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NY S07245
Bill
Status
1/14/2020
Primary Sponsor
Jessica Ramos
Click for details
AI Summary
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Changes workers' compensation law to allow employers and carriers to "encourage" rather than "require" claimants to use contracted network pharmacies for prescribed medicines.
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Permits claimants to obtain medications from any New York state-registered, in-state pharmacy of their choice, with employers or carriers liable for charges under the established fee schedule, provided medications are causally related to work injuries and comply with state formulary requirements.
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Excludes out-of-state pharmacies and non-FDA approved compound medications from coverage, allowing employers or carriers to deny charges from these sources.
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Authorizes licensed New York pharmacists to dispense medications outside the network when carriers refuse payment, fail to respond to reauthorization requests, or deny claims for specified reasons including maximum medical improvement or case settlement.
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Requires non-network pharmacies dispensing medications under emergency circumstances to follow fee schedules, treatment guidelines, and formulary requirements, with carriers obligated to pay approved claims within ten days.
Legislative Description
Relates to contracted network pharmacy use.
Last Action
PRINT NUMBER 7245A
10/16/2020