Legislative Memo

Lev Ginsburg
Director of Government Affairs
T 518.465.7511


S.6405/A.9005, Part G, Section 24



Preferred Provider Organization use to 120 days



February 1, 2016


The Business Council strongly supports the Governor's proposal to extend the period within which an injured worker may be directed to care inside a preferred provider network (PPO) to 120 days, found in S.6405/A.9005, Part G, Section 24.

Extending the period within which an injured worker may be directed to care inside a PPO has been proven to reduce the number of lost work days per claim and, most importantly, to improve worker satisfaction with their medical care. Since PPOs can utilize the expertise of specialist such as occupational physicians, the care is more designed for injured workers and more likely of positive outcomes.

New York State law currently limits the number of days that an employee may be directed to a provider at 30 days, and if a collective bargaining agreement exists, any use of PPOs must be collectively bargained. New York’s neighbors have adopted much longer PPO periods, ranging from 90 days to lifetime of the claim. Pennsylvania recently increased their PPO directed care to 90 days and has seen a drastic reduction in lost time from work, a dramatic increase in employee satisfaction with care and a corresponding drop in controverted cases over medical care.

New York’s employers are always looking for ways to bend the cost curve in workers’ compensation while guaranteeing the best care for our injured employees. The extension of the availability of PPOs for injured workers under the workers’ comp system accomplishes both of these goals while also significantly reducing the administrative burden on the Workers’ Compensation Board. This proposal is a win/win/win proposition.

For these reasons, The Business Council strongly supports this proposal, and urges its adoption by the Senate and Assembly.