NY State Senate Bill S1026A

Archive: Last Bill Status - Passed Senate

Introduced
In Committee
On Floor Calendar
- Passed Senate
- Passed Assembly
Delivered to Governor
Signed/Vetoed by Governor

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Actions

view actions (23)

	Assembly Actions - Lowercase Senate Actions - UPPERCASE
May 23, 2022	referred to labor returned to assembly repassed senate
May 17, 2022	amended on third reading 1026a
May 17, 2022	vote reconsidered - restored to third reading returned to senate recalled from assembly
Mar 30, 2022	referred to labor delivered to assembly passed senate
Mar 02, 2022	advanced to third reading
Mar 01, 2022	2nd report cal.
Feb 28, 2022	1st report cal.555
Jan 05, 2022	referred to labor returned to senate died in assembly
May 03, 2021	referred to labor delivered to assembly passed senate
Mar 04, 2021	advanced to third reading
Mar 03, 2021	2nd report cal.
Mar 02, 2021	1st report cal.495
Jan 06, 2021	referred to labor

Votes

Bill Amendments

Original

A (Active)

Original

A (Active)

S1026 - Details

See Assembly Version of this Bill:: A1013
Current Committee:: Assembly Labor
Law Section:: Workers' Compensation Law
Laws Affected:: Amd §13, Work Comp L
Versions Introduced in Other Legislative Sessions:: 2019-2020: S7245, A8117
2023-2024: S1974, A1219

S1026 - Summary

Relates to contracted network pharmacy use.

S1026 - Sponsor Memo

S1026 - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1026
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  Sen.  RAMOS  -- read twice and ordered printed, and when
   printed to be committed to the Committee on Labor
 
 AN ACT to amend the workers' compensation law, in relation to contracted
   network pharmacy use

   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 a new paragraph 6 is added to read as follows:
   (5) Notwithstanding any other provision of this chapter, if an employ-
 er or carrier has contracted with a pharmacy to provide prescribed medi-
 cine 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
 ENCOURAGE  CLAIMANTS  TO  USE  IT  EXCLUSIVELY,  CLAIMANTS  MAY   OBTAIN

 PRESCRIBED  MEDICINES  AT  THE PHARMACY OR PHARMACIES OF THEIR CHOICE SO
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD04906-01-1

