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

                                         6992

                              2009-2010 Regular Sessions

                                 I N  A S S E M B L Y

                                    March 18, 2009
                                      ___________

       Introduced by M. of A. GIANARIS -- read once and referred to the Commit-
         tee on Labor

       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:

    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 two new paragraphs 6 and 7 are added to read as follows:
    4    (5) Notwithstanding any other provision of this chapter, if an employ-
    5  er or carrier has contracted with a pharmacy to provide prescribed medi-
    6  cine  to  claimants, then such employer or carrier may require claimants
    7  to obtain all prescribed medicines from the pharmacy with which  it  has
    8  contracted,  except  if  a  medical emergency occurs and it would not be
    9  reasonably possible to obtain immediately required  prescribed  medicine
   10  from  the pharmacy with which the employer or carrier has a contract. An
   11  employer or carrier that requires claimants to obtain  prescribed  medi-
   12  cines from a pharmacy with which it has a contract must notify claimants
   13  of  the  pharmacy  or  pharmacies  with  which  it  has  a contract, the
   14  locations and addresses of the pharmacy or  pharmacies,  if  applicable,
   15  how  to initially fill and refill prescriptions through the mail, inter-
   16  net, telephone or other means, and any other required  information  that
   17  must be supplied to the pharmacy or pharmacies. If the pharmacy or phar-
   18  macies  with which the employer or carrier contracts does not offer mail
   19  order service and does not have a physical location within a  reasonable
   20  distance  from  the claimant, as defined by regulation of the board, the
   21  claimant may obtain prescribed medicines at the pharmacy  or  pharmacies
   22  of his or her choice and the employer or carrier will be liable for such
   23  charges  in accordance with the fee schedule prescribed in section thir-
   24  teen-o of this chapter.  PROVIDED, HOWEVER, THAT AN EMPLOYER OR  CARRIER
   25  SHALL BE PROHIBITED FROM REFUSING TO ALLOW A CLAIMANT TO UTILIZE A PHAR-

        EXPLANATION--Matter in ITALICS (underscored) is new; matter in brackets
                             [ ] is old law to be omitted.
                                                                  LBD10198-01-9
       A. 6992                             2

    1  MACY OF HIS OR HER CHOICE TO FURNISH THE PRESCRIBED MEDICATIONS REQUIRED
    2  BY  THE  CLAIMANT  AS  LONG  AS  SUCH PHARMACY'S CHARGES COMPLY WITH THE
    3  PUBLISHED PRICES AS DEFINED IN PARAGRAPH SIX OF THIS SUBDIVISION.
    4    (6)  IF AN EMPLOYER OR CARRIER HAS CONTRACTED WITH A PHARMACY PURSUANT
    5  TO PARAGRAPH FIVE OF THIS SUBDIVISION  THEN  SUCH  EMPLOYER  OR  CARRIER
    6  SHALL  BE  REQUIRED  TO  SUBMIT AND PUBLISH THE PRICES FOR ALL AVAILABLE
    7  MEDICINES, INCLUDING ALL MANAGEMENT FEES  THAT  ARE  PAID  FOR  PHARMACY
    8  SERVICES,  TO THE BOARD. THE BOARD SHALL ESTABLISH RULES AND REGULATIONS
    9  TO PROVIDE FOR THE DISSEMINATION AND ACCESS OF THE PRICES SUBMITTED  AND
   10  PUBLISHED  BY  THE  EMPLOYER  OR  CARRIER  TO  ANY  PHARMACY WHO HAS NOT
   11  CONTRACTED WITH AN EMPLOYER OR CARRIER.
   12    (7) ANY PHARMACY THAT HAS PROVIDED PRESCRIBED MEDICINE TO  A  CLAIMANT
   13  AND  HAS  NOT BEEN REIMBURSED IN ACCORDANCE WITH THE PROVISIONS OF PARA-
   14  GRAPH ONE OF THIS SUBDIVISION SHALL BE ENTITLED TO  MAINTAIN  AN  ACTION
   15  AGAINST  THE  EMPLOYER  AND  CARRIER  TO RECOVER THE AMOUNTS DUE TO SUCH
   16  PHARMACY PURSUANT TO THIS SUBDIVISION IN ACCORDANCE WITH REGULATIONS  TO
   17  BE  ESTABLISHED  BY THE BOARD OR THE CHAIRMAN. WHERE A PHARMACY BILL HAS
   18  BEEN DETERMINED TO BE DUE AND OWING IN ACCORDANCE WITH THE PROVISIONS OF
   19  THIS SUBDIVISION, THE BOARD SHALL INCLUDE IN THE  AMOUNT  OF  THE  AWARD
   20  INTEREST  OF NOT MORE THAN ONE AND ONE-HALF PERCENT PER MONTH PAYABLE TO
   21  THE PHARMACY IN ACCORDANCE WITH THE RULES AND REGULATIONS PROMULGATED BY
   22  THE BOARD.
   23    S 2. This act shall take effect immediately.