S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 5183--A

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            February 14, 2011
                               ___________

Introduced  by  M.  of A. SIMOTAS, HEVESI, BENEDETTO, COLTON, MONTESANO,
  ROBERTS, GUNTHER, REILLY, GALEF,  STEVENSON,  GIBSON,  MENG,  SCHIMEL,
  CASTELLI,  RAIA, MURRAY, BURLING, WEPRIN, TITUS, SPANO, LAVINE, PERRY,
  ZEBROWSKI, HOOPER -- Multi-Sponsored by -- M. of A. BRAUNSTEIN,  BREN-
  NAN,  CALHOUN,  COOK, CROUCH, DUPREY, GABRYSZAK, GLICK, HEASTIE, KATZ,
  LATIMER, MAGEE, MARKEY, SALADINO, SAYWARD -- read once and referred to
  the Committee on Labor -- committee discharged, bill amended,  ordered
  reprinted as amended and recommitted to said committee

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:

  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  three  new  paragraphs  6,  7  and  8 are added to read as
follows:
  (5) [Notwithstanding any other provision of this chapter,  if]  IF  an
employer or carrier has contracted with a pharmacy to provide prescribed
medicine  to claimants, then such employer or carrier may require claim-
ants 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 claimants to obtain prescribed medi-
cines 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,  inter-
net,  telephone  or other means, and any other required information that
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.
                                                           LBD08819-02-1
              

A. 5183--A                          2

macies 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  thir-
teen-o of this [chapter] ARTICLE.
  (6) NOTWITHSTANDING PARAGRAPH FIVE OF THIS SUBDIVISION, AN EMPLOYER OR
CARRIER SHALL BE PROHIBITED FROM REFUSING TO ALLOW A CLAIMANT TO UTILIZE
A  PHARMACY  OF  HIS OR HER CHOICE TO FURNISH THE PRESCRIBED MEDICATIONS
REQUIRED BY THE CLAIMANT AS LONG AS SUCH PHARMACY'S CHARGES COMPLY  WITH
THE PUBLISHED PRICES.
  (7)  ANY  PHARMACY THAT HAS PROVIDED PRESCRIBED MEDICINE TO A CLAIMANT
AND HAS NOT BEEN REIMBURSED IN ACCORDANCE WITH THE PROVISIONS  OF  PARA-
GRAPH  ONE  OF  THIS SUBDIVISION SHALL BE ENTITLED TO MAINTAIN AN ACTION
AGAINST THE CARRIER TO RECOVER THE AMOUNTS DUE TO SUCH PHARMACY PURSUANT
TO THIS SUBDIVISION IN ACCORDANCE WITH REGULATIONS TO BE ESTABLISHED  BY
THE  BOARD OR THE CHAIRMAN. WHERE A PHARMACY BILL HAS BEEN DETERMINED TO
BE DUE AND OWING IN ACCORDANCE WITH THE PROVISIONS OF THIS  SUBDIVISION,
THE  BOARD SHALL INCLUDE IN THE AMOUNT OF THE AWARD INTEREST OF NOT MORE
THAN ONE AND ONE-HALF PERCENT PER  MONTH  PAYABLE  TO  THE  PHARMACY  IN
ACCORDANCE WITH THE RULES AND REGULATIONS PROMULGATED BY THE BOARD.
  (8)  NOTWITHSTANDING  ANY OTHER PROVISION IN THIS CHAPTER, THE INITIAL
FILL OF A PRESCRIPTION MEDICINE IN CONNECTION WITH A CLAIM FOR  BENEFITS
UNDER  THIS  CHAPTER  SHALL  NOT CONTAIN A SUPPLY OF SUCH MEDICINE FOR A
PERIOD OF LONGER THAN FOURTEEN DAYS. FOR THE PURPOSES OF THIS PARAGRAPH,
"INITIAL FILL" SHALL BE DEFINED AS A PRESCRIPTION OR  A  COMBINATION  OF
PRESCRIPTIONS FOR MEDICATION ISSUED BY AN AUTHORIZED MEDICAL PROVIDER AT
THE  TIME  OF  DISCOVERY  OF  INJURY  OR  ILLNESS  BUT SHALL NOT INCLUDE
PRESCRIPTIONS THAT MAY BE WRITTEN SEVENTY-TWO HOURS  OR  MORE  FROM  THE
TIME OF INITIAL MEDICAL CARE.
  S 2.  Section 88 of the workers' compensation law, as amended by chap-
ter 635 of the laws of 1996, is amended to read as follows:
  S 88. Administration expenses. The entire expense of administering the
state  insurance  fund shall be paid out of such fund which shall not be
considered an agency or a fund of the state for the purposes of  section
four  of the state finance law.  The portion of such expenses applicable
and chargeable to the disability benefits fund shall be determined on an
equitable  basis  with  due  allowance  for  the  division  of  overhead
expenses.   There shall be submitted to the director of the budget quar-
terly financial statements on a calendar year basis.  In no  case  shall
the  amount  of  administrative expenditures so authorized for an entire
year from the workers' compensation fund exceed twenty-five  per  centum
of  the  earned  premiums for such insurance for that year.  [In no case
shall the amount of administrative expenditures authorized for the disa-
bility benefits fund for an entire year exceed twenty-five per centum of
the premiums earned by that fund for such insurance for that  year.]  No
payment,  expenditure or refund out of the state insurance fund shall be
subject to pre-audit by the department of audit and control as  provided
by section one hundred eleven of the state finance law. All appointments
to  positions in the state insurance fund shall be made subject to civil
service requirements.
  S 3. Section 88 of the workers' compensation law, as amended by  chap-
ter 6 of the laws of 2007, is REPEALED.
  S 4.  This act shall take effect immediately.

