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New York State
Workers' Compensation Board
OFFICE OF THE CHAIR
20 Park Street   Albany, New York 12207
Governor Eliot Spitzer


Subject No. 046-197

Increase in Medical Authorization Request Threshold

To:State Insurance Fund, Workers' Compensation Insurance Carriers, Self-insured Employers, Third Party Administrators, Scheduling Services and Health Care Providers

Date: June 28, 2007

Effective July 11, 2007, the threshold amount above which prior authorization for special services, such as surgery, consultations, diagnostic testing, and physical therapy, must be requested will be increased. Section 28 of Chapter 6 of the Laws of 2007, amended Workers' Compensation Law § 13-a(5) to increase the authorization threshold amount from $500 to $1,000. The increase in the threshold amount is applicable to all requests made on or after July 11, 2007. Accordingly, the five hundred dollar maximum no-request-necessary cost ceiling of Workers' Compensation Law Section 13-a(5) will increase to one thousand dollars on July 11, 2007.

If you have any questions regarding this change, please contact David Austin at the Bureau of Health Management (800)-781-2362 or david.austin@wcb.state.ny.us.

 

Donna Ferrara
Chair