Results 1 to 3 of 3
  1. #1
    Join Date
    Jan 2015
    Posts
    14

    Default Nysif Formulary

    Over the last few months I have received notices from NYSIF that my meds will no longer be on their formulary. Just like that, NYSIF and I'm sure other insurers are eliminating meds without a hearing. I have tried to get my state senator and assemblyman to respond to my requests for explanation to no avail. If the judge sets monetary and medical requirements at a hearing, how can the insurer change these at will? They have pretty much dropped this into the lap of the doctors forcing them to jump thru hoops to get a continuation of meds with no guarantee.

  2. #2
    Join Date
    Oct 1971
    Posts
    5,118

    Default Re: Nysif Formulary

    If the judge sets monetary and medical requirements at a hearing, how can the insurer change these at will?
    Judges aren't qualified to determine medications, they determine whether you're entitled to medical and that's it.
    The insurer has nothing to do with it, changes are determined by the Board on the basis of the "effectiveness and appropriateness for the treatment of illnesses and injuries covered under the Workers’ Compensation Law."
    Formulary drugs do not require prior authorization.

    New York Workers’ Compensation Drug Formulary
    Introduction
    Legislation enacted in April 2017 required the New York State Workers’ Compensation Board to establish a drug formulary. The New York Workers’ Compensation Drug Formulary (NY WC Formulary) is based on a medication’s effectiveness and appropriateness for the treatment of illnesses and injuries covered under the Workers’ Compensation Law.
    The NY WC Formulary drug list designates drugs as either “Phase A”, “Phase B” or “Perioperative.” Additionally, some drugs are listed as second-line therapy (2nd line) and may only be used when other drugs associated with the phase of treatment have been deemed ineffective. Drugs not listed on the NY WC Formulary are considered non-formulary.
    Formulary drugs do not require prior authorization.
    http://www.wcb.ny.gov/content/main/h...y/overview.jsp

    NY Workers’ Compensation Drug Formulary
    November 5, 2019
    http://www.wcb.ny.gov/drug-formulary...-formulary.pdf

    Tony
    Moderator Responses are based on my personal bias, experience and research - They do not represent the views of the admin nor may be accepted in the legal community, always consult an attorney.

  3. #3
    Join Date
    Jan 2015
    Posts
    14

    Default Re: Nysif Formulary

    Thanks Tony. As usual a well informed response. It's just hard to believe that meds I have been taking for over thirteen years will be discontinued.

Similar Threads

  1. No Response from NYSIF
    By sissaacc in forum New York
    Replies: 3
    Last Post: 12-15-2011, 05:11 PM
  2. NYSIF Tatics
    By charger2011 in forum New York
    Replies: 0
    Last Post: 07-04-2011, 07:11 AM
  3. Replies: 1
    Last Post: 07-19-2010, 02:32 PM
  4. NYSIF Are Criminals!
    By bluntforcetrauma in forum New York
    Replies: 1
    Last Post: 04-08-2008, 08:32 PM

Bookmarks

Posting Permissions

  • You may not post new threads
  • You may not post replies
  • You may not post attachments
  • You may not edit your posts
  •  
 


Find a Lawyer