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 5183--B

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            February 14, 2011
                               ___________

Introduced  by  M.  of A. SIMOTAS, HEVESI, BENEDETTO, COLTON, MONTESANO,
  ROBERTS, GUNTHER, REILLY, GALEF,  STEVENSON,  GIBSON,  MENG,  SCHIMEL,
  CASTELLI,  RAIA, MURRAY, BURLING, WEPRIN, TITUS, SPANO, LAVINE, PERRY,
  ZEBROWSKI, HOOPER, ROSENTHAL -- Multi-Sponsored by -- M. of A.  BRAUN-
  STEIN,  BRENNAN,  CALHOUN,  COOK,  CROUCH,  DUPREY,  GABRYSZAK, GLICK,
  HEASTIE, KATZ, LATIMER, MAGEE, MARKEY, SALADINO, SAYWARD -- read  once
  and  referred  to the Committee on Labor -- committee discharged, bill
  amended, ordered reprinted as amended and recommitted to said  commit-
  tee  --  reported  and  referred to the Committee on Ways and Means --
  committee discharged, bill amended, ordered reprinted as  amended  and
  recommitted to said committee

AN   ACT  to  amend  the  workers'  compensation  law,  in  relation  to
  prescription prices and pharmacies for injured employees

  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  three  new  paragraphs  6,  7  and  8 are added to read as
follows:
  (5) [Notwithstanding any other provision of this chapter,  if]  IF  an
employer or carrier has contracted with a pharmacy to provide prescribed
medicine  to claimants, then such employer or carrier may require claim-
ants 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 claimants to obtain prescribed medi-
cines 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,  inter-

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
                                                           LBD08819-04-1
              

