N.Y. Comp. Codes R. & Regs. tit. 12 § 325-4.2

Current through Register Vol. 46, No. 25, June 18, 2024

Section 325-4.2 - Duties of hospitals and health maintenance organizations

A hospital or health maintenance organization authorized by the chair to provide out-patient medical treatment and care shall:

(a) provide treatment and services required under section 13 of the Workers' Compensation Law on an out-patient basis to claimants for workers' compensation;

(b) require that full and truthful medical reports be prepared and signed by a doctor who is authorized by the chair to treat workers' compensation claimants and who is actually rendering the treatment, and to submit such reports directly to the chair and the carrier, pursuant to subdivision 4 of section 13-a of the Workers' Compensation Law, and to section 325-1.3 of this Part.

(c) retain in the out-patient facility copies of all reports submitted for each claimant treated;

(d) maintain a log clearly identifying each claimant treated under the provisions of the Workers' Compensation Law;

(e) render only those services specified in the hospital's or health maintenance organization's operating certificate or certificate of authority issued by the New York State Department of Health; and notify the chair immediately of any change in, or renewal of, the operating certificate or certificate of authority and submit a copy of the new certificate; and notify the chair at once in the event the operating certificate or certificate of authority is suspended or revoked;

(f) charge for services rendered under the Workers' Compensation Law in accordance with the appropriate fee schedule(s) established by the chairman and be bound by the provisions of section 13-f of the Workers' Compensation Law;

(g) be bound by section 13-g of the Workers' Compensation Law and by the rules for arbitration of disputed bills for treatment and care; and

(h) make available for inspection by the chairman or his authorized representative, the premises, equipment and all books and records of the out- patient facility.

N.Y. Comp. Codes R. & Regs. Tit. 12 § 325-4.2