Summary#
A-11714 would amend New York’s Workers’ Compensation Law, changing rules for unpaid bills for medical care or supplies in workers’ compensation cases. Its stated goal is to increase consequences for employers, insurers, or self-insured employers that do not pay; the bill does not guarantee that bills will be paid faster.
- The bill keeps the 45-day deadline to pay a bill or give the provider or supplier written notice explaining why it is not being paid. It also keeps a process for the provider or supplier to ask the Workers’ Compensation Board for an award.
- For a bill the Board finds due, the bill keeps interest of up to 1.5% per month, calculated from the applicable deadline or final decision on liability, whichever is later.
- If an employer, insurer, or self-insured employer does not pay a Board award within 15 days, interest would accrue at 3% per month from the 16th day until payment.
- A provider or supplier could ask the Board to find a pattern or practice of non-payment. If the Board finds one and finds payment is due, interest would be 3% to 5% per month. The Board must consider the severity, duration, and frequency of the conduct and how many providers or suppliers were affected.
- For egregious or repeated violations that constitute a pattern or practice, the Board could also impose a civil penalty of up to 25% of the amount due. A pattern or practice includes three or more violations within 12 months, or other repeated conduct the chair finds shows a systemic failure to comply.
- The bill would take effect immediately if enacted. It is introduced and is not law.
What it means for you#
- Medical care providers and suppliers: You could ask the Board to determine that an employer, insurer, or self-insured employer has a pattern or practice of non-payment. The bill does not set out detailed rules for how the Board would decide that request.
- Employers, insurers, and self-insured employers: The 45-day pay-or-explain requirement remains in the amended text. They could face higher interest and, in qualifying pattern-or-practice cases, a penalty of up to 25%.
- Workers receiving medical care: The bill changes payment consequences between payers and providers or suppliers. It does not directly change workers’ eligibility for compensation or medical care.
- The public: The Workers’ Compensation Board and its chair would make the decisions described in the bill. It does not create a new agency.
Money#
No cost estimate is available in the supplied material.
- Employers, insurers, or self-insured employers could owe increased interest and, in some cases, a civil penalty. The bill does not estimate how often these payments might arise or their total value.
- The chair would continue to assess $50 against an employer for each Board award covered by that provision; the bill says that amount goes to the state treasury.
- The bill does not state who receives the additional civil penalty of up to 25%.
What is unclear#
- The supplied material does not include the full current Workers’ Compensation Law, so the current law and the bill’s changes could not be independently checked against the parent Act.
- The bill does not explain what evidence the Board would use or what steps it would follow to decide a pattern-or-practice request.
- The chair may treat other repeated conduct as a pattern or practice. The bill does not define every type of conduct that could qualify.
- The bill does not identify the recipient of the additional civil penalty.
- It does not estimate how many cases could qualify or how much additional interest or penalties could be owed.
Case for#
- The bill appears intended to address late or repeated non-payment of medical bills in workers’ compensation cases.
- Higher interest when an award goes unpaid, and potentially higher rates for a pattern or practice, could give payers a stronger financial reason to pay amounts found due.
- The Board would have to consider how severe and frequent the conduct was and how many providers or suppliers were affected when setting the pattern-case interest rate.
- The bill preserves a route for a provider or supplier to seek payment through the Board when a bill remains unpaid.
Case against#
- Higher interest and penalties could increase costs for employers, insurers, or self-insured employers, but the bill provides no estimate of the likely amount.
- The chair’s authority to decide what other repeated conduct shows a systemic failure could leave important parts of the pattern-or-practice standard open to interpretation.
- The bill does not spell out the process for pattern-or-practice claims, including how the Board would assess evidence.
- The bill does not say who receives the additional penalty of up to 25%, leaving a financial detail unresolved.