New York Workers’ Compensation Board suspends drug formulary refill compliance
The New York Workers’ Compensation Board (WCB) has temporarily suspended application of drug formulary refill/renewal requirements, moving them from January 1, 2021, to an undetermined date at this time.
When the drug formulary was adopted, the WCB included a split effective date with all new prescriptions subject to formulary requirements as of December 5, 2019 and all renewals or refills of ongoing therapy subject to formulary requirements as of June 5, 2020.
Early in 2020, due to COVID and a concern for injured person access to their physicians to discuss possible changes to their medications, the WCB pushed back application of formulary requirements for refills/renewals until January 1, 2021. This week, the WCB announced the previously scheduled January 1, 2021 application date has been temporarily suspended.
During this temporary suspension period, the WCB will:
- Address feedback from providers and payers regarding the formulary
- Make system and process improvements by aligning formulary requirements with the initial release of the WCB’s new business information system – OnBoard
- Continue outreach and education to key users on all new developments
As the drug formulary processes continue to evolve, the Optum Workers’ Comp and Auto No-fault Public Policy and Regulatory Affairs team will continue to monitor the latest developments on behalf of our clients.
Should you have any questions regarding this or any other public policy development, please contact the team at OWCAPolicyMatters@optum.com