Due to the unprecedented health care challenges caused by the COVID-19 pandemic, the New York State Workers’ Compensation Board has extended the deadline for providers to obtain prior authorization for renewals of non-formulary medications. The previous deadline of June 5, 2020, has now been moved to January 1, 2021. This means that the formulary implementation will be delayed for “legacy drugs,” or those dispensed and prescribed prior to the initial rollout of the state formulary on December 5, 2019. The rule will still apply to new prescriptions issued to injured workers.
By extending this deadline six months to January 1, 2021 the board is hoping to reduce the impact the current crisis may have on a health care provider’s ability to implement the new standard. It is also designed to give more time to ensure that prescription renewals are consistent with the New York Workers’ Comp Formulary. Most importantly, the goal is to ensure that injured workers are not negatively affected by this emergency, particularly those who are using non-formulary medications requiring prior authorization.
To adapt to this change, myMatrixx will be taking any necessary steps to ensure implementation for clients. For further information about this alert or other legislative or regulatory changes, please contact WCCompliance@express-scripts.com.