State Legislation

New York

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As a service to our clients, CorVel is providing links to information related to the COVID-19 pandemic provided by the states.

Legislature Status: Reconvened week of April 3 to pass budget. Unlikely they will return for second half of session.

New York Department of Health Coronavirus resource page.
April 15, 2020 – The Governor announced that he is issuing an executive order that all people in the state must wear a mask or mouth and nose covering in public, whenever they are in a situation where they cannot maintain social distancing of 6 feet or less.
April 13, 2020 – The Governor announced the formation of a regional coalition with New Jersey Governor Phil Murphy, Connecticut Governor Ned Lamont, Pennsylvania Governor Tom Wolf, Delaware Governor John Carney, Massachusetts Governor Charlie Baker, and Rhode Island Governor Gina Raimondo to develop a unified regional framework to gradually lift the states’ stay at home orders while minimizing the risk of increased spread of the virus.
April 11, 2020 – The Governor announced a partnership with the New York State Court System to create a pro bono network of volunteer lawyers.
April 11, 2020 – The Governor issued a letter calling on the U.S. Treasury to ensure New Yorkers do not have their stimulus payments frozen by banks or seized by creditors, a practice known as garnishment.
April 11, 2020 – The Governor joined Maryland Governor Larry Hogan in a bipartisan effort calling for $500 billion in aid to states to offset drastic state revenue shortfalls.
April 11, 2020 – New York is putting together a team to study the possibility of a ‘second wave,’ the Governor said. This group will study what happened in other countries across the world to determine the possibility of people catching the virus again.

Legislation

SB 7500 Makes appropriations for the support of government – State Operations Budget, including funds for transfer by the governor for services and expenses related to the outbreak of COVID-19. Eligible for Governor.
SB 7503 Makes appropriations for the support of government – Aid to Localities Budget, including funds to support the state response to COVID-19 related to elementary and secondary education, and public transportation services. Eligible for Governor.
SB 7506 Enacts into law major components of legislation necessary to implement the state education, labor, housing and family assistance budget for the 2020-2021 state fiscal year, including several measures to respond to and mitigate the impact of the COVID-19 outbreak and to provide temporary relief to individuals. Enacted.
SB 7508 Enacts into law major components of legislation necessary to implement the state transportation, economic development and environmental conservation budget for the 2020-2021 state fiscal year, including measures responding to the COVID-19 outbreak. Enacted.
SB 7919 Temporarily expands the definition of disaster in state law to include disease outbreak and permits the Governor to issue any directive necessary to respond to a state disaster emergency. Makes an appropriation of $40 million from the State Purposes Account of the General Fund for responding to the outbreak of coronavirus disease. Enacted.
SB 7996 Provides that school districts are entitled to an apportionment of state aid for the closure of schools due in response to the novel coronavirus, even when no state of emergency has been declared. Pending.
SB 8014 A Provides that certain schools receive tuition payments from the state for any period of time such schools are required to close in response to the outbreak of COVID-19. Pending.
SB 8041 Amends the volunteer firefighters’ benefit law and the volunteer ambulance workers’ benefit law, in relation to COVID-19 exposure during a state of emergency. Pending.
AB 10152/SB 8090 Amends the Labor Law; provides requirements for sick leave and the provision of certain employee benefits when such employee is subject to a mandatory or precautionary order of quarantine or isolation due to COVID-19; provides for sick leave. Pending.
AB 10169 Amends the Election Law; authorizes absentee voting where a voter is unable or averse to appear personally at the polling place because of an imminent, impending or urgent threat resulting from a disease outbreak, including but not limited to the coronavirus disease 2019 (COVID-19). Pending.
AB 10182 Extends the renewal of driver’s licenses, non-driver identification cards and inspections of motor vehicles for three months. Pending.
AB 10204 Amends the Retirement & Social Security Law; relates to the retiree earnings cap for health care workers during a declared public health related state of emergency declared by the governor. Pending.
AB 10207 Establishes that all voting for the April 2020 presidential primary be conducted by absentee ballot; no application for such shall be necessary and the local board of elections shall provide such ballot at least 15 days prior to to April 28, 2020. Pending.
AB 10208 Establishes the Coronavirus Pandemic Small Business and Not-For-Profit Organization Loan Program. Pending.
SB 8091 Provides provisions for certain employee benefits when such employee is subject to a mandatory or precautionary order of quarantine or isolation due to COVID-19. Enacted.
SB 8107 Requires SUNY and CUNY schools to refund students for housing credits and boarding charges used or charged for the period of time when such schools are closed or shut down due to the coronavirus pandemic. Pending.
SB 8110 Establishes the small business containment assistance program; makes an appropriation therefor. Pending.
SB 8109 Suspends mortgages and loans from state-chartered banks and state-chartered credit unions for small businesses and restaurants that have closed or reduced services due to the coronavirus disease 2019 (COVID-19). Pending.
SB 8112 Amends the Election Law; decreases the number of signatures needed for designating petitions and independent nominations by one-third for political subdivisions, wholly or in part, within a county in which one or more residents have been confirmed to be diagnosed with coronavirus disease 2019 (COVID-19) for year two thousand twenty. Pending.
SB 8117 Relates to a presumption regarding impairment of health caused by COVID-19 and in relation to sick leave. Provides police, sheriffs, corrections, parole and probation officers with medical care coverage and sick leave if such employee is exposed to COVID-19 while working and then tests positive for COVID-19. Pending.
SB 8118 Amends the General Business Law; prohibits negative credit reporting on consumers who have suffered financial harm as a result of the declared state of emergency relating to the coronavirus. Pending.
SB 8119 Amends the transportation Law; relates to paratransit services within the state and city of New York during the coronavirus disease 2019 (COVID-19) pandemic. Pending.
SB 8122 Authorizes the New York city department of finance to extend until June 15, 2020, the deadline for the filing of applications and renewal applications for certain real property tax abatement programs in the interest of the health and safety of the public due to coronavirus disease (COVID-19). Pending.
SB 8123 Permits any individual to receive free coronavirus disease 2019 (COVID-19) testing; provides that such individuals may be tested anonymously and no identifying information shall be provided to any non-medical state or federal agency. Pending.
SB 8124 Requires airlines and travel insurance companies to provide refunds for travel cancelled due to coronavirus disease 2019 (COVID-19). Pending.
SB 8125 Suspends all rent payments for certain residential tenants and small business commercial tenants if such tenant has lost employment or was forced to close their place of business and certain mortgage payments for landlords of such tenants in the state for ninety days following the effective date of this act in response to the outbreak of coronavirus disease 2019 (COVID-19). Pending.
SB 8126 Amends the Retirement & Social Security Law; relates to the retiree earnings cap for health care officials and workers during a declared public health related state of emergency declared by the governor. Pending.
SB 8139 Relates to suspending rent payments for certain tenants in response to the outbreak of COVID-19. Pending.
SB 8140 Establishes a COVID-19 emergency rental assistance program; implements a program of rental assistance in the form of emergency vouchers for eligible individuals or families; defines terms. Pending.
AB 8686 Establishes the empire state inclusive value ledger establishment and administration act to create a master account and system of individual wallets to make and receive payments to state entities and residents of the state; authorizes the disbursement of a portion of unclaimed remittances to workers who have been furloughed or unable to work due to Coronavirus. Pending.
AB 10226 Requires certain perils be covered under business interruption insurance during the coronavirus disease 2019 (COVID-19) pandemic. Pending.
AB 10227 Amends the Election Law; relates to moving the date of the presidential primary to June 23, 2020; permits absentee voting in the event of an imminent, impending or urgent threat resulting from a disease outbreak; removes certain presidential candidates and their delegates from primary ballot where the candidate has suspended their campaigns or removed themselves from consideration for election to such office. Pending.
AB 10239 Establishes a coronavirus disease 2019 presumption for accidental disability retirement and accidental death benefits. Pending.
AB 10255 Establishes a Coronavirus Emergency Small Landlord Assistance Fund; provides that local housing authorities shall provide assistance to owners of a real property portfolio whose tenants have had their rent payments suspended for the costs associated with the operation and maintenance of such properties. Pending.
AB 10261 Suspends all student loan, mortgage, auto loan, credit card, and utility payments for ninety days in response to the outbreak of coronavirus disease. Pending.
AB 10266 Enacts the Small Business Emergency Recovery Act; requires the Executive to direct all unallocated settlement funds that are reserved in the Economic Uncertainties Fund and any further settlement money that may be received by the state to small business relief purposes consistent with the intent of the Act; establishes the Small Business and Not for Profit Recovery Loan Program; relates to the coronavirus state of emergency. Pending.
AB 10290 Provides that no default in the payment of rent due or judgment of possession shall be entered between March seventh, two thousand twenty and a date six months after the expiration of the state disaster emergency, as such term is defined in section twenty of the executive law, declared pursuant to executive order two hundred two of two thousand twenty, as amended. Pending.
AB 3005 Enacts into law major components of legislation necessary to implement the state public protection and general government budget for the 2021-2022 state fiscal year. Enacted.

