New York Governor Kathy Hochul is spearheading comprehensive legislative and regulatory reforms to significantly improve access to medical treatment for injured workers—changes that will ultimately benefit New York employers by ensuring better care and faster recovery times.

The proposed reforms eliminate long-standing barriers that delay or limit timely, high-quality care. Key components of the package include:

• Automatically authorizing all eligible licensed medical providers in New York to treat injured workers.
• Permitting medical and surgical residents and fellows to provide care under the supervision of a licensed provider.
• Increasing workers’ compensation fee schedule rates and aligning reimbursements with Medicare rates.
• Requiring insurers to cover medical care while a claim is in dispute, ensuring faster access to treatment.
• Allowing insurers to fund medical treatment for up to one year without accepting liability for the claim.

By removing bureaucratic obstacles and ensuring injured workers receive immediate, quality medical care, these reforms will help get employees back to work faster and reduce lost productivity.

For employers, this means lower claims costs, a more efficient workforce, and a better overall business environment in New York.

As strong advocates for a better workers’ compensation system, daisyBill fully supports these transformative proposals. Below, we outline the details of these potentially game-changing initiatives.

2025 State of the State: Audacious Proposals

Below is an excerpt from the Governor’s 2025 State of the State Book, a compendium of initiatives the Governor intends to pursue in 2025. This section outlines major changes to the workers’ comp system, which we unpack in this article.

The Other 90%: Allowing All NY Providers to Treat Injured Workers

According to the 2025 State of the State Book, the state's Workers' Compensation Board (WCB) has authorized only about 10% of New York’s 80,000 medical providers to treat workers’ compensation claimants due to restrictive authorization rules.

As a result, according to an update on the Governor’s website, 40% of injured workers must travel to a different county to find a provider, with rural and suburban claimants driving an average of 35 miles or more for treatment.

The proposal eliminates the WCB authorization requirement, allowing all eligible licensed medical providers to treat injured workers automatically. This reform removes an administrative hurdle that discourages provider participation (and severely limits care options).

All Hands on Deck (Including Residents and Fellows)

Another critical component of the reforms allows medical and surgical residents and fellows to treat injured workers under a "supervising provider."

By integrating residents and fellows into workers’ compensation, the proposal invites academic hospitals and healthcare systems into the system, further expanding the pool of providers to which injured workers can turn for care.

Keeping Providers in the System

The proposals aim to attract and retain providers in the NY workers’ comp system by addressing the financial and administrative barriers driving them away.

The proposals offer three significant changes:

1. Increasing workers’ compensation fee schedule rates to make them “comparable to private health insurance” rates. To make workers' comp financially sustainable for practices, reimbursement must account for the extra practice expenses associated with treating injured workers.
   
2. Requiring insurers to cover medical care while claims are in dispute, ensuring injured workers receive treatment without delays or out-of-pocket costs. The current system forces workers to wait for necessary care while insurers determine liability.
   
3. Allowing insurers to pay for medical treatment without accepting liability for up to one year. This enables insurers to facilitate medical care "without prejudice," i.e., without committing to covering non-medical indemnity costs.
   
   According to WCB Executive Director Steven Scotti, 65% of workers' comp claims are “medical only,” requiring treatment but not other benefits like wage replacement. In these cases, insurers can pay for medical treatment without assuming responsibility for the broader claim, potentially eliminating delays to care.

We ♥️ NY Workers' Comp Reform Proposals

New York is taking a practical, rational, and fair-minded approach to fixing systemic worker compensation issues.

Instead of adding complexity, as is often the case with legislative and regulatory reform, these proposals simplify and streamline provider eligibility and treatment delivery, reduce administrative burdens, and incentivize provider participation without unfairly burdening any stakeholder.

The result? A system that works better for injured workers, medical providers, employers, and even payers.

These proposals exemplify common-sense reform to create a more effective care delivery system for injured workers. Other states struggling with provider shortages and excessive delays should take note. New York sets the standard for modernizing workers' compensation without compromising fairness or financial sustainability.

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