 S. 1026                             2
 
 LONG AS THAT PHARMACY IS REGISTERED AS  A  RESIDENT,  IN-STATE  PHARMACY
 WITH  THE  NEW  YORK STATE BOARD OF PHARMACY AND THE EMPLOYER OR CARRIER
 WILL BE LIABLE FOR SUCH CHARGES IN  ACCORDANCE  WITH  THE  FEE  SCHEDULE
 PRESCRIBED  IN SECTION THIRTEEN-O OF THIS ARTICLE SO LONG AS THE MEDICA-
 TIONS ARE CAUSALLY RELATED TO THE CLAIMANTS' WORK RELATED  INJURIES  AND
 ARE IN ACCORDANCE WITH THE NEW YORK STATE WORKERS' COMPENSATION PHARMACY
 FORMULARY AND ALL OTHER APPLICABLE BOARD REGULATIONS REGARDING PHARMACY.
 THIS  PARAGRAPH WILL NOT APPLY TO ANY RESIDENT, IN-STATE PHARMACIES THAT
 ARE CONTRACTED WITH THE NETWORK PHARMACY THAT THE  EMPLOYER  OR  CARRIER
 DESIGNATES  AS  THEIR  PREFERRED  AND  ENCOURAGED NETWORK PHARMACY. SUCH
 PHARMACIES ARE OBLIGATED TO PROCESS ALL CLAIMS  THROUGH  THEIR  CONTRACT
 WITH THE EMPLOYER'S OR CARRIER'S DESIGNATED NETWORK PHARMACY. THIS PARA-
 GRAPH  WILL  ALSO 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  WILL HAVE THE RIGHT TO DENY ANY
 CHARGES THAT ORIGINATE FROM NON-RESIDENT,  OUT-OF-STATE  PHARMACIES  AND
 DENY  ANY  CHARGES  FOR NON-FDA APPROVED EXTEMPORANEOUS COMPOUND MEDICA-
 TIONS.
   (6) (I) ANY PHARMACIST LICENSED AND REGISTERED TO PRACTICE IN NEW YORK
 STATE PURSUANT TO ARTICLE ONE HUNDRED THIRTY-SEVEN OF THE EDUCATION  LAW
 SHALL  BE  PERMITTED TO DISPENSE MEDICATION TO A CLAIMANT OUTSIDE OF THE
 NETWORK WHERE:
   (A) THE CARRIER HAS REFUSED TO PAY FOR THE CLAIMANT'S  MEDICATION  AND
 THE CLAIMANT IS UNABLE TO ACCESS A NETWORK PHARMACY; OR
   (B) THE CLAIMANT'S MEDICATION NEEDS TO BE REAUTHORIZED MONTHLY, AND IS
 SO AUTHORIZED, BUT IS DENIED BECAUSE:
   (I) THE CARRIER FAILED TO RESPOND TO THE REAUTHORIZATION;
   (II)  MEDICAL  REPORTS  WERE  NOT FILED FOR REAUTHORIZATION OR A FILED
 MEDICAL REPORT CONTAINS A DEFECT;
   (III) THE MEDICATION HAS BEEN AUTHORIZED  IN  THE  PAST,  HOWEVER  THE
 CARRIER  DENIES AUTHORIZATION CLAIMING THAT THE MEDICAL TREATMENT GUIDE-
 LINES DO NOT SUPPORT REAUTHORIZATION;
   (IV) AN INDEPENDENT MEDICAL EXAMINER DISAGREES WITH REAUTHORIZATION;
   (V) REAUTHORIZATION HAS BEEN DENIED BECAUSE MAXIMUM  MEDICAL  IMPROVE-
 MENT HAS BEEN REACHED; OR
   (VI) THE CASE IS IN THE PROCESS OF BEING SETTLED.
   (II)  ANY  PHARMACY  THAT  AGREES TO DISPENSE MEDICATION TO A CLAIMANT
 UNDER SUBPARAGRAPH (I) OF THIS PARAGRAPH SHALL:
   (A) FOLLOW THE FEE SCHEDULE PRESCRIBED IN SECTION THIRTEEN-O  OF  THIS
 ARTICLE;
   (B) FOLLOW ALL TREATMENT GUIDELINES;
   (C)  FOLLOW  THE  NEW YORK STATE WORKERS' COMPENSATION PHARMACY FORMU-
 LARY;
   (D) VERIFY THAT THE MEDICATION IS CAUSALLY RELATED TO  THE  CLAIMANT'S
 WORK RELATED INJURIES; AND
   (E)  ASSUME  ALL  LIABILITY FOR THE MEDICATION IF A CASE IS NOT ESTAB-
 LISHED OR IF THE MEDICATION IS NOT LATER APPROVED.
   (III) UPON APPROVAL OF ANY MEDICATION DISPENSED BY A PHARMACY PURSUANT
 TO SUBPARAGRAPH (I) OF THIS PARAGRAPH, SUCH PHARMACY SHALL  BE  ENTITLED
 TO  RECEIVE  PROMPT  PAYMENT FOR SUCH MEDICATION FROM THE CARRIER WITHIN
 TEN DAYS OF SUCH APPROVAL, AND SHALL BE PERMITTED TO CONTINUE TO PROVIDE
 SUCH MEDICATION TO THE CLAIMANT AFTER  SUCH  CLAIMANT'S  CASE  HAS  BEEN
 ESTABLISHED OUTSIDE OF THE NETWORK.
   § 2. This act shall take effect immediately.

S1026A (ACTIVE) - Details

See Assembly Version of this Bill:: A1013
Current Committee:: Assembly Labor
Law Section:: Workers' Compensation Law
Laws Affected:: Amd §13, Work Comp L
Versions Introduced in Other Legislative Sessions:: 2019-2020: S7245, A8117
2023-2024: S1974, A1219

S1026A (ACTIVE) - Summary

Relates to contracted network pharmacy use.

S1026A (ACTIVE) - Sponsor Memo

 
BILL NUMBER: S1026A

SPONSOR: RAMOS
 
TITLE OF BILL:

An act to amend the workers' compensation law, in relation to contracted
network pharmacy use

 
PURPOSE OR GENERAL IDEA OF BILL:

To authorize workers' compensation claimants to use any in-state pharma-
cy that is registered with the education department.

 
SUMMARY OF PROVISIONS:

Sections 1-2 of the bill amend paragraph 5 of subdivision (i) of section
13 of the workers' compensation law, as added by chapter 6 of the laws
of 2007.

Section 1 of the bill allows employers or insurance carriers to encour-
age claimants to obtain all prescribed medications from contracted phar-
macies.

