Senate Bill S1974A

2023-2024 Legislative Session

Relates to contracted network pharmacy use

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Current Bill Status - On Floor Calendar


  • Introduced
    • In Committee Assembly
    • In Committee Senate
    • On Floor Calendar Assembly
    • On Floor Calendar Senate
    • Passed Assembly
    • Passed Senate
  • Delivered to Governor
  • Signed By Governor

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Bill Amendments

2023-S1974 - Details

See Assembly Version of this Bill:
A1219
Law Section:
Workers' Compensation Law
Laws Affected:
Amd §13, Work Comp L
Versions Introduced in Other Legislative Sessions:
2019-2020: S7245, A8117
2021-2022: S1026, A1013

2023-S1974 - Summary

Relates to contracted network pharmacy use.

2023-S1974 - Sponsor Memo

2023-S1974 - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                   1974
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 17, 2023
                                ___________
 
 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 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
 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
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD01454-01-3
              

2023-S1974A (ACTIVE) - Details

See Assembly Version of this Bill:
A1219
Law Section:
Workers' Compensation Law
Laws Affected:
Amd §13, Work Comp L
Versions Introduced in Other Legislative Sessions:
2019-2020: S7245, A8117
2021-2022: S1026, A1013

2023-S1974A (ACTIVE) - Summary

Relates to contracted network pharmacy use.

2023-S1974A (ACTIVE) - Sponsor Memo

2023-S1974A (ACTIVE) - Bill Text download pdf

                             
                     S T A T E   O F   N E W   Y O R K
 ________________________________________________________________________
 
                                  1974--A
 
                        2023-2024 Regular Sessions
 
                             I N  S E N A T E
 
                             January 17, 2023
                                ___________
 
 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 --
   committee discharged, bill amended, ordered reprinted as  amended  and
   recommitted to said committee

 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. Subdivision (i) of section 13 of the workers'  compensation
 law is amended by adding a new paragraph 6 to read as follows:
   (6) (I) NOTWITHSTANDING PARAGRAPH FIVE OF THIS SUBDIVISION, A CLAIMANT
 SHALL  NOT BE REQUIRED TO OBTAIN PRESCRIBED MEDICINES THROUGH A PHARMACY
 WITH WHICH THE EMPLOYER  OR  CARRIER  HAS  A  CONTRACT  AND  MAY  OBTAIN
 PRESCRIBED MEDICINES FROM A PHARMACY OF HIS OR HER CHOICE WHEN:
   (A)  THE  EMPLOYER OR INSURANCE CARRIER HAS REFUSED TO PROVIDE PAYMENT
 FOR THE CLAIMANT'S PRESCRIBED MEDICATION AND THE CLAIMANT IS  UNABLE  TO
 OBTAIN THE PRESCRIBED MEDICATION FROM A PHARMACY WITH WHICH THE EMPLOYER
 OR  CARRIER  HAS  A  CONTRACT  DUE  TO  THE  FAILURE  TO  AUTHORIZE SUCH
 PRESCRIBED MEDICATION WITHIN SEVENTY-TWO HOURS OF SUCH REQUEST; OR
   (B) THE PRESCRIBED MEDICATION IS SCHEDULED FOR REAUTHORIZATION BUT THE
 EMPLOYER OR CARRIER HAS FAILED TO REAUTHORIZE SUCH PRESCRIBED MEDICATION
 WITHIN SEVENTY-TWO HOURS OF THE REQUEST FOR ONE OR MORE OF THE FOLLOWING
 REASONS:
   (I) THE EMPLOYER, CARRIER, OR NETWORK PHARMACY FAILED  TO  RESPOND  TO
 THE REAUTHORIZATION REQUEST;
   (II) MEDICAL REPORTS HAVE NOT YET BEEN FILED FOR REAUTHORIZATION, OR A
 FILED MEDICAL REPORT CONTAINS A DEFECT;
   (III)  THE  MEDICATION  HAS  BEEN  AUTHORIZED  PREVIOUSLY; HOWEVER THE
 EMPLOYER OR CARRIER DENIES REAUTHORIZATION ON THE BASIS THAT THE MEDICAL
 TREATMENT GUIDELINES DO NOT SUPPORT REAUTHORIZATION;
 
  EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                       [ ] is old law to be omitted.
                                                            LBD01454-03-4
              

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