Bill Text: NY S02978 | 2009-2010 | General Assembly | Amended
Bill Title: Relates to prescription prices and pharmacies for injured employees.
Spectrum: Partisan Bill (Democrat 7-0)
Status: (Engrossed - Dead) 2010-07-01 - referred to labor [S02978 Detail]
Download: New_York-2009-S02978-Amended.html
S T A T E O F N E W Y O R K
________________________________________________________________________
2978--B
Cal. No. 547
2009-2010 Regular Sessions
I N S E N A T E
March 9, 2009
___________
Introduced by Sens. SAVINO, ADDABBO, DIAZ, DILAN, KRUEGER, STAVISKY,
THOMPSON -- 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, amended and ordered reprinted, retaining its place in
the order of third reading -- again amended and ordered reprinted,
retaining its place in the order of third reading
AN ACT to amend the workers' compensation law, in relation to
prescription prices and pharmacies for injured employees and to repeal
section 88 of such law relating thereto
THE PEOPLE OF THE STATE OF NEW YORK, REPRESENTED IN SENATE AND ASSEM-
BLY, DO ENACT AS FOLLOWS:
1 Section 1. Paragraph 5 of subdivision (i) of section 13 of the work-
2 ers' compensation law, as added by chapter 6 of the laws of 2007 is
3 amended and three new paragraphs 6, 7 and 8 are added to read as
4 follows:
5 (5) [Notwithstanding any other provision of this chapter, if] IF an
6 employer or carrier has contracted with a pharmacy to provide prescribed
7 medicine to claimants, then such employer or carrier may require claim-
8 ants to obtain all prescribed medicines from the pharmacy with which it
9 has contracted, except if a medical emergency occurs and it would not be
10 reasonably possible to obtain immediately required prescribed medicine
11 from the pharmacy with which the employer or carrier has a contract. An
12 employer or carrier that requires claimants to obtain prescribed medi-
13 cines from a pharmacy with which it has a contract must notify claimants
14 of the pharmacy or pharmacies with which it has a contract, the
15 locations and addresses of the pharmacy or pharmacies, if applicable,
16 how to initially fill and refill prescriptions through the mail, inter-
17 net, telephone or other means, and any other required information that
18 must be supplied to the pharmacy or pharmacies. If the pharmacy or phar-
EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
[ ] is old law to be omitted.
LBD10198-04-0
S. 2978--B 2
1 macies with which the employer or carrier contracts does not offer mail
2 order service and does not have a physical location within a reasonable
3 distance from the claimant, as defined by regulation of the board, the
4 claimant may obtain prescribed medicines at the pharmacy or pharmacies
5 of his or her choice and the employer or carrier will be liable for such
6 charges in accordance with the fee schedule prescribed in section thir-
7 teen-o of this chapter.
8 (6) NOTWITHSTANDING PARAGRAPH FIVE OF THIS SUBDIVISION, AN EMPLOYER
9 OR CARRIER SHALL BE PROHIBITED FROM REFUSING TO ALLOW A CLAIMANT TO
10 UTILIZE A PHARMACY OF HIS OR HER CHOICE TO FURNISH THE PRESCRIBED MEDI-
11 CATIONS REQUIRED BY THE CLAIMANT AS LONG AS SUCH PHARMACY'S CHARGES
12 COMPLY WITH THE PUBLISHED PRICES.
13 (7) ANY PHARMACY THAT HAS PROVIDED PRESCRIBED MEDICINE TO A CLAIMANT
14 AND HAS NOT BEEN REIMBURSED IN ACCORDANCE WITH THE PROVISIONS OF PARA-
15 GRAPH ONE OF THIS SUBDIVISION SHALL BE ENTITLED TO MAINTAIN AN ACTION
16 AGAINST THE EMPLOYER AND CARRIER TO RECOVER THE AMOUNTS DUE TO SUCH
17 PHARMACY PURSUANT TO THIS SUBDIVISION IN ACCORDANCE WITH REGULATIONS TO
18 BE ESTABLISHED BY THE BOARD OR THE CHAIRMAN. WHERE A PHARMACY BILL HAS
19 BEEN DETERMINED TO BE DUE AND OWING IN ACCORDANCE WITH THE PROVISIONS OF
20 THIS SUBDIVISION, THE BOARD SHALL INCLUDE IN THE AMOUNT OF THE AWARD
21 INTEREST OF NOT MORE THAN ONE AND ONE-HALF PERCENT PER MONTH PAYABLE TO
22 THE PHARMACY IN ACCORDANCE WITH THE RULES AND REGULATIONS PROMULGATED BY
23 THE BOARD.
24 (8) NOTWITHSTANDING ANY OTHER PROVISION IN THIS CHAPTER, THE INITIAL
25 FILL OF A PRESCRIPTION MEDICINE IN CONNECTION WITH A CLAIM FOR BENEFITS
26 UNDER THIS CHAPTER SHALL NOT CONTAIN A SUPPLY OF SUCH MEDICINE FOR A
27 PERIOD OF LONGER THAN FOURTEEN DAYS. FOR THE PURPOSES OF THIS PARAGRAPH,
28 "INITIAL FILL" SHALL BE DEFINED AS A PRESCRIPTION OR A COMBINATION OF
29 PRESCRIPTIONS FOR MEDICATION ISSUED BY AN AUTHORIZED MEDICAL PROVIDER AT
30 THE TIME OF DISCOVERY OF INJURY OR ILLNESS BUT SHALL NOT INCLUDE
31 PRESCRIPTIONS THAT MAY BE WRITTEN SEVENTY-TWO HOURS OR MORE FROM THE
32 TIME OF INITIAL MEDICAL CARE.
33 S 2. Section 88 of the workers' compensation law, as amended by chap-
34 ter 635 of the laws of 1996, is amended to read as follows:
35 S 88. Administration expenses. The entire expense of administering the
36 state insurance fund shall be paid out of such fund which shall not be
37 considered an agency or a fund of the state for the purposes of section
38 four of the state finance law. The portion of such expenses applicable
39 and chargeable to the disability benefits fund shall be determined on an
40 equitable basis with due allowance for the division of overhead
41 expenses. There shall be submitted to the director of the budget quar-
42 terly financial statements on a calendar year basis. In no case shall
43 the amount of administrative expenditures so authorized for an entire
44 year from the workers' compensation fund exceed twenty-five per centum
45 of the earned premiums for such insurance for that year. [In no case
46 shall the amount of administrative expenditures authorized for the disa-
47 bility benefits fund for an entire year exceed twenty-five per centum of
48 the premiums earned by that fund for such insurance for that year.] No
49 payment, expenditure or refund out of the state insurance fund shall be
50 subject to pre-audit by the department of audit and control as provided
51 by section one hundred eleven of the state finance law. All appointments
52 to positions in the state insurance fund shall be made subject to civil
53 service requirements.
54 S 3. Section 88 of the workers' compensation law, as amended by chap-
55 ter 6 of the laws of 2007, is REPEALED.
56 S 4. This act shall take effect immediately.
