N.Y. Comp. Codes R. & Regs. tit. 12 § 342.2

Current through Register Vol. 46, No. 51, December 18, 2024

Section 342.2 - Notice of objection to bill and podiatrist's decision regarding arbitration

(a) Notice of objection by a carrier to any podiatry bill shall be given to the chair in duplicate and two copies to the podiatrist whose bill is in dispute within 30 days after such bill has been rendered on the form (A-1) prescribed by the chair for that purpose. Where compensability of the claim is controverted and has not yet been determined, or where other issues requiring Workers' Compensation Board determination are interposed as reasons for nonpayment of the bill, the notice of objection shall so state.

(b) Upon receipt of such notice of objection (form A-1) the podiatrist may request arbitration by notifying the chair in accordance with the following:

(1) if only arbitration issues are raised, the request for arbitration shall he 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 podiatrist; and

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

If the podiatrist wishes to arbitrate the bill, he shall complete and sign the request for arbitration and forward it to the podiatry arbitration committee together with a check to the order of the chair, Workers' Compensation Board, in the sum of $5 as a minimum arbitration fee. Notwithstanding any provision in this section to the contrary, upon application of the podiatrist, the chair may for good cause shown excuse the podiatrist for the delay in filing the request for arbitration, and schedule the disputed bill for arbitration.

(c) Failure of the podiatrist 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 podiatrist, the chair may for good cause shown excuse the podiatrist 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 § 342.2