of subdivision two of this section shall be
guilty of a misdemeanor.
4. Nothing in this section shall be construed as limiting in any
respect the power or duty of the chairman to investigate instances of
misconduct, either before or after investigation by a medical society or
board as herein provided, or to temporarily suspend the authorization of
any physician that he may believe to be guilty of such misconduct.
Last modified: July 31, 2006 |