New York Regulatory Updates 06/07/2023

SB 6651 – Includes Coverage of Treatment Rendered By a Massage Therapist

Issues: Workers’ Compensation (General)

Summary:

This measure expands workers’ compensation law to include services provided by massage therapists. This measure defines “massage therapist” as an individual licensed and has completed and passed a formal course of study and an examination in accordance with state requirements. This measure takes effect 30 days after enactment.

Most Recent Update:

06/01/2023 – Passed Senate; Referred to Labor. Additional Outlook: This measure was introduced during the 2021-2022 legislative session as
SB 2138.

AB 6832 – Relates to Workers’ Access to Treatment

Issues: Workers’ Compensation (General)

Summary:

This measure increases the exemption from prior authorization from $1,000 to $1,500 per service. It also extends any willing provider protections at the network negotiated rate for certain services in excess of $1,500. Those services include special diagnostic tests, x-rays, and MRIs. It takes effect upon enactment.

Most Recent Update:

05/12/2023 – Amended

SB 6775 – Authorizes the Care and Treatment of Injured Employees By Duly Licensed or Certified Acupuncturists Under the Workers’ Compensation Program

Issues: Workers’ Compensation (General)

Summary:

This measure provides for acupuncture treatment under workers’ compensation. It outlines basic requirements including record keeping, licensure, billing and delegates creation of a fee schedule. It takes effect 180 days after enactment.

Most Recent Update:

05/09/2023 – Outlook: This measure has been introduced and referred to the Senate Labor Committee, chaired by Senator Jessica Ramos (D). The sponsor does not sit on the committee of referral. This measure is eligible for consideration in the committee of referral. Additional Outlook: According to the sponsor: “The medical field of acupuncture provides positive health benefits to patients where traditional treatments have not been successful.
The opportunity for patients to receive acupuncture services should not be denied in cases where physicians determine that the patient would benefit from the treatment. Acupuncturists in New York are granted licensure upon demonstration that they possess the professional skills and expertise required to assure quality of care and responsible practice of medicine. To be licensed in New York, acupuncturists not only must have national certification, and meet state education requirements, but they must also have extensive acupuncture clinical experience in general health problems, diagnosis and treatment. Current state workers’ Compensation law allows for only licensed physicians and psychologists to be reimbursed for services. This bill allows those patients who would benefit most to receive specialized medical treatment from qualified acupuncturists. The bill would not result
in increased costs to the state, since the need for acupuncture would be determined by a physician as an alternative to other treatments, and not by the patient.”

New York Regulatory Updates 04/20/2023

SB 5867 – Provides That Either Party to a Workers Compensation Claim Can Request a Hearing

Issues: Workers’ Compensation (General)

Summary:

This measure allows either party within a workers’ compensation case to request a hearing, which must take place within 45 calendar days of the request. It also requires initial hearings within 60 days of receiving a medical report. It takes effect upon enactment.

Most Recent Update:

3/20/2023 This measure was introduced and referred to the Senate Labor Committee. This measure is eligible for consideration in the committee of referral.

AB 5745 – Relates to Claims For Mental Injury Premised Upon Extraordinary Work-Related Stress Incurred at Work

Issues: Workers’ Compensation (General)

Summary:

This measure extends workers’ compensation benefits for mental injury premised upon extraordinary work-related stress incurred at work to any worker. It also removes the requirement that the stress occur during an emergency.
It takes effect January 1 following enactment.

Most Recent Update:

03/23/2023 This measure has been referred to the Assembly Labor Committee. The sponsor does sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

New York Regulatory Updates 3/3/2023

SB 4030 – Relates to Presumptions For Injured Workers In Opioid Overdose Claims For Compensation

Issues: Workers’ Compensation (General), Workers Compensation – Opioid Overdose Claims

Summary:

This measure pertains to workers’ compensation law. This measure adds that the death of an injured worker due to opioid overdoes is compensable where that injured worker was prescribed opioids as a result of his or her workplace injury. This measure will take effect immediately.

Most Recent Update:

2/12/2023 This measure has been introduced for the 2023 legislative session and referred to the Senate Labor Committee. The sponsor does sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

AB 3531 – Relates to the Designation of Workers’ Compensation Coverage For Certain Employees

Issues: Workers’ Compensation (General)

Summary:

This measure allows the employer or the board to designate employees to be covered by workers’ compensation insurance, rather than the insurer. It bars the insurer from charging premiums based on employees not designated by the employer. It takes effect upon enactment.

Most Recent Update:

02/03/2023 This measure has been introduced for the 2023 legislative session and referred to the Assembly Committee on Labor. The sponsor does not serve on the committee of referral. This measure is eligible for consideration in the committee of referral.

AB 4617 – Includes Lyme Disease and Other Tick-Borne Diseases As Occupational Diseases For Purposes of Workers’ Compensation

Issues: Workers’ Compensation (General)

Summary:

This measure provides coverage under workers’ compensation for Lyme disease and other tick-borne diseases. It requires similar coverage under private health insurance plans. It is effective 120 days after enactment.

Most Recent Update:

2/17/2023 – This measure has been referred to the Senate Committee on Labor. The sponsor does not sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

AB 4665 – Requires Insurers to Send Notices of Renewal of Certain Policies to the Insured No Later Than Thirty Days Prior to the Expiration of the Policy

Issues: Workers’ Compensation (General)

Summary:

This measure prohibits renewal or extensions of insurance policies, contracts insurance, or certificates of insurance unless the insurance provider extends the policy under certain conditions. This measure prohibits an insurance policy, contract of insurance, or certificate of insurance issued and delivered on and after the effective date of this measure to be renewed or extended beyond its policy period or term unless the insurer provides written notice of renewal or extension of the policy to the insured no later than 30 days prior to the expiration of the policy period or term. Every notice of renewal must be delivered to the insured as prescribed by the insurance superintendent. This measure takes effect 90 days after passage.

Most Recent Update:

02/21/2023 This measure has been introduced for the 2023 legislative session and referred to the Assembly Committee on Insurance, chaired by Assemblymember David Weprin (D). The sponsor of this measure does not sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

AB 4713 – Relates to Insurance Coverage For Medical Marihuana

Issues: Workers’ Compensation (General), Workers Compensation (Medical Marijuana)

Summary:

This measure clarifies that medical marijuana is considered a “prescription drug,” a “covered drug,” and a “health care service” under applicable law. This measure requires that medical marijuana be deemed a “prescription drug,” a “covered drug,” and a “health care service” under applicable laws regarding medical assistance and workers’ compensation for purposes of medical assistance coverage, regardless of federal financial participation. The commissioner is authorized to certify a dispensing site solely for the purposes of medical marijuana. This measure takes effect on the first day of April following enactment.

Most Recent Update:

02/22/2023 This measure was introduced and referred to Assembly Health Committee.This measure is eligible for consideration in the committee of referral.

New York Regulatory Updates 2/6/2023

HB 337 – Relates to Providing Access to the Workers’ Compensation System, Timely and Meaningful Wage Replacement Benefits, and Medical Treatment; and to Improve Efficiency of the System and Cost Savings; Repealer

Issues: Workers’ Compensation (General)

Summary:

This measure makes a wide array of changes to the workers’ compensation system, including:
1. Removing exclusive remedy provisions when the employer violated safety rules
2. Removing the waiting period for payment to workers.
3. Creates a board for an annual review of the medical fee schedule.
4. Defines independent medical examiners as physicians examining on behalf of an employer.
5. Makes a number of definitional changes relating to partial and total disability, and applies cost of living adjustment to these and death benefits.
6. Guarantees at least one hearing per claim.
7. Audits employer premiums annually and more.

Most Recent Update:

1/4/2023 This measure has been introduced for the 2023 legislative session and referred to the Assembly Committee on Labor, chaired by Assemblymember Latoya Joyner (D). The sponsor does sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

A 00294 – Allows Certain Claimants to Be Reclassified As Permanent Total Disability or Total Industrial Disability Due to Extreme Hardship

Issues: Workers’ Compensation (General)

Summary:

Under this measure, in cases where the loss of wage-earning capacity is greater than 50% (rather than 75% as stated in current law), a claimant may request that the board reclassify the claimant to permanent total disability or total industrial disability due to factors reflecting extreme hardship. This measure defines extreme hardship as the injured worker’s income from Social Security disability benefits and disability pension, if applicable, would be less than 50 percent of his or her average weekly wage upon termination of permanent partial disability benefits; the injured worker will be unable to meet expenses for himself or herself and any dependents upon termination of permanent partial disability benefits; additional medical, functional, or vocational factors arising subsequent to the classification of permanent partial disability have further eroded the injured worker’s wage earning capacity; or the injured worker’s income would be below the Federal Poverty Guidelines upon termination of permanent partial disability benefits. This measure will take effect immediately upon enactment. This measure will take effect immediately upon enactment.

