What's happening
This bill allows injured employees to use any pharmacy for prescriptions if the pharmacy's charges are below the state's fee schedule.
Why it matters
Shifts power toward injured workers in choosing where to fill prescriptions. , giving them flexibility and possibly better access to medications—especially important for those who may have transportation or mobility challenges.
May increase competition among pharmacies. to offer prescription drugs at prices below the state’s fee schedule, potentially reducing overall costs for both workers and the workers’ compensation system.
Limits employers’ and insurers’ ability to steer injured workers exclusively to contracted pharmacies. , which could disrupt exclusive or preferred pharmacy agreements and affect how such contracts are negotiated in the future.
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Who cares
Injured workers
The bill would let workers’ compensation claimants use a pharmacy of their choice if its charges are below the pharmaceutical fee schedule adopted by the chair.
Employers and workers’ compensation insurers
They could not require claimants to use a contracted pharmacy when the claimant’s chosen pharmacy charges below that fee schedule.
Pharmacies outside employer or insurer networks
They could serve claimants who choose them despite a contracted-pharmacy requirement, provided their charges are below the fee schedule.
Headline styles
Let Injured Workers Choose Pharmacies
Plain English, a few words. Used as the page title.
Sponsors
13 Co-sponsors
3 Multi-sponsors
History
- Referred to labor
- Referred to labor
Full text
2 pagesUnderlined is new[Struck] is removedOfficial text on nysenate.gov ↗
STATE OF NEW YORK
864
2019-2020 Regular Sessions
IN ASSEMBLY
January 11, 2019
Introduced by M. of A. SIMOTAS, HEVESI, BENEDETTO, COLTON, MONTESANO, GUNTHER, GALEF, RAIA, WEPRIN, TITUS, PERRY, ZEBROWSKI, L. ROSENTHAL, ABINANTI -- Multi-Sponsored by -- M. of A. BRAUNSTEIN, COOK, GLICK -read once and referred to the Committee on Labor
AN ACT to amend the workers' compensation law, in relation to prescription prices and pharmacies for injured employees
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 and a new paragraph 6 is added to read as follows:
(5) [Notwithstanding any other provision of this chapter, if] If an employer or carrier has contracted with a pharmacy to provide prescribed medicine to claimants, then such employer or carrier may require 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 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
EXPLANATION--Matter in italics (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD01467-01-9
A. 864 2
charges in accordance with the fee schedule prescribed in section thirteen-o of this [chapter] article.
(6) Notwithstanding paragraph five of this subdivision, an employer or carrier shall be prohibited from refusing to allow a claimant to utilize a pharmacy of his or her choice to furnish the prescribed medications required by the claimant as long as such pharmacy's charges are below the pharmaceutical fee schedule adopted by the chair.
§ 2. This act shall take effect on the one hundred eightieth day after it shall have become a law.
Reflowed for reading: line numbers and page breaks removed. Cite the official text.
Summaries, headlines and scores are AI-generated from the official bill text. How we score bills. Source: NYS Open Legislation.