NY A10413

Codifies Workers' Compensation Board regulations (effective July 2025) allowing injured workers to obtain prescription medication from out-of-network pharmacies when contracted pharmacies fail to dispense within required timeframes

Permits out-of-network pharmacy access when authorization decisions are delayed beyond regulatory timeframes, when emergency medications are needed to prevent imminent harm, or under other board-specified circumstances

Requires out-of-network pharmacies to follow the workers' compensation pharmacy fee schedule, medical treatment guidelines, and formulary, and to assume financial responsibility if the claim is denied or medication deemed non-compensable

Establishes that out-of-network access conditions are self-executing and do not require prior Workers' Compensation Board approval, and that using out-of-network pharmacies cannot be used as evidence against claim compensability

Mandates the Workers' Compensation Board submit a report within 3 years analyzing out-of-network utilization frequency, medication access delays, litigation impacts, costs, and stakeholder feedback