PROVIDER NETWORK RULES for NEW YORK
Provider Selection
Unless in a certified program the employee must select the treating provider from an extensive list of authorized providers developed by the Workers' Compensation Board (WCB).
An employee may waive the right to select an authorized provider and enter a carrier – or employer-sponsored network if the injured worker signs form C 3.1 at the time of injury.
Managed Care Options
Certified PPO program: Employees have restricted choice of provider - employees working within certified counties are required to treat with a PPO provider for up to 30 days after the initial treatment by a PPO provider.
Provider Lists
Provider lists and directories may be utilized in all counties. Any employee postings provided by the employer or insurer related to the utilization of an employer or insurer recommended network or health care provider must clearly indicate that such utilization is voluntary.
PROVIDER NETWORK RULES FOR NEW YORK ROC
Provider Selection
The employee chooses the treating provider, but the employer may recommend a designated network or healthcare provider to an injured employee.
Provider Lists
Panels, lists and directories are allowed, and must clearly indicate the using network providers is purely voluntary.
PROVIDER NETWORK RULES FOR NEW YORK PPO
Provider Selection
The employee chooses the treating provider from a network list. After 30 days post initial treatment, the employee may seek treatment from a state authorized provider of his or her choice
Provider Lists
Lists and directories are allowed.