Regulatory Compliance
New York
CorVel is a national provider of industry leading workers’ compensation solutions to New York payors. Incidents and injuries can be reported to our 24/7 call center, to the online claims system or via mobile apps. Reports are immediately processed by our proprietary rules engine where medical management begins immediately as needed, and the claim is assigned to a Claims Adjuster within one business day or less of initial receipt.
Our comprehensive return to work program ensures collaboration and communication with all interested parties including the injured worker, employer, human resources, medical and safety teams, and healthcare providers. We use technology, compassionate case management for employees and cost containment measures, to give New York employers a superior program.
New York State Direct Deposit Notice
New York State Direct Deposit Form
New York Regulatory Updates 12/29/2024
New York SB 6929 – Relates to Workers’ Access to Treatment
Issues: Workers’ Compensation (General)
Summary For 06/06/2024
This measure increases the exemption from prior authorization from $1,000 to $1,500 per service. It also extends any willing provider protections at the network negotiated rate for certain services in excess of $1,500. Those services include special diagnostic tests, x-rays, and MRIs. It takes effect upon enactment.
Most Recent Update:
- 11/22/2024 – Vetoed by Governor Kathy Hochul (D)
New York Regulatory Updates 10/08/2024
New York AB 1204 – Authorizes the Treatment of Workers’ Compensation Injuries By an Occupational Therapy Assistant and a Physical Therapist Assistant
Issues: Workers’ Compensation (General)
Summary For 05/22/2024
This measure allows that under the direction and supervision of an authorized occupational therapist or physical therapist, occupational therapy or physical therapy services may be rendered by an occupational therapy or physical therapy assistant. This supervision shall be evidenced by signed records of instructions for treatment and signed records of the patient’s condition and progress, together with records of instruction for treatment, if any, will be maintained by the physical therapist or occupational therapist and by the referring physician, physician assistant, podiatrist, or nurse practitioner.
The measure takes effect 30 days after enactment.
Most Recent Update:
- 09/27/2024 – Signed by Governor Kathy Hochul (D)
New York Regulatory Updates 08/06/2024
New York AB 9106 – Authorizes the Commissioner of Labor and the Workers’ Compensation Board to Issue Stop-Work Orders
Issues: Workers’ Compensation (General)
Summary For 05/22/2024
This measure amends the labor law and the workers’ compensation law relating to stop-work orders.
This measure allows the Commissioner of Labor and the Workers’ Compensation Board (commissioner) to issue stop-work orders for an employer who violates payment of wages, the Minimum Wage Act, minimum wage standards and protective labor practices for farm workers, if the aggregate amount exceeds $1,000, and workers’ compensation coverage.
This measure allows the commissioner to issue a stop-work order if the Department of Labor is notified of any local, city, or federal labor violation relating to the payment of wages or workers’ compensation by an employer. The commissioner must notify an employer in writing of their intention to issue a stop-work order within 72 hours of a violation. The notice must: (1) notify the employer’s right to a hearing; (2) notify the employer that they have seventy-two hours to address the violation or violations before the stop-work order will be issued; and (3) state the reasons the commissioner based their decision to issue a stop-work order and how the employer must comply. The employer has 72 hours to comply and notify the commissioner. If the employer does not comply, the commissioner must issue a stop-work order ceasing all business operations of the employer at every site with a violation until the employer complies. Failure or refusal to comply with a stop-work order will result in the assessment of a penalty between $1,000 – $5,000 for each day the employer is not in compliance. An employee affected by a stop-work order must be paid their regular rate for the period or the first 10 days the employee would have been scheduled to work if the stop-work order had not been issued, whichever is less, by the employer.
This measure takes effect immediately.
Most Recent Update:
- 07/22/2024 – Enacting Clause Struck
New York Regulatory Updates 07/11/2024
New York AB 1204 – Authorizes Treatment of Workers’ Compensation Injuries By an Occupational Therapy Assistant and a Physical Therapist Assistant
Issues: Workers’ Compensation (General)
Summary For 05/22/2024
This measure allows that under the direction and supervision of an authorized occupational therapist or physical therapist, occupational therapy or physical therapy services may be rendered by an occupational therapy or physical therapy assistant. This supervision shall be evidenced by signed records of instructions for treatment and signed records of the patient’s condition and progress, together with records of instruction for treatment, if any, will be maintained by the physical therapist or occupational therapist and by the referring physician, physician assistant, podiatrist, or nurse practitioner.
