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6 7 7. EMERGENCY. Claim may need to be sustained by record of details that 15. PRORATION OF SCHEDULED UNIT FEE. When the schedule specifies establish fact of emergency. a unit fee for a definite treatment and period of after care, and the patient is transferred from one to another physician, the employer (or carrier) is 8. PAYMENT OF MEDICAL FEES. Section 13-f. No physician shall responsible for the amount stated in the schedule. If the concerned physi- collect or receive a fee from the injured claimant. A hospital shall not cians agree upon amount of proration they shall render separate bills be entitled to remuneration paid to a physician on its staff. accordingly; in the event of no agreement or disagreement, the matter Section 13-f (1). "Fees for medical services shall be payable only to a shall be settled by the Board of the local County Medical Society, or by physician or other lawfully qualified person permitted by Section 13-b of an arbitration committee appointed by it-without cost to the contestants. this Chapter, or to the agent or to the executor or administrator of the 16. Presence of physician during examination by employer's (or carrier's) estate of such physician." physician, routine fee. WRITTEN NOTICE OF CONTEST by the employer (or carrier) shall be filed of the amount of the bill for medical care or hospital service within 17. Investigation and observation (without examination) by medical inspector 30 days after receipt of bill, or the right to an impartial examination of acting for employer (or carrier) ; if presence of injured employee's physi- the fairness of the amount claimed "shall be deemed to be waived and the cian is required by carrier or employer the fee to the employee's physician amount claimed by such physician or hospital shall be deemed to be the shall be $4.00. fair value of the services rendered by him or it." 18. Physician of "especially qualified" enrollment, who makes written opinion or testimony, fee fixed by Commissioner, Section 13 (d). 9. DISAGREEMENT "as to value of medical aid rendered under this Chapter shall be decided by an arbitration committee." Section 13-g (2). 19. PENALTY FEES. "When transfer of patient by employer (or carrier) has not been authorized under this Section," Section 13-a (3) (2) : Same 9A. NO INSURANCE CASES. Sec. 13-g of Chapter 258 of the Laws of 1935 as total paid to other physicians or as determined by arbitration committee. has been amended effective July 1, 1940 as follows: 20. Owners of plants requiring high frequency treatments may apply to the (4) In claims where the employer has failed to secure compensation to Industrial Commissioner for modification of the established fees in the his employees as required by section fifty of this chapter, the board may medical fee schedule. The Commissioner will cause an investigation to be make an award for the value of medical services or treatment rendered made in each instance and act upon the record when established. This to such employees, in accordance with the schedule of fees and charges privilege will be granted only on the assurance that it will not interfere prepared and established under the provisions of section thirteen-a of with the employee's right of free choice of physician. this chapter. Such award shall be made to the physician or hospital entitled thereto. A default in the payment of such award may be 21. In order to facilitate the prompt payment of medical bills, a discount of enforced in the manner provided for the enforcement of compensation 5 per cent will be allowed on all medical bills in amounts of $15.00 or awards as set forth in section twenty-six of this chapter. over, if paid within 30 days, except on controverted cases when the 30-day limit shall run from the date that a decision is rendered finding the In all cases coming under this subdivision the payment of the claim of claim compensible. the physician or hospital for medical or surgical services or treatment shall be subordinate to that of the claimant or his beneficiaries. 