Most Recent Update:

01/04/2023 This measure has been referred to the House Committee on Labor. The sponsor does sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

AB 334 – Authorizes Workers’ Compensation Claimants to Use any In-State Pharmacy That Is Registered With the Education Department

Issues: Workers’ Compensation (General)

Summary:

This measure allows workers’ compensation claimants to obtain prescribed medicines at their preferred pharmacy assuming the pharmacy is registered as a resident, in-state pharmacy with the education department. The employer or carrier will still be liable for all charges, except for charges from any non-residents, out-of-state pharmacies, or for compound medications not approved by the Food and Drug Administration.

Most Recent Update:

1/6/2023 This measure has been introduced for the 2023 legislative session and referred to the House Committee on Labor. The sponsor sits on the committee of referral. This measure is eligible for consideration in the committee of referral.

AB 391 – Relates to Eligibility For Classification As Permanent Total Disability

Issues: Workers’ Compensation (General)

Summary:

This measure makes changes to eligibility for permanent total disability. Employees with an inability to perform the full range of sedentary work, or approval for federal social security disability benefits as a result of a compensable accident or occupational disease, are considered eligible for permanent total disability.

Most Recent Update:

1/9/2023 This measure has been referred to the House Committee on Labor. The sponsor does sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

AB 571 – Relates to Notification In the Case of a Change to a Workers’ Compensation Claims Representative

Issues: Workers’ Compensation (General)

Summary:

This measure states that an injured employee must be notified if there is a change to the claims representative assigned to the employee. This measure applies to workers’ compensation. This measure requires that when an injured employee who is entitled to workers’ compensation benefits and a claims representative has been assigned to the worker’s claim, the insurance or self-insured employer must notify the injured worker if they are re-assigned a claims representative, or the case no longer requires a claims representative to be necessary. This measure requires this notification to be delivered by electronic means or by certified or registered mail, return receipt requested, to the last known address of the injured employee within fourteen business days of the change in claims representative. This measure defines “claims representative” as any employee, agent, or other representative of an insurance carrier or self-insured employer that is responsible for processing, adjudicating, or in any way effecting the settlement of a workers’ compensation claim. This measure takes effect on the ninetieth day after it becomes law.

Most Recent Update:

1/9/2023 This measure has been introduced for the 2023 legislative session and referred to the Assembly Labor Committee. The sponsor does not sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

SB 921 – Relates to the Workers’ Compensation Benefit of Certain Disabled Employees

Issues: Workers’ Compensation (General)

Summary:

This measure amends the weekly compensation benefits of a disabled employee in New York. This measure applies to workers’ compensation. This measure states that a disabled employee is entitled to the following compensation starting on or after January 1:

In 2025, it must be fifty percent of the employee’s average weekly wage but must not exceed fifty percent of the state average weekly wage.
In 2026, it must be fifty-five percent of the employee’s average weekly wage but must not exceed fifty-five percent of the state average weekly wage.
In 2027, it must be sixty percent of the employee’s weekly average wage but must not exceed sixty percent of the state average weekly wage.
On or after January first of each succeeding year, must be sixty-seven percent of the employee’s average weekly wage but must not exceed sixty-seven percent of the state average weekly wage.

This measure takes effect immediately if passed.

Most Recent Update:

1/9/2023 This measure has been introduced for the 2023 legislative session and referred to the Senate Labor Committee. The sponsor does not serve on the committee of referral. This measure is eligible for consideration in the committee of referral.

AB 691 – Relates to Providing For an Initial Hearing In Every Case For a Claim of Compensation

Issues: Workers’ Compensation (General)

Summary:

This measure provides for an initial hearing in every case for a claim of workers’ compensation.

Most Recent Update:

1/11/2023 This measure has been referred to the House Committee on Labor. The sponsor does not sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

AB 852 – Authorizes Licensed Clinical Social Workers to Provide Services to Injured Employees Under Workers’ Compensation Coverage

Issues: Workers’ Compensation (General)

Summary:

This measure specifies that:

a licensed clinical social worker may legally treat an injured employee
a person may be removed from the list of people competent to provide licensed clinical services by the chair of the clinical social work practice committee.
the chair may also recommend that such person be authorized to perform independent medical examinations, but solely as an advisory to the chair and subject to committee scrutiny
the head of the board of medical examiners has the authority to notify the employer, carrier, and claimant that the claimant is entitled to be examined by a qualified licensed clinical social worker
the unwillingness of the claimant to submit to an independent medical evaluation may preclude him or her from collecting compensation.
a bill for services supplied by a licensed clinical social worker to a claimant and the value of the disputed bill will be decided by a single arbitrator process in accordance with the chair’s guidelines.
the board or the chair may impose a monetary award on the parties for the value of the disputed services. A provider who initiates arbitration, including a single arbitrator proceeding, must pay a charge set by the board.
the report or testimony of an authorized social worker concerning the condition of an injured person may be considered competent evidence within the limits specified by law.
no one who has solicited or hired someone to solicit medical treatment, examination, or care for an employee with a claim, or who has refused to appear before, testify before, submit to, or answer questions from the chair, board, clinical social work committee, or any other duly authorized committee.

Most Recent Update:

1/11/2023 This measure has been introduced for the 2023 legislative session and referred to the Senate Labor Committee. The sponsor does not serve on the committee of referral. This measure is eligible for consideration in the committee of referral.

AB 1014 – Permits Telemedicine Services For Mental and Behavioral Health Issues Under the Workers’ Compensation System

Issues: Workers’ Compensation (General)

Summary:

This measure amends workers’ compensation, permitting telemedicine services for mental and behavioral health issues under the workers’ compensation system.
Telehealth visits for psychological testing, treatment, and counseling by psychiatrists, psychologists, and licensed clinical social workers are permitted one in-person visit within twelve months of the first video telehealth visit and within six months of the first audio-only telehealth visit. This measure takes effect immediately after being signed by the Governor.

Most Recent Update:

1/13/2023 This measure has been introduced for the 2023 legislative session and referred to the House Committee on Labor. The sponsor does not sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

AB 1219 – Relates to Contracted Network Pharmacy Use

Issues: Workers’ Compensation (General)

Summary:

This measure allows individuals to obtain prescribed medicines from any licensed in-state pharmacy if an employer or insurance carrier fails to provide access to the medication, provided that the network pharmacy or insurance carrier refused to pay for the claimant’s medication and the claimant is unable to access medication, and the claimant’s medication needs to be on a schedule but has not been authorized within 72 hours. Pharmacists dispensing medication under these conditions must follow the state workers’ compensation pharmacy fee schedule, medical treatment guidelines, and pharmacy formulary, and assume all liability for the medication if a case is not established or if the medication is not later approved. Pharmacies must receive prompt payments, within 45 business days of approval, from insurance carriers and continue providing medication to the claimant outside of the network after the claimant’s case has been established.This measure takes effect 30 days after enactment.

Most Recent Update:

01/13/2023 This measure has been introduced and referred to the Assembly Labor Committee, chaired by Assemblywoman Latoya Joyner (D). The sponsor sits on the committee of referral. This measure is eligible for consideration in the committee of referral.

A 01204 – Authorizes Treatment of Workers’ Compensation Injuries By an Occupational Therapy Assistant and a Physical Therapist Assistant

Issues: Workers’ Compensation (General)

Summary:

This measure allows that under the direct supervision of an authorized occupational therapist or physical therapist, occupational therapy or physical therapy services may be rendered by an occupational therapy or physical therapy assistant. This supervision shall be evidenced by signed records of instructions for treatment and signed records of the patient’s condition and progress. Reports of such treatment and supervision shall be made by the provider to the chair in the format prescribed by the chair at such times as the chair may require.

Most Recent Update:

AB 1237 – Relates to the Workers’ Compensation Benefit of Certain Disabled Employees

Issues: Workers’ Compensation (General)

Summary:

This measure clarifies the weekly benefit which the disabled employee is entitled to receive for disability commencing on or after 1/1/2025 shall be (50%) fifty percent of the employee’s average weekly wage but shall not exceed (50%) fifty percent of the state average weekly wage, on or after 1/1/2026 shall be (55%) fifty-five percent of the employee’s average weekly wage but shall not exceed (55%) fifty-five percent of the state average weekly wage, on or after 1/1/2027 shall be (60%) sixty percent of the employee’s weekly average wage but shall not exceed (60%) sixty percent of the state average weekly wage, and on or after January first of each succeeding year, shall be (67%) sixty-seven percent of the employee’s average weekly wage but shall not exceed (67%) sixty-seven percent of the state average weekly wage.

Most Recent Update:

1/13/2023 This measure has been introduced and referred to the Assembly Labor Committee, chaired by Assemblywoman Latoya Joyner (D). The sponsor sits on the committee of referral. This measure is eligible for consideration in the committee of referral.

SB 1974 – Relates to Contracted Network Pharmacy Use

Issues: Workers’ Compensation (General)

Summary:

Most Recent Update:

1/31/2023 This measure was heard on January 31 in the Senate Labor Committee. The measure passed committee by a unanimous vote. This measure awaits consideration on the floor.

