Expanded Provider Law
Overview
As part of Governor Cuomo's 2019-2020 budget, a new law was passed expanding the types of medical providers that can be authorized to treat injured workers in the New York State workers' compensation system. As of January 1, 2020, licensed clinical social workers, nurse practitioners and acupuncturists, as well as current ancillary providers, including physician assistants, occupational therapists and physical therapists may apply to become Board-authorized providers.
This law is expected to bring thousands of providers into the NYS workers' compensation system and dramatically improve injured workers' access to health care.
Note: All providers who can be authorized by the NYS Workers' Compensation Board to treat injured workers must be Board-authorized to continue treating injured workers after Jan. 1, 2020. Ancillary providers who currently treat must become authorized (or have an authorization application pending with the Board) to continue treating after January 1, 2020.
Frequently Asked Questions
- What is the purpose of the Expanded Provider Law? The Law is designed to modernize and improve the workers' compensation health care options available to injured workers. It is expected to bring thousands of new providers into the NYS Workers' Compensation system.
- What provider types are currently able to treat injured workers in the NYS Workers' Compensation System? Prior to this law taking effect, only physicians, chiropractors, podiatrists, and psychologists were able to be authorized to treat injured workers. Nurse practitioners, physician assistants, occupational therapists and physical therapists could treat injured workers, but only under the personal supervision of a Board-authorized provider.
-
How do new providers apply to become Board authorized?
To apply, medical providers need to:
- Sign up to use the Medical Portal.
- Complete the required training courses — training must be completed before the application can be submitted.
- Fill out the New Provider Authorization Request online application, accessible on the Medical Portal, and submit it to the Board.
- Physician Assistants must have their Board authorized supervising physician sign the Supervising Physician Affirmation form and attach the signed form to their application.
- When can the new provider types apply to receive Board authorization to treat injured workers? The new online application for authorization is now available to LCSWs, acupuncturists, PTs, OTs, NPs and PAs.
- How long after applying will new providers know if they have been approved for authorization? All authorization applications will be handled as expeditiously as possible.
- When can new providers who are granted Board-authorization begin to treat injured workers? New provider types, if authorized, can begin treating injured workers on January 1, 2020. Ancillary providers who currently treat must become authorized (or have an authorization application pending with the Board) to continue treating after January 1, 2020.
- Once approved, will providers need to renew authorization? New and existing authorized providers, will be expected to re-register with the Board every two to three years, consistent with the renewal of their New York State license. This will help ensure the Board's records and public listings remain up-to-date.
- I am a new provider, and I am not familiar with the Workers' Compensation system. Will training be available? Yes, required training for new providers is available through the Medical Portal. You can also access introductory training on the NYS Workers' Compensation System in the resources section of this page.
- Where can injured workers find a listing of Board-authorized providers? To find an authorized and registered health care provider or IME, please use the Health Care Provider & IME Search.
Provider-specific Questions
- If a patient is referred to a specialist (e.g., Family Care to an Orthopedic group) or to a different type of practice (e.g., Orthopedic to Neurologist), may a Physician Assistant (PA) treat the injured worker during the initial visit to the new practice? While the PA may participate in the office visit, for the initial treatment in the office (even if it is a referral), the supervising physician must submit the report of treatment offering an opinion on causal relationship and diagnosis.
Related Resources
Watch this space for additional resources and information for new providers.
- Changes for Authorized Providers: Who Can Do What (Chart)
- Video: NYS Workers’ Compensation 101 for Medical Providers
- Subject Number 046-1207: Adoption of Expanded Provider Regulations
- Addition of Part 323 of 12 NYCRR (Medical Provider Authorization)
- Amendment of 12 NYCRR Part 324 and Section 325-1.4
- Amendment of 12 NYCRR 329-1.3, Part 333, Section 348.2, Section 301.3, and Addition of New Part 329-4 (Medical Fee Schedules)
- Video: Signing up to access the Medical Portal (5 min)
- Supervising Physician Affirmation
- Video: Medical Society Provider Authorization Training (13 min)
- Medical and Billing Form Updates/Clarifications (08/13/20)
- Video: Billing Updates for Providers: CMS-1500 and Expanded Provider Initiatives (24 min)
Fact Sheets
- Acupuncturists
- Licensed Clinical Social Workers
- Nurse Practitioners
- Occupational Therapists
- Physical Therapists
- Physician Assistants
Request Informational Session or Materials
