New York revises drug formulary proposal and releases updated medication list

January 29, 2019 · Policy Matters team

The New York Workers’ Compensation Board (WCB) has released a third proposed rule version of the drug formulary and an updated drug list. This action follows the WCB’s review of submitted comments, as well as continued collaboration with stakeholders.

What action should stakeholders take?
The revised proposal contains modifications significant enough to require a new posting on the WCB’s website and a comment period. The current comment period closes February 22, 2019 and we urge all interested stakeholders to provide the WCB with further insight.

Stakeholder input incorporated
The Optum Workers’ Comp and Auto No-Fault (OWCA) Government Affairs Team has reviewed the new proposed rule and it appears to incorporate several changes OWCA and other stakeholders advocated for which will help streamline the formulary and implementation process.

Proposed changes include:

Restructuring the drug phases from three to two while maintaining the perioperative drug indication list.
Applying formulary requirements to the date of ‘accident or injury’ and outlining that formulary effectiveness will be six months from final adoption on all new prescriptions and 12 months on all prescription refills or renewals regardless of the date of injury.

>OWCA position
OWCA supports these revisions and efforts by the WCB to continue working closely with stakeholders to develop their drug formulary. It is important to note that until a final adopted rule is published, all language and regulatory structure is subject to change. Barring any unforeseen activity, OWCA believes a final adopted rule, which will initiate the implementation timeline, should be forthcoming shortly.

Source for proposed rule, comment responses and updated drug list
Copies of the current proposed rule language, the WCB responses to previous public comments and an updated drug list can be found at: http://www.wcb.ny.gov/drug-formulary-regulation/