SB 1878 – Permits Telemedicine Services For Mental and Behavioral Health Issues Under the Workers’ Compensation System

Issues: Workers’ Compensation (General)

Summary:

This measure applies to workers’ compensation benefits. This measure requires at least one in-person visit within the first 12 months of the first video telehealth visit for services provided by psychiatrists, psychologists, and licensed clinical social workers. The exception to this measure is if the provider believes that an in-person visit will disrupt the service delivery or the in-person visit will cause undue hardship to the patient or their family. This measure takes effect immediately.

Most Recent Update:

1/17/2023 This measure has been introduced for the 2023 legislative session and referred to the Senate Labor Committee. The sponsor does not sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

AB 1499 – Relates to Presumptions For Injured Workers In Opioid Overdose Claims For Compensation

Issues: Workers’ Compensation (General)

Summary:

Most Recent Update:

1/17/2023 This measure has been introduced for the 2023 legislative session and referred to the Assembly Committee on Labor, chaired by Assemblymember Latoya Joyner (D) The sponsor does not serve on the committee of referral. This measure is eligible for consideration in the committee of referral.

SB 2568 – Relates to Insurance Coverage For Medical Marihuana

Issues: Workers’ Compensation (General)

Summary:

Most Recent Update:

1/23/2023 This measure has been introduced and referred to the Senate Health Committee. This measure is eligible for consideration in the committee of referral.

SA 2145 – Enacts the Covid-19 Injured Workers’ Protection Act

Issues: Workers’ Compensation (General)

Summary:

This measure amends workers’ compensation law to account for treatment by a medical provider for COVID-19. This measure adds that it must be presumed that treatment rendered by a medical provider for COVID-19 was done so on an emergent basis. Medical providers treating patients for COVID-19 need not be authorized by existing law. This measure adds that employers may initiate compensation payments for 60 days. Payment of temporary compensation must terminate after 60 days and an employer must provide the notice of termination within 60 days of the first payment. This measure takes effect immediately.

Most Recent Update:

1/23/2023 This measure has been referred to the House to Labor Committee. The sponsor does sit on the committee of referral.

A 1815 – Provides an Exemption from Workers’ Compensation Coverage For Certain Members of a Recognized Religious Sect

Issues: Workers’ Compensation (General)

Summary:

This measure allows an exception to the workers’ compensation law by a religious employer for their religious employees, so long as the religion has a long-standing commitment of non-involvement in government or private insurance in the event of death, injury, etc. This measure functionally includes only the Amish and Mennonites.

Most Recent Update:

1/23/2023 This measure has been introduced for the 2023 legislative session and referred to the Assembly Committee on Labor. The sponsor does not sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

S 2546 – Relates to Notification In the Case of a Change to a Workers’ Compensation Claims Representative

Issues: Workers’ Compensation (General)

Summary:

This measure requires insurance carriers and self-insured employers to provide notice of change to a workers’ compensation claims representative electronically or by mail within 14 business days. The notice must include the name and contact information of the new claims representative. This measure takes effect 90 days after enacted.

Most Recent Update:

1/23/2023 This measure has been introduced for the 2023 legislative session and referred to the Senate Committee on Labor. The sponsor does not sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

New York Regulatory Updates 6/8/2022

AB 8930 – Includes Coverage of Treatment Rendered By a Massage Therapist

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

See 2/3/2022 update below for full summary.

Most Recent Update:

5/11/2022 This measure was heard and passed on May 11 in the Assembly Labor Committee, and referred to the Rules Committee This measure is eligible for consideration in the committee of referral.

SB 1026 – Relates to Contracted Network Pharmacy Use

Issues: Workers’ Compensation (Medical Coverage And Reimbursement), Workers’ Compensation (Prescription Drug Formulary), Workers’ Compensation (Pharmacy Fee Schedule), Workers’ Compensation (General)

Summary:

The measure amends worker compensation law and further outlines requirements for employers and carriers in regard to pharmacies. See Update 4/2/2021 for full summary.

Most Recent Update:

5/23/2022 This measure repassed the Senate with a vote of 60-1 and was referred to the Assembly Labor Committee. This measure is eligible for consideration in the committee of referral.

New York Regulatory Updates 2/3/2022

AB 8614 – Includes Lyme Disease and Other Tick-Borne Diseases As Occupational Diseases For Purposes of Workers’ Compensation

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure adds Lyme disease and other tick-borne diseases as occupational diseases for purposes of workers’ compensation. This measure adds Lyme disease and other tick-borne diseases as disabilities for workers’ compensation purposes. This measure will take effect on the 120th day after it will have become a law.

Most Recent Update:

1/10/2022 This measure has been introduced and referred to the Assembly Labor Committee, chaired by Assemblymember Latoya Joyner (D). This measure is eligible for consideration in the committee of referral.

AB 8638 – Provides For Payment of Bills For Pharmaceutical Services

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure amends a workers compensation law for bill payments in relation to pharmaceutical services by adding a new section. This measure requires medical care providers or suppliers to include an approved license pharmacist and that the term “medical or supplies” includes prescription medication. There is no set effective date.

Most Recent Update:

1/10/2022 This measure has been introduced and referred to the Assembly Labor Committee chaired by Assemblymember Latoya Joyner (D). This measure awaits committee consideration.

AB 8930 – Includes Coverage of Treatment Rendered By a Massage Therapist

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure amends the workers’ compensation law to include massage therapists as authorized providers. This measure amends the workers’ compensation law to include massage therapists as authorized providers. This measure defines “massage therapist” to mean licensed and have completed a formal course of study and have passed an examination in accordance with the education law, the regulations of the commissioner of education, and the requirements of the board of regents. This measure is effective 13 days after signing.

Most Recent Update:

1/10/2022 This measure was introduced and referred to the Assembly Labor Committee, chaired by Assemblymember Latoya Joyner (D). This measure is eligible for consideration in the committee of referral.

SB 2138 – Includes Coverage of Treatment Rendered By a Massage Therapist

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure adds licensed massage therapists to the list of authorized providers to provide care under workers’ compensation law. This measure applies to licensed massage therapists. This measure defines “massage therapist” as a person licensed and has completed a formal course of study and passed an examination in accordance with the education law, the regulations of the Commissioner of Education, and the requirements of the Board of Regents. The measure permits a massage therapist to provide treatment to an injured worker upon the prescription or referral of authorized physicians, physician assistants, podiatrists, or nurse practitioners. The measure clarifies the record, report, or opinion of a massage therapist will not be considered evidence of the causal relationship of any condition to a work-related accident or occupational disease. This measure will take effect 30 days after enactment.

Most Recent Update:

1/10/2022 This measure was heard on January 10 in the Senate Labor Committee. The measure passed by a unanimous vote. This measure is eligible for consideration on the Senate floor.

SB 5288 – Authorizes the Care and Treatment of Injured Employees By Duly Licensed or Certified Acupuncturists Under the Workers’ Compensation Program

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This bill permits injured workers to seek acupuncturist treatment under workman’s compensation. This bill requires that acupuncturists apply for authorization and apply by codes of conduct to be promulgated by the chair and the committee established under this section. This bill adds section 13-q to the workers’ compensation law. This bill permits injured employees to be treated by licensed acupuncturists for injuries which may be lawfully treated by acupuncturists. This bill permits medical bureaus and medical centers operated by labor and management organizations, hospitals, and HMOs to provide acupuncture services and requires they keep records thereof. This bill requires acupuncturists to apply for authorization under this section with the acupuncturist practice committee and refrain from seeking renumeration from a person treated under this section for the same injury as a private patient if they are removed from the list of acupuncturists authorized under this chapter. This bill requires the board of acupuncturists recommend qualified individuals to the chair. This bill requires the chair establish a schedule or schedules to define localities for charges and fees in accordance with rules promulgated by the chair in accordance with recommendations from the board of acupuncturists for fair renumeration. The chair must distinguish between treatment rendered by a licensed and registered acupuncturist and a certified acupuncturist in establishing fees. No claim for services is valid against an employer unless the acupuncturist provides notice of treatment within 24 hours and a complete report within 15 days as well as followup reports on progress within three weeks or agreed upon intervals. The employer is entitled to have the party assessed by a third party acupuncturist to be compensated by the board.

If the bill is not rendered to the employer within 30 days the employer will notify the chair and the acupuncturist of a demand for an impartial examination. If not, such right is waived and if there is a disagreement as to payment of fees the committee will decide for both parties including interest if so required and fees to be paid by both parties to the committee.

This bill makes the testimony of an authorized acupuncturist competent evidence but not controlling. This bill requires the chair promulgate rules governing acupuncture services which conform to the rules presently in effect. The chair will appoint a single acupuncture practice committee with specified membership, none of whom shall render services under this section nor employ anyone who does. They will hear, investigate, and make findings on charges of misconduct under rules to be prescribed by the chair and make non-binding rulings to the chair, who will act on these rulings as appropriate to remove acupuncturists from the list who are guilty of misconduct, exceeded their competence, failed to submit to evaluation, rendered services for less than the fixed fee, or solicited professional treatment of an injured employee with a claim under this chapter or refused to appear before the committee or chair or engaged in forbidden conduct regarding division, transference, assignment, splitting, or credit, or other division of a fee unless acting in a partnership. Violations are a misdemeanor. This act is effective 180 days after becoming law.

