Relates to prescription prices and pharmacies for injured employees.
TITLE OF BILL: An act to amend the workers' compensation law, in relation to prescription prices and pharmacies for injured employees
PURPOSE: This legislation would restore the ability of a claimant, in a workers' compensation case, to choose a pharmacy to provide necessary medication for his or her injuries if such pharmacy adheres to the published prices for medications.
SUMMARY OF PROVISIONS: Section 1 - amends paragraph 5 of subdivision (i) of section 13 of the Workers Compensation law and adds three new paragraphs 6, 7 and 8 as follows:
* allows a claimant to use the pharmacy of their choice if t:he pharmacy adheres to the published prices for medications; * allows a pharmacy to have standing in a disputed workers compensation claim; and, * provides that an "initial fill" cannot be for more than 14 days within the first 72 hours of initial medical care.
Section 2 - amends section 88 of the worker's compensation law deleting language regarding administrative expenditures.
Section 3 - repeals section 88 of the workers compensation law.
Section 4 - provides for an immediate effective date.
JUSTIFICATION: The Workers Compensation Reform Bill, Chapter 6 of the Laws of 2007, made significant and important changes to the workers compensation law. Included in these changes was the creation of a pharmaceutical fee schedule that should result in significant savings to the State of New York. But, when this legislation was passed and signed into law, language was placed into the legislation that eliminated an employee's ability to choose his or her pharmaceutical care. The ability to choose one's own pharmacy is an important right. The choice of a pharmacy ensures that the employee gets the best possible healthcare and it eliminates the ability of an employer or carrier to control the employee's healthcare options. Currently, an overwhelming majority of the states in the United States provide an employee with the ability to choose his or her own pharmacy. New York has always taken this position and the bill would simply restore the rights of the employee to choose their own healthcare provided that the pharmacy they choose adheres to the established fee schedule.
LEGISLATIVE HISTORY: 2010 Passed Senate
Savings to the workers compensation system were derived from the creation of a pharmaceutical fee schedule that was established by Chapter 6 of the Laws of 2007. The changes to the legislation would not impact that fee schedule and therefore would not impose any additional costs to the state.
LOCAL FISCAL IMPLICATIONS: None.
EFFECTIVE DATE: This act shall take effect immediately.
STATE OF NEW YORK ________________________________________________________________________ 3749--C 2011-2012 Regular Sessions IN SENATE March 3, 2011 ___________Introduced by Sens. ROBACH, ADDABBO, JOHNSON, MARTINS, MAZIARZ, McDO- NALD, SAVINO, VALESKY -- read twice and ordered printed, and when printed to be committed to the Committee on Labor -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee -- recommitted to the Committee on Labor in accordance with Senate Rule 6, sec. 8 -- committee discharged, bill amended, ordered reprinted as amended and recommitted to said committee 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 ASSEM- BLY, DO ENACT AS FOLLOWS: Section 1. Paragraph 5 of subdivision (i) of section 13 of the work- ers' compensation law, as added by chapter 6 of the laws of 2007 is amended and two new paragraphs 6 and 7 are 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 claim- ants 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 medi- cines 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, inter- net, telephone or other means, and any other required information that must be supplied to the pharmacy or pharmacies. If the pharmacy or phar- macies with which the employer or carrier contracts does not offer mailEXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD08819-08-2 S. 3749--C 2
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 thir- teen-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 COMPLY WITH THE PUBLISHED PRICES. (7) NOTWITHSTANDING ANY OTHER PROVISION OF THIS CHAPTER, THE INITIAL FILL OF A PRESCRIPTION MEDICINE IN CONNECTION WITH A CLAIM FOR BENEFITS UNDER THIS SUBDIVISION SHALL NOT CONTAIN A SUPPLY OF SUCH MEDICINE FOR A PERIOD OF LONGER THAN FOURTEEN DAYS. FOR THE PURPOSES OF THIS PARAGRAPH, "INITIAL FILL" SHALL BE DEFINED AS A PRESCRIPTION OR A COMBINATION OF PRESCRIPTIONS FOR MEDICATION ISSUED BY AN AUTHORIZED MEDICAL PROVIDER AT THE TIME OF DISCOVERY OF INJURY OR ILLNESS BUT SHALL NOT INCLUDE PRESCRIPTIONS THAT MAY BE WRITTEN SEVENTY-TWO HOURS OR MORE FROM THE TIME OF INITIAL MEDICAL CARE. S 2. This act shall take effect immediately.