Bill > A10413

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 consistent. It allows injured workers to obtain prescription medication from a pharmacy of their choice outside of an employer or insurance carrier's contracted network under specific circumstances, such as when a contracted pharmacy fails to dispense an authorized medication within the WCB's established timeframes, or when authorization is delayed. The bill also permits out-of-network access for emergency medications necessary to prevent imminent harm and for other situations the WCB may define by regulation to address delays. Pharmacies dispensing medication out-of-network must adhere to the WCB's fee schedules and medical treatment guidelines, and they will be responsible for the cost if the workers' compensation claim is denied or the medication is found to be non-compensable. If the medication is deemed compensable, the employer or carrier will reimburse the pharmacy according to the established fee schedule. The bill also mandates that the WCB submit a report within three years of its effective date, analyzing the implementation of these provisions, including data on out-of-network pharmacy use, medication access delays, litigation, costs, and stakeholder feedback, with recommendations for improvements.

Labor and Employment

https://www.nysenate.gov/legislation/bills/2025/A10413