Most Recent Update:

1/05/2022 This measure was referred to the Senate Labor Committee, chaired by Senator Jessica Ramos (D). This measure is eligible for consideration in the committee of referral.

SB 6373 – Relates to Claims For Mental Injury Premised Upon Extraordinary Work-Related Stress Incurred at Work

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure amends the workers’ compensation law, in relation to claims for mental injury premised upon work-related stress. The measure expands the eligibility of workers to file stress injury claims. This measure applies to any worker who has filed a claim for workers compensation in relation to work related stress. This measure amends the workers compensation law by deleting the list of specific first responders and replacing it with “workers” which expands the eligibility to cover all workers. This measure deletes the phrase “in a work-related emergency” and replaces it with, “at work” and removes the comma between, “claim” and “upon changing the intent of the sentence so the board may not disallow a claim of stress related injury. This measure takes effect on the first of January next succeeding the date on which it shall have become a law.

Most Recent Update:

1/10/2022 At the January 10 hearing, this measure passed the Senate Labor Committee by a unanimous vote. This measure is eligible for further consideration in the Senate chamber.

New York Regulatory Updates 8/5/2021

AB 1307 – Relates to the Establishment of Rates of Payment and Delivery of Health Care Services

Issues: Workers’ Compensation (Pharmacy Fee Schedule)

Summary:

The measure amends statute to establish rates of payment delivery of health care services under the workers’ compensation system. This measure is applicable to workers’ compensation. The measure requires the Workers’ Compensation Board in consultation with the board’s medical director, to biennially prepare and establish a rate schedule in the state, schedules limited to defined localities, charges, and fees for podiatry treatment and care, rendered under the workers’ compensation system. The measure requires the Workers’ Compensation Board in consultation to biennially prepare and establish a rate schedule in the state, schedules limited to defined localities, charges, and fees for chiropractic treatment and care, rendered under the workers’ compensation system. The measure requires the Workers’ Compensation Board in consultation to biennially prepare and establish a rate schedule in the state, schedules limited to defined localities, charges, and fees for psychological treatment and care, rendered under the workers’ compensation system. This measure takes effect upon enactment.

Most Recent Update:

8/5/2021 The New York Legislature recessed for the 2021 Legislative Session. Measures carryover from odd-numbered years to even-numbered years. All measures will retain their current place and may be acted upon if the legislature reconvenes at the call of the Speaker of the Assembly, the President of the Senate, or the Governor. When the legislature convenes for the start of the 2022 Legislative Session in January, any bills that did not pass will be returned to their chamber of origin.

AB 1396 – Provides For Pharmacy Benefit Management and the Procurement of Prescription Drugs at a Negotiated Rate For Dispensation; Repealer

Issues: Workers’ Compensation (Prescription Drug Formulary)

Summary:

The measure creates transparency provisions for pharmacy benefit managers (PBM). This measure is applicable to PBMs. The measure mandates funds received by PBMs to be received in trust for the health plan or provider and will only be used pursuant to the PBM’s contract with the plan or provider. The measure outlines reporting requirements to such a provider or health plan on any pricing discounts, rebates, and other mechanisms received by the PBM. The measure prohibits a PBM from substituting a prescription drug for another in dispensing a prescription without the approval of the prescriber. The measure outlines appeals processes between a PBM and a contracting agent such as a PSAO. The measure creates reporting requirements for PBM’s on or before July 1 of each year beginning in 2020. The measure outlines licensing requirements for PBM’s and discusses the required documentation.

Most Recent Update:

AB 1396 – Ensures Timely Access to High-Quality Medical Care

Issues: Workers’ Compensation (Utilization Review and Appeals), Workers’ Compensation (General)

Summary:

This measure amends statute to ensure timely access to high-quality medical care for workers’ compensation claimants. The measure is applicable to workers’ compensation claimants. The measure stipulates that prior authorization procedures shall be issued and maintained for the purpose of expediting authorization of treatment of injured workers. The pre-authorization list must not be construed or relied upon to support the premise that procedures not included on the pre-authorized list should be denied. Pre-authorized procedures shall not be given preference over alternative forms of treatment that are not on the pre-authorized procedures list. The pre-authorization list must include current enrollment in an addiction treatment program for all injured works subject to opioid weaning. The measure will take effect upon enactment.

Most Recent Update:

SB 3762 – Provides For Pharmacy Benefit Management and the Procurement of Prescription Drugs at a Negotiated Rate For Dispensation; Repealer

Issues: Workers’ Compensation (Prescription Drug Formulary)

Summary:

The measure proves for pharmacy benefit management and the procurement of prescription drugs to be dispensed to patients, or the administration or anagement of prescription drug benefits. It establishes funds received by a pharmacy in trust for the health plan or providers and providers for accountability of such funds. This measure is applicable to pharmacy benefit managers (PBMs). This measure mandates that PBMs must have a duty and obligation to the covered individual and the health plan or provider. The measure outlines certain duties, accountabilities, and transparency requires for the PBM. It mandates that the PBM cannot substitute or cause the substituting of one prescription drug for another. A PBM must include a reasonable process to appeal in certain situations. The measure mandates funds received by PBM’s to be received in trust for the health plan or provider and will only be used pursuant to the PBM’s contract with the plan or provider. The measure outlines reporting requirements to such a provider or health plan on any pricing discounts, rebates, and other mechanisms received by the PBM. The measure adds registration requirements for pharmacy benefit mangers and reporting requirements for pharmacy benefit managers. It includes requirements on acting without a license and the licensing of a pharmacy benefit manager. The measure outlines provisions for suspension of a registration of a PBM, penalties for violation, revoked registrations, change of address, and applicability to other laws. If enacted, this measure will take effect 90 days after becoming law.

Most Recent Update:

6/10/2021 This measure passed the Assembly on June 10 with a vote of 149-0. This measure is eligible to be sent to Governor Andrew Cuomo (D), who must request that measure be sent to him. If the Governor vetoes this measure, this measure will be sent back to its chamber of origin.

New York Regulatory Updates 7/12/2021

SB 1026

Summary:

The measure amends worker compensation law and further outlines requirements for employers and carriers in regard to pharmacies. See Update 4/2/2021 for full summary.

Most Recent Update:

5/3/2021 This measure passed the Senate with a vote of 62-1 and was referred to the Assembly Labor Committee. This measure awaits consideration in the committee of referral.

SB 4111 – Relates to Prescription Drug Formulary Changes During a Contract Year

Issues: Workers’ Compensation (Prescription Drug Formulary)

Summary:

This measure relates to prescription drug formulary changes during a contract year. See Update 6/3/2021 for full summary.

Most Recent Update:

5/26/2021 This measure substituted AB 4668 and passed the Assembly with a vote of 147-0. This measure is eligible to be sent to Governor Andrew Cuomo (D).

New York Regulatory Updates 6/3/2021

AB 1013 – Relates to Contracted Network Pharmacy Use

Issues: Workers’ Compensation (Pharmacy Fee Schedule), Prompt Payment, Workers’ Compensation (General)

Summary:

This measure amends statute to remove the ability of an employer or workers’ compensation carrier to require a claimant to obtain prescribed medications from a contracted pharmacy. This measure is applicable to workers’ compensation. This measure allows an employer or carrier to contract with a network pharmacy and encourage claimants to use it, however, claimants ultimately may obtain prescribed medications at the pharmacy or pharmacies of their choice, so long as that pharmacy is registered as a resident, in-state pharmacy. The measure further provides that the employer or carrier will be liable for the charges for such prescriptions in accordance with the workers’ compensation fee schedule.

The measure does not apply to out-of-state pharmacies or compound medications that the claimant is prescribed. The measure mandates any pharmacist can be permitted to dispense medication to a claimant outside of the network where the carrier has refused to pay for the claimant’s medication and the claimant is unable to access a network pharmacy, the claimant’s medication needs to be reauthorized monthly, and is authorized, but is denied because the carrier failed to respond to the reauthorization, medical reports were not filed for reauthorization or a filed medical report contains a defect, the medication has been authorized in the past, however, the carrier denies authorization claiming that the medical treatment guidelines do not support reauthorization, an independent medical examiner disagrees with reauthorization; reauthorization has been denied because maximum medical improvement has been reached, or the case is in the process of being settled.

The measure mandates any pharmacy that agrees to dispense medication to a claimant follow the fee schedule prescribed. follow all treatment guidelines, follow the New York state workers’ compensation pharmacy formulary, verify that the medication is causally related to the claimant’s work-related injuries; and assume all liability for the medication if a case is not established or if the medication is not later approved. The measure provides that upon approval of any medication dispensed by a pharmacy, for such pharmacy to be entitled to receive prompt payment for such medication from the carrier within ten days of such approval, and may be permitted to continue to provide such medication to the claimant after such claimant’s case has been established outside of the network. Any pharmacist licensed will be permitted to dispense medication outside of the network under various circumstances.

