NY S09331

Codifies into law the Workers' Compensation Board's July 2025 regulations allowing injured workers to obtain prescription medications from out-of-network pharmacies when network pharmacies fail to dispense within required timeframes

Permits out-of-network pharmacy access when authorization decisions are delayed, emergency medications are needed to prevent imminent harm (including opioid antagonists, insulin, cardiac and seizure medications, antibiotics), or other board-specified conditions exist

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 board approval, and that using an out-of-network pharmacy 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