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14.00 SELECTION OF PROVIDERS OF MEDICAL SERVICES

Policy

Individuals served by NYSCB are free to choose a qualified medical practitioner providing that the practitioner adheres to NYSCB standards.

Who Are Providers of Medical Services

Providers of medical services may include the following:

1. attending physicians

2. psychologists and psychiatrists

3. low vision specialists

4. optometrists and ophthalmologists

5. other health professionals including physician's assistants

Note

In addition, physician's assistants providing general medical examinations must be:

1. employed by an agency or physician,

2. supervised by a physician who is licensed in New York State, and

3. certified by the National Commission for Certification of Physician's Assistants

Payment for services rendered must be made to the physician or agency involved.

NYSCB Standards

All medical practitioners providing a service to a individuals applying for or receiving services from NYSCB must be:

1. appropriately licensed or approved by the State of New York,

2. willing and able to comply with NYSCB reporting requirements,

3. willing and able to deliver services in accordance with a individual's vocational rehabilitation needs and plan, and

4. willing to accept fees for services as established by New York State as full payment for services.

Medical Fee Exception

An exception to the established medical fee may be made only if the medical service is not available from a practitioner who will accept the established fee. In such a case, the district manager must secure prior approval from Central Office. The approval request must contain supporting justification from the district manager.

Procedure for Selecting A Provider of Medical Services

The following procedure is to be used when selecting a provider of medical services:

1. The counselor should inform the individual of the opportunity to choose a medical practitioner (provider of service).

2. When an individual expresses a preference for a practitioner who meets NYSCB established standards, that practitioner should be used.

3. When an individual does not express any preference, the counselor will provide the individual with a representative list of several appropriate practitioners from which the individual may make a selection.