Some New York physicians are continuing to speak out about the state's workers' compensation fee schedules and treatment guidelines, which they say limit urine testing that could help monitor opioid abuse.

In its new medical fee schedules, approved last month, the Workers' Compensation Board removed the words “at least” from its ground rules governing urine testing of patients in pain management. Doctors filed comments last fall and said the change could mean testing that has been done at least four times a year would now be limited to a maximum of four.

"They just need to be monitored more closely, and that's going to take more than four times a year," Dr. Cheryl Hart, a workers' comp physician, told a Buffalo TV news station.

"I worry for (patients) that, in their desperation, they may seek other avenues to seek pain relief," Hart said, "perhaps illegally."

The board noted during the rulemaking process in December that the change was made in keeping with its medical treatment guidelines, and that confirmatory lab testing is “always available” when an in-office screening reveals an unexplained result.

In a statement to the TV station, the board also said the rules regarding urine drug testing “are specific to a patient’s clinical circumstances, and therefore the type and number of tests performed are determined by medical professionals, and billing will vary by case.”

The fee schedule and rules are set to take effect in April.