The measure will take effect upon enactment.

Most Recent Update:

5/4/2021 This measure was amended and recommitted to the Assembly Labor Committee, chaired by Assemblymember Joyner (D). This measure is eligible for committee consideration.

AB 3005 – Enacts into law major components of legislation necessary to implement the state public protection and general government budget for the 2021-2022 state fiscal year.

Issues: Workers’ Compensation (Medical Coverage And Reimbursement), Workers’ Compensation (General)

Summary:

This measure would allow the New York State Insurance Fund (SIF) to cover policyholders’ out-of-state operations provided policyholders’ main operations are in State. This measure provides greater coverage options for current SIF customers and expands service offerings for prospective customers. This measure expands the purposes of the State Insurance Fund to permit it to enter agreements with insurers licensed to write workers’ compensation insurance in states outside New York to issue policies to state insurance fund policyholders covering those policyholders’ obligations to secure the payment of workers’ compensation benefits under the laws of states other than New York.

This measure also authorizes the State Insurance Fund to receive premiums into its workers’ compensation fund for policies written under such agreements and to pay from such fund:
i) reimbursement of all losses and loss adjustment expenses under such policies; and
ii) fees and other costs, including but not limited to those for claims services, relating to such agreements.

For a policyholder to be eligible for insurance in states other than New York provided through agreements entered into under this subdivision, either:
i) the policyholder’s workers’ compensation premiums with the state insurance fund covering its employees under this chapter must be greater than the premiums charged to cover the policyholder’s obligations to pay workers’ compensation benefits in all states, in the aggregate, other than New York when covered under such agreements; or
ii) the payroll for the policyholder’s operations in New York must be greater than the policyholder’s payroll in all states, in the aggregate, other than New York when covered under such agreements for the prior policy period.

In order for a policyholder to be eligible for insurance in other states, the policyholder must meet the state insurance fund’s underwriting criteria for other states coverage as specified by rules of the commissioners. This measure defines “premiums” to mean estimated premiums as determined by the state insurance fund at the beginning of the policy period.

Most Recent Update:

4/19/2021 This measure was signed by the governor and enacted.

AB 7336 – Makes Provisions Permanent Relating to Disability Due to Disease or Malfunction of the Heart or Coronary Arteries.

Issues: Workers’ Compensation (Medical Coverage And Reimbursement), Workers’ Compensation (General)

Summary:

This measure amends the New York code to amend the volunteer firefighters’ benefit law, relating to disability due to disease or malfunction of the heart or coronary arteries, in relation to making such provisions permanent. This measure is applicable to volunteer firefighters in the state. This measure amends the volunteer firefighters’ benefit law, relating to disability due to disease or malfunction of the heart or coronary arteries. This measure establishes shall apply only in cases where the injury-causing death or disability occurred on or after such date of taking effect. This measure, if enacted, will go into effect immediately after enactment.

Most Recent Update:

5/5/2021 This measure has been introduced and referred to the Assembly Local Governments Committee, chaired by Assemblymember Thiele (R). This measure is eligible to be scheduled for a hearing at the discretion of the chair.

SB 4111 – Relates to Prescription Drug Formulary Changes During a Contract Year

Issues: Workers’ Compensation (Prescription Drug Formulary)

Summary:

This measure relates to prescription drug formulary changes during a contract year. This measure establishes that a health care plan may not remove a prescription drug from a formulary under the enrollment year. The plan may also not add new or additional formulary restrictions during the enrollment year but may move a prescription drug to a tier with a larger copayment if a generic drug is added to the formulary at the same time. Policyholders must be notified of the intent to remove a prescription drug from a formulary thirty days prior to the open enrollment period for the consecutive plan year.

Most Recent Update:

4/27/2021 This measure passed the Senate with a 53-9 vote. It was delivered to the Assembly and Referred to Assembly Insurance, chaired by Kevin Cahill (D). This measure is eligible for further consideration in the Assembly.

New York Regulatory Updates 5/5/2021

AB 3005 – Enacts into law major components of legislation necessary to implement the state public protection and general government budget for the 2021-2022 state fiscal year.

Issues: Workers’ Compensation (Medical Coverage And Reimbursement), Workers’ Compensation (General)

Summary:

Most Recent Update:

4/7/2020 On April 6, this measure passed the Assembly. This measure was then substituted for its companion in the Senate (SB 2505). Also on April 6, this measure passed the Senate after being substituted by a vote of 43-20. On April 7, this measure was sent to Governor Andrew Cuomo (D). Since the Legislature is in session, the governor has 10 days, excluding Sundays, to sign or veto this measure. If the governor does not sign this measure, this measure will be enacted without a signature. If the governor vetoes this measure, this measure will be sent back to its chamber of origin with a message
explaining the governor’s objections and recommendations which will remove such objections. The
Legislature can overturn the governor’s veto with a 2/3 majority vote in both legislative chambers.

SB 4111 – Relates to Prescription Drug Formulary Changes During a Contract Year

Issues: Workers’ Compensation (Prescription Drug Formulary)

Summary:

This measure relates to prescription drug formulary changes during a contract year. This measure establishes that a health care plan may not remove a prescription drug from a formulary under the enrollment year. The plan may also not add new or additional formulary restrictions during the enrollment
year but may move a prescription drug to a tier with a larger copayment if a generic drug is added to the
formulary at the same time. Policyholders must be notified of the intent to remove a prescription drug from a formulary thirty days prior to the open enrollment period for the consecutive plan year.

Most Recent Update:

3/16/2021 This measure passed the Senate Insurance Committee with a vote of 9-0. This measure is eligible for further consideration in the Senate.

SB 2505 – Enacts into law major components of legislation necessary to implement the state public protection and general government budget for the 2021-2022 state fiscal year

Issues: Workers’ Compensation (Medical Coverage And Reimbursement), Workers’ Compensation (General)

Summary:

This measure defines “premiums” to mean estimated premiums as determined by the state insurance fund
at the beginning of the policy period.

Most Recent Update:

4/6/2021 On April 6, this measure was substituted by its companion measure from the Assembly, AB 3005. The Assembly bill will be the vehicle for this measure moving forward, and was sent to Governor Andrew Cuomo (D) on April 7. This measure is unlikely to receive further consideration, as it has been substituted by its companion measure.

New York Regulatory Updates 4/2/2021

SB 1026

Summary:

The measure amends worker compensation law and further outlines requirements for employers and carriers in regard to pharmacies. This measure is applicable to workers’ compensation. The measure mandates if an employer or carrier has contracted with a pharmacy to provide prescribed medicine to claimants, the employer or carrier can encourage claimants to obtain all prescribed medications from the pharmacy it has contracted with. The measure stipulates claimants can obtain prescribed medicines at a pharmacy of their choice as long as it is registered as a resident, in-state pharmacy with the New York Board of Pharmacy and the employer or carrier will be liable for such charges in accordance with the fee schedule, relevant to work-related injuries and are in accordance with the New York workers’ compensation pharmacy formulary and other applicable board regulations.

The measure does not apply to any resident, in-state pharmacies that are contracted with the network pharmacy that the employer or carrier designates as their preferred and encouraged network pharmacy. Such pharmacies must process all claims through their contracts with the employer’s or carrier’s designated pharmacy. The measure mandates the employer or carrier can have the right to deny any charges from non-resident, out-of-state pharmacies, and deny charges for non-FDA-approved compound medications.

The measure mandates any pharmacist is permitted to dispense medication to a claimant outside of the network where:
1. The carrier has refused to pay for the claimant’s medication and the claimant is unable to access a network pharmacy
2. The claimant’s medication needs to be reauthorized monthly and is so authorized, but is denied because: (I) the carrier failed to respond to the reauthorization; (II) medical reports were not filed for reauthorization or a filed medical report contains a defect; (III) the medication has been authorized in
the past, however, the carrier denies authorization claiming 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 improvement has been reached; or (VI) the case is in the process of being settled.

The measure clarifies any pharmacy that agrees to dispense medication to a claimant under subparagraph
(i) of the measure must:
1. Follow the fee schedule prescribed in section thirteen-o of this article;
2. Follow all treatment guidelines;
3. Follow the New York State workers’ compensation pharmacy formulary;
4. Verify that the medication is causally related to the claimant’s work-related injuries;
5. Assume all liability for the medication if a case is not established or if the medication is not later approved.

The measure mandates upon approval of any medication dispensed by a pharmacy pursuant to subparagraph (i) of this paragraph, such pharmacy shall be entitled to receive prompt payment for such
medication from the carrier within ten days of such approval and shall be permitted to continue to provide
such medication to the claimant after such claimant’s case has been established outside of the network. The measure will take effect immediately.

Most Recent Update:

3/2/2021 This measure was heard in the Senate Labor Committee and passed the committee with an undisclosed vote. This measure awaits further consideration in the Senate.