Provides requirement for the employer to notify claimants of the pharma-
cy or pharmacies with which it has contracted, the respective locations
and addresses, and if applicable, on how to fill and refill
prescriptions through the mail, internet, telephone or other means and
any other information that needs to be provided to the pharmacy.
Provides circumstances under which a claimant can obtain prescribed
medications from out-of-network pharmacies if an employer or carrier
fails to provide the required access for medication to the claimant.

Provides requirements for dispensation of medication by pharmacists and
establishes liability for medication.

Requires the insurance carrier to pay the pharmacy directly within
forty-five business days of approval of any dispensed medication.

Section 2 sets the effective date.

 
DIFFERENCE BETWEEN ORIGINAL AND AMENDED VERSION (IF APPLICABLE):

Makes technical changes and does not require the pharmacy to verify that
the medication is causally related to the claimant's work-related inju-
ries.

Increases the number of days within which the insurance carrier must pay
the pharmacy upon approval of any dispensed medication from 10 to 45
days.

Changes the effective date.

 
JUSTIFICATION:

This bill will provide workers compensation claimants with greater flex-
ibility by allowing them to fill their prescriptions not only at network
pharmacies with whom an employer or carrier encourages an exclusive
relationship, but also at pharmacies that are registered as resident,
instate pharmacies with the New York State Department of Education.
While providing injured claimants with the convenience they need to best
remedy their ailments, this legislation also has the added benefit of
conferring economic gain to our State's small businesses.

 
FISCAL IMPLICATIONS:

To be determined.

 
EFFECTIVE DATE:
This act shall take effect on the thirtieth day after it shall become
law.

S1026A (ACTIVE) - Bill Text download pdf

 
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1026--A
     Cal. No. 555
 
                        2021-2022 Regular Sessions
 
                             I N  S E N A T E
 
                                (PREFILED)
 
                              January 6, 2021
                                ___________
 
 Introduced  by  Sen.  RAMOS  -- read twice and ordered printed, and when
   printed to be committed to the Committee on Labor  --  recommitted  to
   the  Committee  on  Labor  in accordance with Senate Rule 6, sec. 8 --
   reported favorably from said committee, ordered to  first  and  second
   report,  ordered to a third reading, passed by Senate and delivered to
   the Assembly, recalled, vote reconsidered, restored to third  reading,
   amended  and  ordered  reprinted,  retaining its place in the order of
   third reading
 
 AN ACT to amend the workers' compensation law, in relation to contracted
   network pharmacy use
 
   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 to read as follows:
   (5)  (I)  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

  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets

                       [ ] is old law to be omitted.
                                                            LBD04906-09-2
 S. 1026--A                          2

