Assembly Actions -
Lowercase Senate Actions - UPPERCASE |
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Mar 05, 2025 |
advanced to third reading |
Mar 04, 2025 |
2nd report cal. |
Mar 03, 2025 |
1st report cal.439 |
Feb 14, 2025 |
referred to labor |
Senate Bill S4926
2025-2026 Legislative Session
Sponsored By
(D, WF) 13th Senate District
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
Actions
Votes
2025-S4926 (ACTIVE) - Details
2025-S4926 (ACTIVE) - Sponsor Memo
BILL NUMBER: S4926 SPONSOR: RAMOS TITLE OF BILL: An act to amend the workers' compensation law, in relation to contracted network pharmacy use SUMMARY OF PROVISIONS: Section 1 Allows employers or insurance carriers to encourage claimants to obtain all prescribed medications from contracted pharmacies. Provides requirement for the employer to notify claimants of the pharma- cy or pharmacies with which it has contracted, the respective locations and addresses, and if applicable, on how to fill and refill prescriptions through the mail, interne, telephone or other means and any other information that needs to be provided to the pharmacy. Provides circumstances under which a claimant can obtain prescribed medications from out-of-network pharmacies if an employer or carrier fails to provide the required access for medication to the claimant.
2025-S4926 (ACTIVE) - Bill Text download pdf
S T A T E O F N E W Y O R K ________________________________________________________________________ 4926 2025-2026 Regular Sessions I N S E N A T E February 14, 2025 ___________ 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. 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 SUCH CLAIMANT'S 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; (IV) AN INDEPENDENT MEDICAL EXAMINER DISAGREES WITH REAUTHORIZATION; (V) REAUTHORIZATION HAS BEEN DENIED BECAUSE MAXIMUM MEDICAL IMPROVE- MENT HAS BEEN REACHED; OR EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets [ ] is old law to be omitted. LBD09234-01-5
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