New York Regulatory Updates 3/5/2021

AB 3005

Issues: Workers’ Compensation (Medical Coverage And Reimbursement), Workers’ Compensation (General)

Summary:

Most Recent Update:

2/18/2021 Governor Andrew Cuomo (D) released his 30-day amendments to his budget proposal on February 18. The Senate Finance and Assembly Ways and Means Committee held joint public hearings to discuss issues included in the proposed state budget this week. Information and video for the February 10 hearing regarding Public Protection policy issues was recently made available. The hearing focused on issues the courts of the state were facing due to COVID-19, prison conditions, and police reform. However, there was some discussion on the use of design build contracts for information technology procurement, data sharing between state government agencies, and body cameras for law enforcement officers. This measure, along with the Governor’s 30-day amendments, are eligible for further consideration and hearings in the Assembly.

AB 3381

Issues: Workers’ Compensation (Medical Coverage And Reimbursement), Workers’ Compensation (General)

Summary:

This measure authorizes the Chair of the Workers’ Compensation Board to adopt a fee schedule establishing maximum fees for ambulance services. This measure relates to ambulance services. This measure establishes a fee schedule covering fees for ambulance services and clarifies that the employer or its insurer is liable for payment of such services. This measure takes effect 180 days following enactment.

Most Recent Update:

1/26/2021 This measure was introduced and referred to the Assembly Labor Committee, chaired by Assemblymember Joyner (D). The sponsor is not a committee member. This measure may be considered at the chair’s discretion.

SB 1026

Issues: Workers’ Compensation (Prescription Drug Formulary), Workers’ Compensation (Pharmacy Fee Schedule), Workers’ Compensation (General)

Summary:

(I) the carrier failed to respond to the reauthorization;

(II) medical reports were not filed for reauthorization or a filed medical report contains a defect;

(III) the medication has been authorized in the past, however, the carrier denies authorization claiming 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 improvement has been reached; or

(VI) the case is in the process of being settled.

The measure mandates upon approval of any medication dispensed by a pharmacy pursuant to subparagraph (i) of this paragraph, such pharmacy shall be entitled to receive prompt payment for such medication from the carrier within ten days of such approval and shall be permitted to continue to provide such medication to the claimant after such claimant’s case has been established outside of the network. The measure will take effect immediately.

Most Recent Update:

1/6/2021 This measure is scheduled to be heard on March 2, 2021, in the Senate Labor Committee, chaired by the sponsor, Senator Jessica Ramos (D). Hearings will be conducted virtually using web-based video conferencing. Testimony may be submitted via email to the Chair’s office. A vote may occur at the discretion of the chair.

SB 2138

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

Most Recent Update:

1/20/2021 This measure was introduced and referred to the Senate Labor Committee chaired by Senator Ramos (D). The sponsor is the chair. This measure may be considered at the chair’s discretion.

SB 2505

Issues: Workers’ Compensation (Medical Coverage And Reimbursement), Workers’ Compensation (General)

Summary:

This measure defines “premiums” to mean estimated premiums as determined by the state insurance fund
at the beginning of the policy period.

Most Recent Update:

New York Regulatory Updates 12/2/2020

SB 5421 – Includes coverage of treatment rendered by a massage therapist

Issues: Workers’ Compensation (General), Workers’ Compensation (Medical Coverage And Reimbursement)

Summary: This measure defines “massage therapist” as a person licensed and having completed a formal course of study and having passed an examination in accordance with the education law, the regulations of the Commissioner of Education, and the requirements of the Board of Regents.

This measure will take effect 30 days after enactment.

Most Recent Update:

11/27/2020 Governor Andrew Cuomo (D) vetoed this measure. This measure will be sent back to its chamber of origin with a message explaining the governor’s objections and recommendations which will remove such objections. The legislature can overturn the governor’s veto with a 2/3 majority vote in both legislative chambers.

New York Regulatory Updates 11/2/2020

AB 7579

Issues: Workers’ Compensation (General), Workers’ Compensation (Medical Coverage And Reimbursement)

Summary:

The measure applies to insurance carriers, injured workers, and eligible persons who receive death
benefits.

The measure mandates compensation payments or any portion of compensation payments to be allowed,
upon the written request from an injured worker or a person entitled to a death benefit, to be deposited
directly in a bank for any purpose to an account in the name of such injured worker or person entitled to a
death benefit, on forms provided by the board, and duly filed in accordance with applicable regulations.

The measure mandates the board to promulgate reasonable rules and regulations to permit the deposit of a payment to be split between multiple accounts by either a dollar amount or exact percentage, provided that such regulations may establish a minimum dollar amount and may limit the maximum number of parietal deposits allowed.

The measure will take effect immediately.

Most Recent Update:

10/30/2020 Sent to Governor

SB 7245 – Relates to Contracted Network Pharmacy Use

Issues: Workers’ Compensation (Prescription Drug Formulary)

Summary:

The measure mandates if an employer or carrier has contracted with a pharmacy to provide prescribed
medicine to claimants, the employer or carrier can encourage claimants to obtain all prescribed medications from the pharmacy it has contracted with.

The measure stipulates claimants can obtain prescribed medicines at a pharmacy of their choice as long as
it is registered as a resident, in-state pharmacy with the New York Board of Pharmacy and the employer or
carrier will be liable for such charges in accordance with the fee schedule, relevant to work-related injuries
and are in accordance with the New York workers’ compensation pharmacy formulary and other applicable
board regulations.

The measure mandates the employer or carrier can have the right to deny any charges from non-resident,
out-of-state pharmacies, and deny charges for non-FDA approved compound medications.
The measure mandates any pharmacist is permitted to dispense medication to a claimant outside of
the network where:
(A) the carrier has refused to pay for the claimant’s medication and the claimant is unable to access a
network pharmacy
(B) the claimant’s medication needs to be reauthorized monthly and is so authorized, but is denied
because:

(I) the carrier failed to respond to the reauthorization;

(II) medical reports were not filed for reauthorization or a filed medical report contains a defect;

(III) the medication has been authorized in the past, however, the carrier denies authorization claiming 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 improvement has been reached; or

(VI) the case is in the process of being settled.

The measure clarifies any pharmacy that agrees to dispense medication to a claimant under subparagraph
(i) of the measure must:
(A) follow the fee schedule prescribed in section thirteen-o of this article;
(B) follow all treatment guidelines;
(C) follow the New York state workers’ compensation pharmacy formulary;
(D) verify that the medication is causally related to the claimant’s work related injuries;
(E) assume all liability for the medication if a case is not established or if the medication is not later
approved.

The measure mandates upon approval of any medication dispensed by a pharmacy pursuant to
subparagraph (i) of this paragraph, such pharmacy shall be entitled to receive prompt payment for such
medication from the carrier within ten days of such approval and shall be permitted to continue to
provide such medication to the claimant after such claimant’s case has been established outside of the
network.

The measure will take effect immediately.

Most Recent Update:

10/16/2020 This measure has been amended in the Senate Labor Committee chaired by Senator Jessica Ramos (D). This measure awaits further consideration from the chair.

New York Regulatory Updates 06/02/2020

AB 8117 – Relates to contracted network pharmacy use

Issues: Workers’ Compensation (General), Workers’ Compensation (Pharmacy Fee Schedule), Prompt Payment

Summary:

This measure removes the ability of an employer or workers’ compensation carrier to require a claimant to obtain prescribed medications from a contracted pharmacy.

This measure allows an employer or carrier to contract with a network pharmacy and encourage claimants to use it, however claimants ultimately may obtain prescribed medications at the pharmacy or pharmacies of their choice, so long as that pharmacy is registered as a resident, in-state pharmacy. The measure further provides that the employer or carrier will be liable for the charges for such prescriptions in accordance with the workers’ compensation fee schedule.

The measure does not apply to out-of-state pharmacies or compound medications that the claimant is prescribed.

The measure mandates any pharmacist can be permitted to dispense medication to a claimant outside of the network where the carrier has refused to pay for the claimant’s medication and the claimant is unable to access a network pharmacy, the claimant’s medication needs to be reauthorized monthly, and is authorized, but is denied because the carrier failed to respond to the reauthorization, medical reports were not filed for reauthorization or a filed medical report contains a defect, the medication has been authorized in the past, however, the carrier denies authorization claiming that the medical treatment guidelines do not support reauthorization, an independent medical examiner disagrees with reauthorization; reauthorization has been denied because maximum medical improvement has been reached, or the case is in the process of being settled.

The measure stipulates upon approval of any medication dispensed by a pharmacy, for such pharmacy to be entitled to receive prompt payment for such medication from the carrier within ten days of such approval, and may be permitted to continue to provide such medication to the claimant after such claimant’s case has been established outside of the network.

The measure will take effect upon enactment.

Most Recent Update:

This measure has been amended. This measure awaits further consideration from the chair.

New York Regulatory Updates 05/15/2020

AB 864 – Relates to prescription prices and pharmacies for injured employees

Issues: Workers’ Compensation (General), Workers’ Compensation (Direction Of Care)

Summary:

This measure allows a workers’ compensation claimant to utilize a pharmacy of their choice.

This measure prohibits an employer or carrier from refusing to allow a claimant to utilize a pharmacy of their choice to furnish prescribed medications required by the claimant so long as the pharmacy’s charges are below the pharmaceutical fee schedule.

