Bill > S09331

This bill aims to ensure injured workers have timely access to necessary prescription medications by codifying existing regulations of the Workers' Compensation Board (WCB) into law, meaning these protections will be permanent and consistently applied. Specifically, it allows injured workers to obtain prescription medication from a pharmacy of their choice outside of a contracted network if certain conditions are met, such as a contracted pharmacy failing to dispense authorized medication within regulatory timeframes, or if the employer or insurance carrier doesn't issue an authorization promptly. It also covers emergency situations requiring immediate medication and other circumstances the WCB may define by regulation to prevent delays that hinder recovery. Pharmacies dispensing medication under these provisions must adhere to WCB fee schedules and treatment guidelines, and will be responsible for costs if the claim is denied or the medication is deemed non-compensable, but will be reimbursed if the medication is approved. The bill also mandates that the WCB submit a report within three years detailing the implementation of these provisions, including data on out-of-network pharmacy use, medication access, litigation, costs, and stakeholder feedback, to inform potential future improvements.

Labor and Employment

https://www.nysenate.gov/legislation/bills/2025/S9331