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Rural Area Flexibility Analysis
Proposed Amendment of Part 324 of 12 NYCRR
(Amendment of the Medical Treatment Guidelines)


  1. Types and estimated numbers of rural areas:

    The amendments to Part 324 of 12 NYCRR (Guidelines or MTG) will apply to all insurance carriers, the State Insurance Fund, self-insured employers, self-insured local governments, local governments that own and/or operate hospitals, attorneys, medical providers, group self-insured trusts, third party administrators and claimants across the state. These individuals and entities exist in all rural areas of the state.
  2. Reporting, recordkeeping and other compliance requirements:

    The proposed amendments should significantly reduce the number of variances requested and thus reduce the reporting and recordkeeping associated with those requests. Adoption of the carpal tunnel syndrome Guidelines will require all medical providers to adhere to those Guidelines and request a variance to perform treatment that deviates from the Guidelines' recommendations. The forms used to request a variance are already in use. It is not anticipated that the proposed amendments will require any additional staffing or resources by rural employers.
  3. Costs:

    The proposed amendments are intended to reduce administrative costs to all parties including rural participants, reduce delays in resolution of disputes, and add clarity and guidance in the treatment of injured workers. As with the original Guidelines adopted in 2010, the Board will offer support for this implementation through training. The Guidelines will be available on the Board's website and anyone will be able to download and print them free of charge. If an individual or entity requests a hardcopy of one or more of the guidelines, the cost will be $10.00 per guideline or $50.00 for all five. This charge is to cover the Board's cost in making the copies. The charge for one or more of the Guidelines on a compact disc is $5.00.
  4. Minimizing adverse impact:

    As stated above, the implementation of Guidelines is expected to reduce costs and consume fewer resources for all participants in the workers' compensation system including rural participants.

    While medical professionals and affected payers will be required to incorporate the Guidelines into their policies, practices, and procedures, the Board will assist in this process by providing training to stakeholders and Board employees. There will be no charge for the training.
  5. Rural area participation:

    The Board shared a summary of the regulations with representatives from the Medical Society of New York, the New York State Chiropractic Association, the New York Physical Therapy Association, the New York State Society of Orthopedic Surgeons, as well as attorneys representing injured workers, and requested comments. Each of these groups has constituents throughout the state including rural areas. In addition, the Board either met with or had conference calls with representatives from most of these entities. Changes were made to the Guidelines/regulations in response to the comments.

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