A. 5183--B                          2

net,  telephone  or other means, and any other required information that
must be supplied to the pharmacy or pharmacies. If the pharmacy or phar-
macies 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  thir-
teen-o of this [chapter] ARTICLE.
  (6) NOTWITHSTANDING PARAGRAPH FIVE OF THIS SUBDIVISION, AN EMPLOYER OR
CARRIER SHALL BE PROHIBITED FROM REFUSING TO ALLOW A CLAIMANT TO UTILIZE
A  PHARMACY  OF  HIS OR HER CHOICE TO FURNISH THE PRESCRIBED MEDICATIONS
REQUIRED BY THE CLAIMANT AS LONG AS SUCH PHARMACY'S CHARGES COMPLY  WITH
THE PUBLISHED PRICES.
  (7)  ANY  PHARMACY THAT HAS PROVIDED PRESCRIBED MEDICINE TO A CLAIMANT
AND HAS NOT BEEN REIMBURSED IN ACCORDANCE WITH THE PROVISIONS  OF  PARA-
GRAPH  ONE  OF  THIS SUBDIVISION SHALL BE ENTITLED TO MAINTAIN AN ACTION
AGAINST THE CARRIER TO RECOVER THE AMOUNTS DUE TO SUCH PHARMACY PURSUANT
TO THIS SUBDIVISION IN ACCORDANCE WITH REGULATIONS TO BE ESTABLISHED  BY
THE  BOARD OR THE CHAIRMAN. WHERE A PHARMACY BILL HAS BEEN DETERMINED TO
BE DUE AND OWING IN ACCORDANCE WITH THE PROVISIONS OF THIS  SUBDIVISION,
THE  BOARD SHALL INCLUDE IN THE AMOUNT OF THE AWARD INTEREST OF NOT MORE
THAN ONE AND ONE-HALF PERCENT PER  MONTH  PAYABLE  TO  THE  PHARMACY  IN
ACCORDANCE WITH THE RULES AND REGULATIONS PROMULGATED BY THE BOARD.
  (8)  NOTWITHSTANDING  ANY OTHER PROVISION IN THIS CHAPTER, THE INITIAL
FILL OF A PRESCRIPTION MEDICINE IN CONNECTION WITH A CLAIM FOR  BENEFITS
UNDER THIS SUBDIVISION SHALL NOT CONTAIN A SUPPLY OF SUCH MEDICINE FOR A
PERIOD OF LONGER THAN FOURTEEN DAYS. FOR THE PURPOSES OF THIS PARAGRAPH,
"INITIAL  FILL"  SHALL  BE DEFINED AS A PRESCRIPTION OR A COMBINATION OF
PRESCRIPTIONS FOR MEDICATION ISSUED BY AN AUTHORIZED MEDICAL PROVIDER AT
THE TIME OF DISCOVERY  OF  INJURY  OR  ILLNESS  BUT  SHALL  NOT  INCLUDE
PRESCRIPTIONS  THAT  MAY  BE  WRITTEN SEVENTY-TWO HOURS OR MORE FROM THE
TIME OF INITIAL MEDICAL CARE.
  S 2.  This act shall take effect immediately.

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 5183--C
                                                        Cal. No. 179

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            February 14, 2011
                               ___________

Introduced  by  M.  of A. SIMOTAS, HEVESI, BENEDETTO, COLTON, MONTESANO,
  ROBERTS, GUNTHER, REILLY, GALEF,  STEVENSON,  GIBSON,  MENG,  SCHIMEL,
  CASTELLI, RAIA, MURRAY, BURLING, WEPRIN, TITUS, LAVINE, PERRY, ZEBROW-
  SKI,  HOOPER,  ROSENTHAL,  TITONE  --  Multi-Sponsored  by -- M. of A.
  BRAUNSTEIN, BRENNAN, CALHOUN, COOK, CROUCH, DUPREY, GABRYSZAK,  GLICK,
  HEASTIE,  KATZ, LATIMER, MAGEE, MARKEY, SALADINO, SAYWARD -- read once
  and referred to the Committee on Labor -- committee  discharged,  bill
  amended,  ordered reprinted as amended and recommitted to said commit-
  tee -- reported and referred to the Committee on  Ways  and  Means  --
  committee  discharged,  bill amended, ordered reprinted as amended and
  recommitted to said committee -- advanced to a third reading,  amended
  and ordered reprinted, retaining its place on the order of third read-
  ing

AN   ACT  to  amend  the  workers'  compensation  law,  in  relation  to
  prescription prices and pharmacies for injured employees

  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 two new paragraphs 6 and 7 are added to read as follows:
  (5)  [Notwithstanding  any  other provision of this chapter, if] IF an
employer or carrier has contracted with a pharmacy to provide prescribed
medicine to claimants, then such employer or carrier may require  claim-
ants  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 claimants to obtain  prescribed  medi-
cines 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,

