N.Y. Comp. Codes R. & Regs. tit. 12 § 328.3

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

Section 328.3 - Physician's decision regarding arbitration

(a) Upon receipt of such notice of objection (form A-1), the physician may request arbitration by notifying the chairman in accordance with the following:

(1) If only arbitration issues are raised, the request for arbitration shall be made within 60 days after receipt of the notice of objection (A-1).

(2) If there are issues requiring adjudication by a Workers' Compensation Law judge in addition to arbitration issues, the request for arbitration shall be made within 60 days of the filing of the decision in favor of the physician.

(3) Failure to make timely request for arbitration shall be deemed a waiver of the right to arbitration.

If the physician wishes to arbitrate the bill, he shall complete and sign the request for arbitration and forward it to the medical registration section together with a check to the order of the Chairman, Workers' Compensation Board, in the sum of five dollars as a minimum arbitration fee. Notwithstanding any provision in this section to the contrary, upon application of the physician, the chairman may for good cause shown excuse the physician for the delay in filing the request for arbitration, and schedule the disputed bill for arbitration.

(b) An authorized physician claiming that a case has been improperly transferred may arbitrate as provided in subdivision (3) of section 13-a of the Workers' Compensation Law by filing his claim with the chairman, Workers' Compensation Board, and forwarding a copy thereof to the carrier.

(c) Failure of the physician to render a bill to the employer or carrier within 90 days from the last day of the month in which services were rendered shall be deemed to be a waiver of the right to arbitrate the bill. Notwithstanding any provision in this section to the contrary, upon application of the physician, the chairman may for good cause shown excuse the physician for the delay in submitting such bill to the carrier and schedule the disputed bill for arbitration.

N.Y. Comp. Codes R. & Regs. Tit. 12 § 328.3