Update on NY Work Comp Drug Formulary

I had the privilege today of speaking at the New York Self-Insurers Association annual meeting in Manhattan. But this blogpost isn’t about my session on medical marijuana along with Renee E. Heitger Esq.

Instead, this blogpost is about what transpired immediately beforehand at the 1:15pm keynote presentation by Hon. Clarissa Rodriguez, Chair, New York State Workers’ Compensation Board. As I had hoped, she provided a status update on their drug formulary since the close of public comments of their second draft of regulations in October 2018. Following are my live tweets via @RxProfessor:

  • #NYSIA WCB Chair *BREAKING* Drug formulary revised draft (per Oct18 public comments) will be released as soon as “next week“, definitely will be implemented in 2019(That means potential release the week of Jan 21 but no indication whether further public comments will be solicited, effective date will be this year)
  • #NYSIA WCB Chair *BREAKING* Drug formulary prior auths will be processed thru Medical Portal (phase 1), variances and other prior auths (phase 2).
  • #NYSIA WCB Chair *BREAKING* Medical portal + drug formulary + prior auth: Provider fills out online form, to carrier dedicated email, defined TAT (turn-around time), 2nd level review, 3rd level review with WCB medical office.(So this is the dispute resolution process)
  • #NYSIA WCB Chair *BREAKING* Additional medical treatment guidelines (e.g. body parts) will be out for public comments “soon”.
  • #NYSIA WCB Chair *BREAKING* New treatment guidelines: New body parts, 6-8 “remaining”, would not confirm what they are (yet).
  • #NYSIA WCB Chair *BREAKING* Question from audience: Will medical #marijuana be addressed in new treatment guidelines? No, but memos to come for guidance on how to handle.

So what does this mean? We’re all going to be very busy in 2019.

And one final comment by Chair Rodriguez, prompted by a question from the audience about support for the whole-person approach, resonated with me (and if you’ve ever read my words or heard me speak, you know why):

  • #NYSIA WCB Chair *BREAKING* “Talk about all the time (at the commission) about holistic approach to pain … Rather than eliminating pain it’s about management of pain.”

You know where to stay tuned for updates…(um, here).