A 11714: Imposes an increased percentage of interest from 1.5% to 3%, or up to 5% for a pattern or practice of non-payment, and other civil penalties on certain employers or their workers compensation insurance carriers for non-payment of a bill for medical care or supplies.

  
  STATE OF NEW YORK ________________________________________________________________________ 11714  IN ASSEMBLY September 16, 2026 ___________ Introduced by COMMITTEE ON RULES -- (at request of M. of A. Bronson) -- read once and referred to the Committee on Labor AN ACT to amend the workers' compensation law, in relation to imposing higher percentage of interest and other civil penalties on certain employers or their workers' compensation insurance carriers for non- payment of a bill for medical care or supplies The People of the State of New York, represented in Senate and Assem- bly, do enact as follows: 1 Section 1. Subdivision 1 of section 13-g of the workers' compensation 2 law, as amended by section 3 of part CC of chapter 55 of the laws of 3 2019, is amended to read as follows: 4 (1) (a) Within forty-five days after a bill for medical care or 5 supplies delivered pursuant to section thirteen of this article has been 6 rendered to the employer or such employer's worker's compensation insur- 7 ance carrier, or to the self-insured employer responsible for payment of 8 medical benefits under this chapter, such employer or its worker's 9 compensation insurance carrier, or such self-insured employer responsi- 10 ble for payment of medical benefits under this chapter, must pay the 11 bill or notify the medical care provider or supplier in the format 12 prescribed by the chair that the bill is not being paid and explain the 13 reasons for non-payment. In the event that the employer or its worker's 14 compensation insurance carrier, or the self-insured employer responsible 15 for payment of medical benefits under this chapter, fails to make 16 payment or notify the medical care provider or supplier within such 17 forty-five day period that payment is not being made, the medical care 18 provider or supplier may notify the board in the format prescribed by 19 the chair that the bill has not been paid and request that the board 20 make an award for payment of such bill. The board or the chair may make 21 an award not in excess of the established fee schedules for any such 22 bill or part thereof which remains unpaid after said forty-five day 23 period or thirty days after all other questions duly and timely raised 24 in accordance with the provisions of this chapter, relating to the 25 employer's liability, such employer's worker's compensation insurance 26 carrier's liability, or for a self-insured employer that is responsible EXPLANATION--Matter in italics (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD16333-01-6 
 A. 11714 2 1 for payment of medical benefits under this chapter, such self-insured 2 employer's liability for the payment of such amount, shall have been 3 finally determined adversely to [the] such employer or such employer's 4 worker's compensation insurance carrier, or such self-insured employer 5 responsible for payment of medical benefits under this chapter, whichev- 6 er is later, in accordance with rules promulgated by the chair, and such 7 award may be collected in like manner as an award of compensation. The 8 chair shall assess the sum of fifty dollars against the employer for 9 each such award made by the board, which sum shall be paid into the 10 state treasury. 11 (b) In the event that the employer or its worker's compensation insur- 12 ance carrier, or the self-insured employer responsible for payment of 13 medical benefits under this chapter, has provided an explanation in 14 writing why the bill has not been paid, in part or in full, within the 15 aforesaid time period, and the parties [can not] cannot agree as to the 16 value of medical aid rendered under this chapter, such value shall be 17 decided by arbitration as set forth in rules and regulations promulgated 18 by the chair. 19 (c) Where a bill for medical care or supplies has been determined to 20 be due and owing in accordance with the provisions of this section the 21 board shall include in the amount of the award interest of not more than 22 one and one-half percent (1 1/2%) per month payable to the medical care 23 provider or supplier, in accordance with the rules and regulations 24 promulgated by the board. Interest shall be calculated from the forty- 25 fifth day after the bill was rendered or from the thirtieth day after 26 all other questions duly and timely raised in accordance with the 27 provisions of this chapter, relating to the employer's liability or such 28 employer's worker's compensation insurance carrier's liability, or for a 29 self-insured employer that is responsible for payment of medical bene- 30 fits under this chapter, such self-insured employer's liability, for the 31 payment of such amount, shall have been finally determined adversely to 32 the employer or its worker's compensation insurance carrier, or self-in- 33 sured employer responsible for payment of medical benefits under this 34 chapter, whichever is later, in accordance with rules promulgated by the 35 chair. 36 (d) If the employer or its worker's compensation insurance carrier, or 37 the self-insured employer responsible for payment of medical benefits 38 under this chapter, fails to pay an award within fifteen days after the 39 award is rendered by the board pursuant to this subdivision, interest 40 shall accrue on the unpaid amount beginning on the sixteenth day after 41 the award is rendered and shall be payable at the rate of three percent 42 per month until the award is paid in full. 43 (e) A medical care provider or supplier that alleges a pattern or 44 practice of non-payment by the employer or its worker's compensation 45 insurance carrier, or the self-insured employer responsible for payment 46 of medical benefits under this chapter, may file a claim with the board, 47 in a form and manner prescribed by the chair, requesting a determination 48 that such employer or its worker's compensation insurance carrier, or 49 such self-insured employer responsible for payment of medical benefits 50 under this chapter, has engaged in a pattern or practice of non-payment 51 and seeking a special award for payment of the bill or bills at issue. 52 (f) Where the board determines that a pattern or practice of non-pay- 53 ment exists and that payment is due and owing pursuant to this subdivi- 54 sion, the board shall include in the award interest at a rate of not 55 less than three percent and not more than five percent per month. In 56 determining the applicable rate of interest, the board shall consider 
 A. 11714 3 1 the severity, duration, and frequency of the pattern or practice of 2 non-payment, including the number of violations, the length of time over 3 which such conduct occurred, and the number of medical care providers or 4 suppliers adversely affected. 5 (g) In cases involving egregious or repeated violations constituting a 6 pattern or practice of non-payment, the board may, in addition to any 7 interest awarded pursuant to this subdivision, impose a civil penalty in 8 an amount not to exceed twenty-five percent of the amount determined to 9 be due and owing. Such penalty shall be payable immediately upon issu- 10 ance of the board's decision. 11 (h) For purposes of this subdivision, the term "pattern or practice" 12 shall mean: 13 (i) three or more violations of this subdivision by the same employer 14 or its insurance carrier, or by the same self-insured employer responsi- 15 ble for payment of medical benefits under this chapter, within a twelve- 16 month period with respect to one or more medical care providers or 17 suppliers; or 18 (ii) such other repeated conduct as the chair determines demonstrates 19 a systemic failure to comply with the requirements of this subdivision, 20 including repeated untimely payment of claims, repeated untimely notices 21 of denial or objection, or other recurring payment practices that unrea- 22 sonably delay reimbursement to medical care providers or suppliers. 23 § 2. This act shall take effect immediately.