Direction of Care Safeguards Under Attack in New York

Posted on by myMatrixx

May 2024: The New York State Assembly is currently considering NY SB 1974/AB 1219, which, if enacted as written, will prohibit prescription drug safeguards that currently protect an injured worker being treated for a workers’ compensation injury.

If enacted as written, the bill will override some prescription safeguards by:

  • Negating the requirement to file or submit a medical report for prescription reauthorizations;
  • Disregarding state medical treatment guidelines related to prescription reauthorization;
  • Allowing a prescription to be filled even when an independent medical examiner disagrees with reauthorization; and
  • Allowing for reauthorization even if the maximum medical improvement has been reached

The bill was introduced by New York Assemblyman Bronson − the newly appointed Chair of the Labor Committee − representing District 138 in Rochester, NY. This bill, like his many previous bills, opposes the employer’s ability to utilize managed care within their workers’ compensation programs. This will result in higher prescription drug cost for the employer, as well as provide higher payouts for pharmacies.

We at MyMatrixx by Evernorth are actively engaging with the sponsors and legislative leaders to raise our concerns on this bill. While we continue to urge them not to pass this harmful legislation, hearing directly from employers would help raise the seriousness of this issue.

This bill could move quickly through the Assembly before the Legislature adjourns on June 6, 2024. If your company does business in New York, particularly in Rochester, NY, please contact the Assemblyman via email at bronsonh@nyassembly.gov or by phone at 585-244-5255 and the Speaker of the Assembly, Carl E. Heastie, via email Speaker@nyassembly.gov or by phone 518-455-3791 and urge them not to pass this legislation.

MyMatrixx Actions

MyMatrixx will monitor the progress of the bill and continue to advocate on behalf of our clients, so the bill serves the benefit of our clients and injured workers and not the pharmacy.

If you have questions regarding this bill, please contact your MyMatrixx Account Management team.