New York, its Workers’ Compensation Board and Gov. Kathy Hochul are reshaping the state’s workers’ comp system, one step at a time.

Catherine Montgomery

Currently, providers who want to treat injured workers must apply for approval with the WCB. Under Hochul’s “universal authorization” for providers, all licensed providers in good standing would be able to treat injured workers.

Hochul first proposed universal provider authorization as part of her 2025 agenda, but the measure failed to advance. Hopefully, the second time’s a charm.

Universal provider authorization would add to a significant list of major comp reforms, including mandatory electronic billing, allowing residents and fellows to treat injured workers and allowing insurers to fund medical care without assuming liability for claims. 

Expanding the provider pool

According to the WCB, only about 10% of eligible providers have state authorization to treat injured workers. This leaves a relatively small pool of providers from which injured workers can seek care, especially in rural areas, where up to 40% of patients must travel outside their own county for treatment.

As we frequently point out regarding California’s system, barriers to treatment access can delay recovery and increase claim duration and costs. 

For practices, eliminating the provider authorization process could change the entire calculus of deciding whether to accept workers’ comp patients. Under Hochul’s proposal, the state would automatically authorize any eligible provider in good standing to treat injured workers “as part of health care providers' licensing through the New York State Education Department.”

For injured workers, this would mean essentially no limits on whom they could see for treatment (aside from preferred provider organization restrictions for initial treatment). An injured worker could see her own primary doctor or a trusted specialist for a work-related injury.

For providers, this is an opportunity to render better continuity of care and expand the practice to include comp patients. 

This is the second consecutive year Hochul has pushed this proposal. According to the WCB, if this push is successful, universal provider authorization would take effect on Jan. 1, 2028.

Marching toward a better system 

For the past several years, New York has been overhauling its workers’ comp system:

• October 2021: The WCB mandated that payers accept e-bills from providers and respond with electronic explanations of benefits (e-EOBs).
• August 2024: The WCB began allowing providers to charge payers up to $1 per e-bill to offset e-billing costs using code CPT 99080.
• May 2025: Resident and fellow physicians received permission to treat injured workers.
• August 2025: The WCB mandated that all providers must submit medical bills and documents electronically through a WCB-approved submission partner.
• March 2026: Providers can formally appeal payers’ denials of CPT 99080.
• January 2027: Insurers will be allowed to pay for injured workers’ medical treatment before accepting liability for the claim for up to one year.

Hopefully, we can add January 2028 to the list as the moment every licensed provider received authorization to treat injured workers, dramatically expanding access to care and decreasing claim costs and durations. 

Keep it up, New York.

Catherine Montgomery is the co-founder and CEO of daisyBill, a provider of workers' comp end-to-end revenue cycle management software. This post appears with permission.