New York Governor proposes changes to medical treatment options for injured workers.

By Rosalind Asch-Hobeck

Governor Proposes Changes

Governor Kathy Hochul has proposed significant reforms to improve medical care access for injured workers in New York as part of her 2025 State of the State agenda. These proposals aim to eliminate barriers to treatment by allowing all eligible healthcare providers to treat workers’ compensation claimants without requiring special authorization from the Workers’ Compensation Board. Currently, only a small percentage of providers are Board-authorized, limiting access to care, especially in rural areas.  If this change is implemented, it would significantly open treatment options for claimants who now are restricted to authorized doctors.

One key proposal would automatically authorize licensed healthcare providers to treat injured workers as part of their professional licensing, expanding provider availability. Another proposal would allow residents and fellow physicians to treat injured workers under supervision, increasing participation from academic hospitals.

Fee Schedule Changes and Insurance Proposals 

One issue that would need to be addressed is the fee schedule for treatment related to workers’ compensation claimants. It is noted that the plan includes financial incentives, such as increasing the workers’ compensation fee schedule to encourage providers to take workers’ compensation patients into their care.  It is anticipated that there will be competitive rates for treatment, which will exceed the current fee schedule.   Additional legislative changes would require private insurers to cover treatment costs while a workers’ compensation claim is disputed, preventing patients from facing delays or out-of-pocket expenses. Another measure would allow insurers to pay for treatment for up to a year without admitting liability, ensuring timely care while not accepting liability. 

Broad Support For Proposals 

The Workers’ Compensation Board sent out a Bulletin explaining the Governor’s proposal, and it included comments by Board officials who agree that this would positively impact injured workers by promoting immediate and convenient treatment options that are now not available to them.  It is supported by Clarissa Rodriguez, Chair of the New York State Workers’ Compensation Board; Dr. Marc Wilkenfeld, a Board-Certified Occupational Medicine Physician; Alaina Evelyn Varvaloucas, Executive Director of the Worker Justice Center of New York; and Dr. Warren Silverman, an expert in Occupational Medicine and Workers’ Compensation. 

Expectations

These proposals build on past reforms aimed at streamlining provider participation, reducing administrative burdens, and expediting billing disputes. Supporters, including medical professionals and worker advocacy groups, praise the plan as a major step toward improving timely, high-quality care for injured workers while benefiting employers and healthcare providers.

While now, injured workers are restricted to authorized medical care, if this measure is passed into law, the system will significantly change as the treatment options for injured workers will expand, and it is anticipated that this will help injured workers recover faster and with better results.

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