New York Workers' Compensation Legislation and Regulations

Workers' Compensation Preferred Provider Organizations (PPO)

Chapter 635 of the Laws of 1996 authorized a number of initiatives intended to reform the New York State Workers' Compensation system. Article 10-A of the Workers' Compensation Law authorizes the Department of Health, in cooperation with the Workers' Compensation Board, to develop and administer a program which enables preferred provider organizations (PPOs) to participate in the delivery of workers' compensation medical care. Under this initiative, the Department of Health is responsible for the development, implementation and administration of a process for the certification and monitoring of participating PPOs.

Please click on this text to review the full PPO regulations - https://www.health.ny.gov/health_care/managed_care/workers_comp/ 

Gallagher Bassett (GB) is pleased to offer MetraComp as our network of choice for the State of New York.

Metracomp, Inc. is a New York State Certified Preferred Provider Organization (PPO) created specifically with workers’ compensation in mind. MetraComp contracts with medical providers that understand the complexities and nuances of workers’ compensation. Providers in the MetraComp network treat with a focus on helping injured employees return to work as soon as medically appropriate.

Benefits of a the Metracomp Certified PPO:

• Initial treatment by a PPO provider is required and has been shown to be a strong indicator of an injured worker remaining in network for all treatment throughout the life of the claim
• Direction of Care for 30 days from the first visit with a PPO provider
• The certified PPO is only means by which employer may direct care and gain some control
• Discounted fee arrangements with participating providers
• Guaranteed timely access to providers
• Mandatory care management including - Utilization review, Telephonic and field case management and Return-to-work
• New York State approved and credentialed PPO network
• Access to a network of providers who are authorized by the New York Workers’ Compensation Board to treat workers’ comp injuries
• Complaints/Grievances Support
• Quality Assurance/Quality Improvement Program

Certified PPO State Coverage by County

If you need additional information regarding the Metracomp Certified PPO and other programs and services offered by Gallagher Bassett Services, please contact your GB Account Executive.