Most Recent Update: This measure has been re-referred to the Assembly Labor Committee, where Marcos A. Crespo (D) serves as Chair.

This measure awaits further consideration from the chair.

New York Regulatory Updates 04/15/2020

SB 1505 – Enacts into law major components of legislation necessary to implement the state public protection and general government budget for the 2019-2020 state fiscal year

Issues: Workers’ Compensation (General), Workers’ Compensation (Utilization Review And Appeals), Utilization Review

Summary:

This measure was amended into scope on March 28. This measure amends the Workers’ Compensation law. Please see summary for current version below.

This measure amends the Workers’ Compensation law, to define “provider” as a licensed acupuncturist, chiropractor, nurse practitioner, occupational therapist, physical therapist, physician, physician assistant, podiatrist, psychologist, or social worker authorized by the chair of the board established in the Workers’ Compensation Law. (Page 16)

This measure allows any provider to provide medical care and treatment in the state of New York in an emergency hospital or urgent care setting providing emergency treatment. (Page 17)

This measure requires that where any care or treatment is rendered, records of the the patient’s condition and progress, together with records of instruction for treatment, if any, are maintained by the physical therapist, occupational therapist or acupuncturist rendering treatment and by the referring physician, physician assistant, podiatrist, or nurse practitioner. (Page 18)

The list of pre-authorized procedures, under the Workers’ Compensation law, is required to be issued and maintained for the purpose of expediting authorization of treatment of injured workers. Such list of pre-authorized procedures will not prohibit varied treatment when the treating provider demonstrates the appropriateness and medical necessity of such treatment. (Page 31)

This measure prohibits an employer, carrier, or third-party administrator form interfering or attempting to interfere with the selection of treatment by an authorized medical provider, including directing or attempting to direct that the injured employee seek treatment from a specific provider or type of provider selected by the employer, carrier, or third-party administrator. It shall not constitute improper interference under this paragraph if the direction or attempt to direct the injured employee to receive treatment from a specific provider or type of provider originates from the authorized medical provider while in the course of providing treatment to the injured employee. (Page 31)

These provisions are effective on January 1, 2020. (page 32)

Most Recent Update: This measure was signed by Governor Andrew Cuomo (D) on April 12. As previously reported, this measure was sent to Governor Andrew Cuomo (D) on April 1. This measure was amended on March 28 to reflect amendments approved by the General Conference Committee. This measure subsequently passed the Senate Finance Committee, the full Senate, the House Ways and Means Committee and the full House on March 31.

This measure is effective April 12; however, please note that the effective date for specific provisions may vary by section.

New York Regulatory Updates 02/17/2020

SB 2054 – An act to amend the public health law and the social services law, in relation to health coverage for medical marijuana

Issues: Workers’ Compensation (Medical Marijuana)

Summary:

This measure relates to medical marijuana insurance coverage.

This measure adds coverage of medical marijuana to public insurance programs and clarifies that it may be covered by private insurance.

This measure deems medical marijuana as a prescription drug.

Most Recent Update: This measure has been re-referred to the Senate Health Committee. This measure awaits a hearing. If scheduled, the hearing will be open to the public.

New York Regulatory Updates 01/15/2020

AB 2005 – Enacts into Law Major Components of Legislation Necessary to Implement the State Public Protection and General Government Budget For the 2019-2020 State Fiscal Year

Issues: Workers’ Compensation (General), Utilization Review, Workers’ Compensation (Utilization Review And Appeals)

Summary:

This measure was amended into scope on March 28. This measure has amends the Workers’ Compensation law. Please see summary for current version below.

This measure amends the Workers’ Compensation law, to define “provider” as a duly duly licensed acupuncturist, chiropractor, nurse practitioner, occupational therapist, physical therapist, physician, physician assistant, podiatrist, psychologist, or social worker authorized by the chair of the board established in the Workers’ Compensation Law. (Page 16)

This measure allows any provider to provide medical care and treatment in the state of New York in an emergency hospital or urgent care setting providing emergency treatment. (Page 17)

Most Recent Update: This measure was substituted by SB 1505 on March 31.

This measure was amended on March 28, to reflect the version agreed to by the General Conference Committee. The negotiating process during the last weeks has included Senate and House leadership as well as the Governor’s office, as they try to reach an agreement before the start of the fiscal year, April 1.

SB 1505 is eligible to be sent to Governor Andrew Cuomo (D), who must request that measure be sent to him. Since the Legislature is in session, the Governor has 10 days, excluding Sundays, to sign or veto this measure. If the Governor does not sign this measure, this measure will be enacted without a signature. If the Governor vetoes this measure, this measure will be sent back to its chamber of origin with a message explaining the Governor’s objections and recommendations which will remove such objections. The Legislature can overturn the Governor’s veto with a 2/3 majority vote in both legislative chambers.

AB 2679 – Ensures timely access to high-quality medical care

Issues: Workers’ Compensation (Utilization Review And Appeals), Workers’ Compensation (General)

Summary:

This measure will ensure timely access to high-quality medical care for workers’ compensation claimants.

The measure stipulates that prior authorization procedures shall be issued and maintained for the purpose of expediting authorization of treatment of injured workers. The pre-authorization list must not be construed or relied upon to support the premise that procedures not included on the pre-authorized list should be denied. Pre-authorized procedures shall not be given preference over alternative forms of treatment that are not on the pre-authorized procedures list. The preauthorization list must be include currently enrollment in addiction treatment program for all injurered works subject to opioid weaning.

Most Recent Update: This measure was referred to the Assembly Labor Committee chaired by Assemblyman Marcos Crespo (D).

This measure awaits further consideration from the chair.

SB 6531 – Provides for pharmacy benefit management and the procurement of prescription drugs at a negotiated rate for dispensation

Issues: Workers’ Compensation (Pharmacy Fee Schedule)

Summary:

This measure relates to prescription drug prices.

This measure imposes several regulations on pharmacy benefits managers (PBMs), including requiring licensure.

The measure requires the Commissioner of Insurance to establish regulations to address conflicts of interest between PBMs and health insurers.

The measure prohibits PBMs from substituting or causing the substitution of a drug without the approval of the prescriber or as explicitly required or allowed by existing law.

The measure requires PBMs to include an appeals process for disputes regarding multi-source drug pricing.

Additionally, the measure prohibits contracts between a PBM and a pharmacy or the pharmacy’s contracting agent, such as a pharmacy services administration organization, from:

i. prohibiting or penalizing a pharmacist from disclosing the cost of the prescription to the individual, the availability of a therapeutic equivalent alternative, or alternative methods of purchasing the medication, including by paying cash, or

ii. charging or collecting a copayment that exceeds the total submitted charges by the pharmacy.

This measure prohibits any person, firm, association, corporation, or other entity from acting as a pharmacy benefit manager without having valid registration as a PBM with the Superintendent of Financial Services and an acting license as a PBM.

This measure requires, on or before July 1 of each year, every pharmacy benefit manager to report to the Superintendent requested information, including any pricing discounts, rebates, clawbacks, or other financial benefits received by the PBM and the terms and conditions of any contract or arrangement between the PBM and any other party relating to pharmacy benefit management services.

The measure requires PBMs to have a duty and obligation to the covered individual and the health plan or provider.

Finally, the measure specifies that the provisions of this measure are severable, in the event that a provision is held to be invalid or unconstitutional.

Most Recent Update:

This measure was vetoed by Governor Andrew Cuomo (D) on December 26, 2019. Vetoed bills are returned to the house that first passed them, together with a statement of the reason for their disapproval. A vetoed bill can become law if two-thirds of the members of each house vote to override the Governor’s veto.

New York Regulatory Updates 11/01/2019

AB 1250 – Authorizes workers’ compensation claimants to use any in-state pharmacy that is registered with the education department.

Issues: Any Willing Provider, Workers’ Compensation (Networks)

Summary:

This measure allows workers’ compensation to use any in-state-pharmacy.

This measure authorizes workers’ compensation claimants to use any in-state pharmacy that is registered as a resident, in-state pharmacy.

Most Recent Update: The New York State Legislature recessed on June 20, 2019. The Assembly may reconvene at the discretion of the Speaker, Carl E. Heastie (D). At that time, this measure will be eligible for consideration as it currently stands.

New York Regulatory Updates 10/01/2019

AB 2183 – Authorizes the care and treatment of injured employees by duly licensed or certified acupuncturists under the workers’ compensation program.

Issues: Workers’ Compensation (General), Workers’ Compensation (Medical Coverage And Reimbursement), Allied Practitioner

Summary:

This measure authorizes the care and treatment of injured employees by a duly licensed and registered acupuncturist upon the referral of an authorized physician under the workers’ compensation program.

This measure defines “acupuncturist” as a person who is:

i. duly licensed and registered as a licensed acupuncturist; or

ii. a certified acupuncturist.

New York Regulatory Updates 7/1/2019

AB 2836 – Provides for pharmacy benefit management and the procurement of prescription drugs at a negotiated rate for dispensation; repealer.