NY A06887

Allows workers' compensation claimants to obtain prescribed medications from any pharmacy of their choice, rather than being required to use an employer or carrier's contracted network pharmacy, when authorization or payment is refused or delayed beyond 72 hours

Specifies qualifying circumstances including: failure to respond to reauthorization requests, unfiled or defective medical reports, denial based on treatment guidelines, independent medical examiner disagreement, maximum medical improvement determination, or pending case settlement

Requires non-network pharmacies dispensing medications under this provision to follow the New York State workers' compensation pharmacy fee schedule, medical treatment guidelines, and pharmacy formulary

Places liability on the dispensing pharmacy for medication charges if the workers' compensation case is not established or the medication is not later approved

Mandates employers or carriers to pay approved claims within 45 business days, using the fee schedule rates or usual and customary charges if the medication is not on the current fee schedule