 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] WHEN
 AN EMPLOYER OR INSURANCE CARRIER FAILS TO PROVIDE  REQUIRED  ACCESS  FOR
 MEDICATION TO A CLAIMANT AS PER THE BOARD GUIDELINES AND PHARMACY FORMU-
 LARY,  CLAIMANTS MAY THEN OBTAIN PRESCRIBED MEDICINES FROM ANY RESIDENT,
 IN-STATE PHARMACY LICENSED AND REGISTERED TO PRACTICE IN NEW YORK  STATE
 PURSUANT  TO  ALL REQUIREMENTS OUTLINED IN SECTION 63.6 OF TITLE 8 NYCRR
 PART 63 UNDER THE FOLLOWING CIRCUMSTANCES:
   (A) THE NETWORK PHARMACY OR INSURANCE CARRIER HAS REFUSED TO  PAY  FOR
 THE  CLAIMANT'S  MEDICATION AND THE CLAIMANT IS UNABLE TO ACCESS MEDICA-
 TION THROUGH A NETWORK PHARMACY DUE TO THE FAILURE TO  AUTHORIZE  WITHIN
 SEVENTY-TWO HOURS OF SUCH REQUEST; OR
   (B)  THE  CLAIMANT'S  MEDICATION  NEEDS TO BE ON A SCHEDULE, AND IS SO
 AUTHORIZED, BUT HAS NOT BEEN AUTHORIZED WITHIN SEVENTY-TWO HOURS OF SUCH
 REQUEST BECAUSE:
   (I) THE INSURANCE CARRIER OR NETWORK PHARMACY FAILED TO RESPOND TO THE
 REAUTHORIZATION REQUEST;
   (II) MEDICAL REPORTS WERE NOT YET  FILED  FOR  REAUTHORIZATION,  OR  A
 FILED MEDICAL REPORT CONTAINS A DEFECT;
   (III)  THE  MEDICATION  HAS  BEEN  AUTHORIZED IN THE PAST; HOWEVER THE
 CARRIER DENIES AUTHORIZATION CLAIMING THAT THE MEDICAL TREATMENT  GUIDE-
 LINES DO NOT SUPPORT REAUTHORIZATION;
   (IV) AN INDEPENDENT MEDICAL EXAMINER DISAGREES WITH REAUTHORIZATION;
   (V)  REAUTHORIZATION  HAS BEEN DENIED BECAUSE MAXIMUM MEDICAL IMPROVE-
 MENT HAS BEEN REACHED; OR
   (VI) THE CASE IS IN THE PROCESS OF BEING SETTLED.
   (II) ANY PHARMACIST THAT AGREES TO DISPENSE MEDICATION TO  A  CLAIMANT
 UNDER THIS PARAGRAPH SHALL:
   (A) FOLLOW THE NEW YORK STATE WORKERS' COMPENSATION PHARMACY FEE SCHE-
 DULE PRESCRIBED IN SECTION THIRTEEN-O OF THIS ARTICLE;
   (B)  FOLLOW ALL NEW YORK STATE WORKERS' COMPENSATION MEDICAL TREATMENT
 GUIDELINES FOR THE CLAIMANT'S SITE OF INJURY FOR WHICH THE MEDICATION IS
 PRESCRIBED;
   (C) FOLLOW THE NEW YORK STATE WORKERS'  COMPENSATION  PHARMACY  FORMU-
 LARY; AND
   (D)  ASSUME  ALL  LIABILITY FOR THE MEDICATION IF A CASE IS NOT ESTAB-
 LISHED OR IF THE MEDICATION IS NOT LATER APPROVED.
   (III) UPON APPROVAL OF ANY MEDICATION DISPENSED BY A PHARMACY PURSUANT
 TO THIS PARAGRAPH, SUCH PHARMACY SHALL BE  ENTITLED  TO  RECEIVE  PROMPT
 PAYMENT  FOR  SUCH MEDICATION FROM THE INSURANCE CARRIER DIRECTLY WITHIN
 FORTY-FIVE BUSINESS DAYS OF SUCH APPROVAL, AND  SHALL  BE  PERMITTED  TO
 CONTINUE  TO  PROVIDE  SUCH  MEDICATION  TO  THE CLAIMANT OUTSIDE OF THE
 NETWORK AFTER SUCH CLAIMANT'S CASE HAS BEEN ESTABLISHED.
   § 2. This act shall take effect on the thirtieth day  after  it  shall
 have become a law. Effective immediately, the addition, amendment and/or
 repeal  of  any  rule  or regulation necessary for the implementation of
 this act on its effective date are authorized to be made  and  completed
 on or before such effective date.

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The New York State Senate

senate Bill S1026A

Sponsored By

Archive: Last Bill Status - Passed Senate

Your Voice

Actions

Votes

May 23, 2022 - floor Vote

Floor Vote: May 23, 2022

Mar 30, 2022 - floor Vote

Floor Vote: Mar 30, 2022

Feb 28, 2022 - Labor committee Vote

Committee Vote: Feb 28, 2022

May 3, 2021 - floor Vote

Floor Vote: May 3, 2021

Mar 2, 2021 - Labor committee Vote

Committee Vote: Mar 2, 2021

Bill Amendments

S1026 - Details

S1026 - Summary

S1026 - Sponsor Memo

S1026 - Bill Text download pdf

S1026A (ACTIVE) - Details

S1026A (ACTIVE) - Summary

S1026A (ACTIVE) - Sponsor Memo

S1026A (ACTIVE) - Bill Text download pdf

Comments

senate Bill S1026A

Share this bill

Sponsored By

Jessica Ramos

Archive: Last Bill Status - Passed Senate

Your Voice

Actions

Votes

May 23, 2022 - floor Vote

Floor Vote: May 23, 2022

Mar 30, 2022 - floor Vote

Floor Vote: Mar 30, 2022

Feb 28, 2022 - Labor committee Vote

Committee Vote: Feb 28, 2022

May 3, 2021 - floor Vote

Floor Vote: May 3, 2021

Mar 2, 2021 - Labor committee Vote

Committee Vote: Mar 2, 2021

Bill Amendments

S1026 - Details

S1026 - Summary

S1026 - Sponsor Memo

S1026 - Bill Text download pdf

S1026A (ACTIVE) - Details

S1026A (ACTIVE) - Summary

S1026A (ACTIVE) - Sponsor Memo

S1026A (ACTIVE) - Bill Text download pdf

Comments