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
              

                                                           LBD08819-09-2

A. 5183--C                          2

how  to initially fill and refill prescriptions through the mail, inter-
net, telephone or other means, and any other required  information  that
must be supplied to the pharmacy or pharmacies. If the pharmacy or phar-
macies  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 thir-
teen-o of this [chapter] ARTICLE.
  (6) NOTWITHSTANDING PARAGRAPH FIVE OF THIS SUBDIVISION, AN EMPLOYER OR
CARRIER SHALL BE PROHIBITED FROM REFUSING TO ALLOW A CLAIMANT TO UTILIZE
A PHARMACY OF HIS OR HER CHOICE TO FURNISH  THE  PRESCRIBED  MEDICATIONS
REQUIRED  BY THE CLAIMANT AS LONG AS SUCH PHARMACY'S CHARGES COMPLY WITH
THE PUBLISHED PRICES.
  (7) NOTWITHSTANDING ANY OTHER PROVISION OF THIS CHAPTER,  THE  INITIAL
FILL  OF A PRESCRIPTION MEDICINE IN CONNECTION WITH A CLAIM FOR BENEFITS
UNDER THIS SUBDIVISION SHALL NOT CONTAIN A SUPPLY OF SUCH MEDICINE FOR A
PERIOD OF LONGER THAN FOURTEEN DAYS. FOR THE PURPOSES OF THIS PARAGRAPH,
"INITIAL FILL" SHALL BE DEFINED AS A PRESCRIPTION OR  A  COMBINATION  OF
PRESCRIPTIONS FOR MEDICATION ISSUED BY AN AUTHORIZED MEDICAL PROVIDER AT
THE  TIME  OF  DISCOVERY  OF  INJURY  OR  ILLNESS  BUT SHALL NOT INCLUDE
PRESCRIPTIONS THAT MAY BE WRITTEN SEVENTY-TWO HOURS  OR  MORE  FROM  THE
TIME OF INITIAL MEDICAL CARE.
  S 2. This act shall take effect immediately.

                            
                    S T A T E   O F   N E W   Y O R K
________________________________________________________________________

                                 5183--D
                                                        Cal. No. 179

                       2011-2012 Regular Sessions

                          I N  A S S E M B L Y

                            February 14, 2011
                               ___________

Introduced  by  M.  of A. SIMOTAS, HEVESI, BENEDETTO, COLTON, MONTESANO,
  ROBERTS, GUNTHER, REILLY, GALEF,  STEVENSON,  GIBSON,  MENG,  SCHIMEL,
  CASTELLI, RAIA, MURRAY, BURLING, WEPRIN, TITUS, LAVINE, PERRY, ZEBROW-
  SKI,  HOOPER,  ROSENTHAL,  TITONE  --  Multi-Sponsored  by -- M. of A.
  BRAUNSTEIN, BRENNAN, CALHOUN, COOK, CROUCH, DUPREY, GABRYSZAK,  GLICK,
  HEASTIE,  KATZ, LATIMER, MAGEE, MARKEY, SALADINO, SAYWARD -- read once
  and referred to the Committee on Labor -- committee  discharged,  bill
  amended,  ordered reprinted as amended and recommitted to said commit-
  tee -- reported and referred to the Committee on  Ways  and  Means  --
  committee  discharged,  bill amended, ordered reprinted as amended and
  recommitted to said committee -- advanced to a third reading,  amended
  and ordered reprinted, retaining its place on the order of third read-
  ing  --  again  amended on third reading, ordered reprinted, retaining
  its place on the order of third reading

AN  ACT  to  amend  the  workers'  compensation  law,  in  relation   to
  prescription prices and pharmacies for injured employees

  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]  IF  an
employer or carrier has contracted with a pharmacy to provide prescribed
medicine  to claimants, then such employer or carrier may require claim-
ants 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 claimants to obtain prescribed medi-
cines from a pharmacy with which it has a contract must notify claimants
of the pharmacy  or  pharmacies  with  which  it  has  a  contract,  the

 EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                      [ ] is old law to be omitted.
              

                                                           LBD08819-14-2

A. 5183--D                          2

locations  and  addresses  of the pharmacy or pharmacies, if applicable,
how to initially fill and refill prescriptions through the mail,  inter-
net,  telephone  or other means, and any other required information that
must be supplied to the pharmacy or pharmacies. If the pharmacy or phar-
macies  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 thir-
teen-o of this [chapter] ARTICLE.
  (6) NOTWITHSTANDING PARAGRAPH FIVE OF THIS SUBDIVISION, AN EMPLOYER OR
CARRIER SHALL BE PROHIBITED FROM REFUSING TO ALLOW A CLAIMANT TO UTILIZE
A PHARMACY OF HIS OR HER CHOICE TO FURNISH  THE  PRESCRIBED  MEDICATIONS
REQUIRED  BY  THE  CLAIMANT AS LONG AS SUCH PHARMACY'S CHARGES ARE BELOW
THE PHARMACEUTICAL FEE SCHEDULE ADOPTED BY THE CHAIR.
  S 2. This act shall take effect on the one hundred eightieth day after
it shall have become a law.