10. "A. AND A." means Authorization and Arrangement established by agree- GENERAL MEDICO SURGICAL SERVICE ment between the physician and the carrier or employer. This designation has been applied where the extreme range of variation and complexity Line in the individual problem renders a fixed minimum standard impractical. No. Item After-Care Fee 49. First visit, home call, including reports $4 00 11. CONCURRENT FEES for two or more physicians for an identical period 50. First office visit, including reports 3 00 of care and treatment will not be allowed except when warranted by com- 51. Office call 2 00 plication or noted need for assistance. When all the required care and 52. Home call - day 3 00 treatment reasonably falls within the range of qualifications of one physi- 53. Home call - night (if call received by doctor cian no other shall claim a fee; only one physician shall be in charge of a between 12 M to 7 A.M.) 5 00 case. Fees for assistants and consultants must be justified. 54. Hospital call 2 00 12. MULTIPLE INJURIES treated by one doctor requiring extensive surgical 55. Consultation with specialist, same fee as regular visit. dressings or care are to be charged for the greatest plus one-half of the lesser fees but limited to two times the greatest fee. Superficial injuries 56. Salvarsan, plus cost of drug 5 00 57. Tetanus Antitoxin, add cost of drug to routine fee. not requiring extensive attention are not to carry cumulative charges. 58. Assistant to surgeon 15 00 This Rule does not apply to multiple x-ray and pathological examinations. (In hospital with interne staff no charge to be made for service of interne or assistant.) 13. EXTENSIVE AND UNUSUAL DRESSINGS. When a patient requires unusual, extensive and extraordinary dressings, the cost of material 59. Strapping of joints. 64. Strapping of shoulder, routine service 1ee plus 1 00 (enumerated and noted in bill) may be added to schedule of fee for service. 65. Strapping of hip, routine service fee plus 1 00 14. UNIT FEES. When the schedule specifies a fee for a service and a period 66. Strapping of sacro-lumbar spine, routine service fee plus 1 00 of after care, and for any reason there is a transfer of the care and treat- 67. Strapping of thorax. routine service fee plus 1 00 ment to a second or other physician, the stated amount in the schedule shall cover the combined fee of all. (For fracture of ribs, see Line 164)

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    "ocrText": "6\n7\n7. EMERGENCY. Claim may need to be sustained by record of details that\n15. PRORATION OF SCHEDULED UNIT FEE. When the schedule specifies\nestablish fact of emergency.\na unit fee for a definite treatment and period of after care, and the patient\nis transferred from one to another physician, the employer (or carrier) is\n8. PAYMENT OF MEDICAL FEES. Section 13-f. No physician shall\nresponsible for the amount stated in the schedule. If the concerned physi-\ncollect or receive a fee from the injured claimant. A hospital shall not\ncians agree upon amount of proration they shall render separate bills\nbe entitled to remuneration paid to a physician on its staff.\naccordingly; in the event of no agreement or disagreement, the matter\nSection 13-f (1). \"Fees for medical services shall be payable only to\na\nshall be settled by the Board of the local County Medical Society, or by\nphysician or other lawfully qualified person permitted by Section 13-b of\nan arbitration committee appointed by it-without cost to the contestants.\nthis Chapter, or to the agent or to the executor or administrator of the\n16. Presence of physician during examination by employer's (or carrier's)\nestate of such physician.\"\nphysician, routine fee.\nWRITTEN NOTICE OF CONTEST by the employer (or carrier) shall be\nfiled of the amount of the bill for medical care or hospital service within\n17. Investigation and observation (without examination) by medical inspector\n30 days after receipt of bill, or the right to an impartial examination of\nacting for employer (or carrier) ; if presence of injured employee's physi-\nthe fairness of the amount claimed \"shall be deemed to be waived and the\ncian is required by carrier or employer the fee to the employee's physician\namount claimed by such physician or hospital shall be deemed to be the\nshall be $4.00.\nfair value of the services rendered by him or it.\"\n18. Physician of \"especially qualified\" enrollment, who makes written opinion\nor testimony, fee fixed by Commissioner, Section 13 (d).\n9. DISAGREEMENT \"as to value of medical aid rendered under this Chapter\nshall be decided by an arbitration committee.\" Section 13-g (2).