The measure takes effect 30 days after enactment.
Most Recent Update:
- 06/04/2024 – Substituted for SB 9462; Passed Senate
AB 6832 – Relates to Workers’ Access to Treatment
Issues: Workers’ Compensation (General)
Summary For 05/15/2023
This measure increases the exemption from prior authorization from $1,000 to $1,500 per service.
It also extends any willing provider protections at the network negotiated rate for certain services in excess of $1,500. Those services include special diagnostic tests, x-rays, and MRIs.
It takes effect upon enactment.
Most Recent Update:
- 06/07/2024 – Substituted by SB 6929
AB 6929 – Relates to Workers’ Access to Treatment
Issues: Workers’ Compensation (General)
Summary For 05/15/2023
This measure increases the exemption from prior authorization from $1,000 to $1,500 per service.
It also extends any willing provider protections at the network negotiated rate for certain services in excess of $1,500. Those services include special diagnostic tests, x-rays, and MRIs.
It takes effect upon enactment.
Most Recent Update:
- 06/07/2024 – Substituted AB 6832; Passed Assembly
Certified PPO Network
In 1996 the New York Workers’ Compensation Law was amended by the addition of Article 10-A to allow employers to use certified Preferred Provider Organizations (PPOs) to deliver medical services to injured workers. CorVel was one of the first managed care companies to submit their application and we were certified March 1998 with the purpose of providing quality, cost effective treatment to injured employees with a goal to return to work as soon as medically possible. We remain committed to this goal and continue to build a network of New York providers based on quality, range of services and location.
Within the Certified PPO program, an employee has the ability to select any provider within the network for treatment of the work related incident during the direction of care period. Treatment outside of the network is subject to denial.
Benefits of the Certified Network
Access to 19,000+ Board Certified physicians in 31 counties
Directed care services for the first 30 days of treatment from initial date of care
Patient channeling and utilization controls through the use of provider panels, posters, and employee handbooks
Focus on patient outcomes and return to work
Access to insurance premium credits
For more information regarding the New York Certified PPO Program, visit www.wcb.ny.gov and click on Health Care Information.
Recommendation of Care Network
CorVel provides managed care, patient advocacy and healthcare financing for patients seeking choice and access. Our commitment to quality and innovative service extends from every CorVel associate to each customer and patient. We have built a network in New York of providers selected from criteria based on quality, range of services, and location.
The Recommendation of Care Network is an alternative to the New York Certified PPO. This program promotes the use of a network provider for treatment of a work related injury, however use of the network is not mandatory for the employee.
Advantages of the Care Network
Access providers in our provider lookup tools with user-friendly searches and driving directions.
PPO discounts available when recommendation of care was followed and a network provider was utilized.
Soft channeling to preferred providers via Advocacy 24/7, case management and utilization review.
This program may also be used in non-certified counties.
New York Medical Treatment Guidelines
The New York Workers’ Compensation Board (WCB) established a program of medical treatment guidelines (MTG) that changed the delivery of medical care to injured employees. The MTG program includes comprehensive, evidence-based guidelines for the treatment of workplace injuries and illnesses involving the neck, back, shoulder, knee, carpal tunnel syndrome and non-acute pain.
We are here to help.
CorVel’s team of state experts, inclusive of New York licensed registered nurses, and NY licensed and WCB certified physicians, will manage optional prior approvals, Variance Requests and C-4 Authorization Requests. Our team of local professionals facilitate timely requests within state guidelines and will distribute completed forms to all interested parties.
The CorVel Advantage
Quality review with defensible outcomes
Timely responses
Cost effective solutions
Integration with CorVel’s Bill Review Services through the Utilization Review module
Comprehensive reporting
Learn more about CorVel’s comprehensive suite of workers’ compensation solutions, or contact a local representative for additional information.
New York Services
- Workers’ compensation claims administration
- Medical bill review in compliance with state requirements
- Local PPO development and management
- Case management services
New York Resources
Includes coverage of treatment rendered by a massage therapist
Ready to get started?
Our team is ready to answer any questions and help you find the right solutions.