What's happening
This bill allows workers' compensation claimants to choose any in-state pharmacy for prescriptions, while letting employers encourage but not require use of network pharmacies.
Why it matters
Strengthens patient choice and access. by allowing injured workers to fill their prescriptions at any registered in-state pharmacy, not just those in employer-selected networks—this could make it easier for claimants to access medication at a convenient location.
Limits employer influence. over where prescriptions are filled: while employers can suggest their network pharmacies, they cannot mandate their use, which may reduce administrative hurdles or delays for claimants.
Protects against out-of-state and certain compounded drug costs. by allowing employers to deny payment for prescriptions filled at non-resident, out-of-state pharmacies and for compounded medications not approved by the FDA—potentially reducing fraud or unnecessary costs but possibly limiting access to specialized treatments.
Impacts pharmacy business and competition. by opening up workers’ compensation prescription filling to any qualified in-state pharmacy, which could benefit local businesses and increase competition, possibly affecting costs or service quality for claimants.
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Who cares
Headline styles
Let Workers Choose Pharmacies
Plain English, a few words. Used as the page title.
Sponsors
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History
- Referred to labor
- Referred to labor
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
1250
2019-2020 Regular Sessions
IN ASSEMBLY
January 14, 2019
Introduced by M. of A. BRONSON -- read once and referred to the Committee on Labor
AN ACT to amend the workers' compensation law, in relation to the provision of prescription medicine to workers' compensation claimants
The People of the State of New York, represented in Senate and Assembly, do enact as follows:
Section 1. Paragraph 5 of subdivision (i) of section 13 of the workers' compensation law, as added by chapter 6 of the laws of 2007, is amended to read as follows:
(5) Notwithstanding any other provision of this chapter, if an employer or carrier has contracted with a pharmacy to provide prescribed medicine to claimants, then such employer or carrier may [require] encourage claimants to obtain all prescribed medicines from the pharmacy with which it has contracted[, except if a medical emergency occurs and it would not be reasonably possible to obtain immediately required prescribed medicine from the pharmacy with which the employer or carrier has a contract]. An employer or carrier that [requires] encourages claimants to obtain prescribed medicines from a pharmacy with which it has a contract must notify claimants of the pharmacy or pharmacies with which it has a contract, the locations and addresses of the pharmacy or pharmacies, if applicable, how to initially fill and refill prescriptions through the mail, internet, telephone or other means, and any other required information that must be supplied to the pharmacy or pharmacies. [If the pharmacy or pharmacies with which the employer or carrier contracts does not offer mail order service and does not have a physical location within a reasonable distance from the claimant, as defined by regulation of the board, the claimant may obtain prescribed medicines at the pharmacy or pharmacies of his or her choice and the employer or carrier will be liable for such charges in accordance with the fee schedule prescribed in section thirteen-o of this chapter.] While an employer or a carrier may contract with a network pharmacy and
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD04729-01-9
A. 1250 2
encourage claimants to use it exclusively, claimants may obtain prescribed medicines at the pharmacy or pharmacies of his or her choice so long as that pharmacy is registered as a resident, in-state pharmacy with the education department, and the employer or carrier shall be liable for such charges in accordance with the fee schedule prescribed in section thirteen-o of this article so long as the medications are casually related to the claimant's work related injuries. Such requirements shall not apply to any non-resident, out-of-state pharmacies nor shall it apply to any compound medications that the claimant is prescribed. The employer or carrier shall have the right to deny any charges that originate from non-resident, out-of-state pharmacies and deny any charges for extemporaneous compound medications that have not been approved by the federal Food and Drug Administration.
§ 2. This act shall take effect on the one hundred twentieth day after it shall have become a law.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
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