\n19. PENALTY FEES. \"When transfer of patient by employer (or carrier)\nhas not been authorized under this Section,\" Section 13-a (3) (2) : Same\n9A. NO INSURANCE CASES. Sec. 13-g of Chapter 258 of the Laws of 1935\nas total paid to other physicians or as determined by arbitration committee.\nhas been amended effective July 1, 1940 as follows:\n20. Owners of plants requiring high frequency treatments may apply to the\n(4) In claims where the employer has failed to secure compensation to\nIndustrial Commissioner for modification of the established fees in the\nhis employees as required by section fifty of this chapter, the board may\nmedical fee schedule. The Commissioner will cause an investigation to be\nmake an award for the value of medical services or treatment rendered\nmade in each instance and act upon the record when established. This\nto such employees, in accordance with the schedule of fees and charges\nprivilege will be granted only on the assurance that it will not interfere\nprepared and established under the provisions of section thirteen-a of\nwith the employee's right of free choice of physician.\nthis chapter. Such award shall be made to the physician or hospital\nentitled thereto. A default in the payment of such award may\nbe\n21. In order to facilitate the prompt payment of medical bills, a discount of\nenforced in the manner provided for the enforcement of compensation\n5 per cent will be allowed on all medical bills in amounts of $15.00 or\nawards as set forth in section twenty-six of this chapter.\nover, if paid within 30 days, except on controverted cases when the 30-day\nlimit shall run from the date that a decision is rendered finding the\nIn all cases coming under this subdivision the payment of the claim of\nclaim compensible.\nthe physician or hospital for medical or surgical services or treatment\nshall be subordinate to that of the claimant or his beneficiaries.\n10. \"A. AND A.\" means Authorization and Arrangement established by agree-\nGENERAL MEDICO SURGICAL SERVICE\nment between the physician and the carrier or employer. This designation\nhas been applied where the extreme range of variation and complexity\nLine\nin the individual problem renders a fixed minimum standard impractical.\nNo.\nItem\nAfter-Care\nFee\n49. First visit, home call, including reports\n$4 00\n11. CONCURRENT FEES for two or more physicians for an identical period\n50. First office visit, including reports\n3 00\nof care and treatment will not be allowed except when warranted by com-\n51. Office call\n2 00\nplication or noted need for assistance. When all the required care and\n52. Home call - day\n3 00\ntreatment reasonably falls within the range of qualifications of one physi-\n53. Home call - night (if call received by doctor\ncian no other shall claim a fee; only one physician shall be in charge of a\nbetween 12 M to 7 A.M.)\n5 00\ncase. Fees for assistants and consultants must be justified.\n54. Hospital call\n2 00\n12. MULTIPLE INJURIES treated by one doctor requiring extensive surgical\n55. Consultation with specialist, same fee as regular\nvisit.\ndressings or care are to be charged for the greatest plus one-half of the\nlesser fees but limited to two times the greatest fee. Superficial injuries\n56. Salvarsan, plus cost of drug\n5 00\n57. Tetanus Antitoxin, add cost of drug to routine fee.\nnot requiring extensive attention are not to carry cumulative charges.\n58. Assistant to surgeon\n15 00\nThis Rule does not apply to multiple x-ray and pathological examinations.\n(In hospital with interne staff no charge to\nbe made for service of interne or assistant.)\n13. EXTENSIVE AND UNUSUAL DRESSINGS. When a patient requires\nunusual, extensive and extraordinary dressings, the cost of material\n59. Strapping of joints.\n64. Strapping of shoulder, routine service 1ee plus\n1 00\n(enumerated and noted in bill) may be added to schedule of fee for service.\n65. Strapping of hip, routine service fee plus\n1 00\n14. UNIT FEES. When the schedule specifies a fee for a service and a period\n66. Strapping of sacro-lumbar spine, routine service fee\nplus\n1 00\nof after care, and for any reason there is a transfer of the care and treat-\n67. Strapping of thorax. routine service fee plus\n1 00\nment to a second or other physician, the stated amount in the schedule\nshall cover the combined fee of all.\n(For fracture of ribs, see Line 164)"
}