Purpose

The objective of our examination was to determine the extent to which NYSIF was penalized by the Workers’ Compensation Board (WCB) for late payment of medical and compensation claims.

Background

The Workers’ Compensation Law (Law) authorizes medical providers and injured workers to report late medical and compensation payments to the WCB when insurance carriers exceed the time limits established in the Law for such payments. The WCB may impose a penalty on insurance carriers for reported late payments, and the Law requires insurance carriers to pay interest on late payment amounts.

Key Findings

NYSIF processes the vast majority of its payments without incurring penalties or interest. However, auditors found NYSIF paid more than $4.1 million in penalties and interest for making late medical and compensation payments during the period January 1, 2010 through December 31, 2016. This included 35,130 penalties totaling $1.2 million for late payments to medical providers and 898 penalties totaling $2.2 million for late compensation payments to injured workers. Additionally, NYSIF paid combined interest of $833,335 to medical providers and injured workers for late medical and compensation payments.

Key Recommendations

• Continue to identify and implement strategies to reduce the amount of late payments resulting in penalties and interest.