Stat RX Pharmacy proudly accepts Workers’ Compensation. We have standard, customized and injury-specific formularies, as well as an experienced accounting team to assist you with all of your workers’ compensation needs.
Patients presenting workers’ compensation should note that due to New York state regulation Section 440.6, prescriptions for brand name drugs will be substituted with generic drugs, except those in accordance with New York Education Law Section 6810(6).
New York Workers’ Compensation Regulations: Section 440.6 Prescription Drugs or Medicines
“When a brand name drug is prescribed to treat an injury for which a carrier or self-insured employer is liable pursuant to Workers’ Compensation Law Section 13, the pharmacist or medical provider dispensing the drug shall substitute a generic drug, except in accordance with New York Education Law Section 6810(6).
A billing statement submitted to a self-insured employer or carrier for a prescription drug dispensed shall include the national drug code number of the prescription drug as listed in the national drug code directory maintained by the federal Food and Drug Administration and shall state separately the price of the prescription drug and the dispensing fee.”
New York Education Law Section 6810(6)
“(a) Every prescription written in this state by a person authorized to issue such prescription shall be on prescription forms containing one line for the prescriber’s signature. The prescriber’s signature shall validate the prescription. Imprinted conspicuously in eight point upper case type immediately below the signature line shall be the words: “THIS PRESCRIPTION WILL BE FILLED GENERICALLY UNLESS PRESCRIBER WRITES ‘d a w’ IN THE BOX BELOW”. Unless the prescriber writes d a w in such box in the prescriber’s own handwriting, the prescriber’s signature shall designate approval of substitution by a pharmacist of a drug product pursuant to paragraph (o) of subdivision one of section two hundred six of the public health law.
No other letters or marks in such box shall prohibit substitution. No prescription forms used or intended to be used by a person authorized to issue a prescription shall have ‘d a w’ preprinted in such box. Such box shall be placed directly under the signature line and shall be three-quarters inch in length and one-half inch in height. Immediately below such box shall be imprinted in six point type the words “Dispense As Written”. Notwithstanding any other provision of law, no state official, agency, board or other entity shall promulgate any regulation or guideline modifying those elements of the prescription form’s contents specified in this subdivision.
To the extent otherwise permitted by law, a prescriber may modify only those elements of the prescription form’s contents not specified in this subdivision. Notwithstanding any other provision of this section or any other law, when a generic drug is not available and the brand name drug originally prescribed is available and the pharmacist agrees to dispense the brand name product for a price that will not exceed the price that would have been charged for the generic substitute had it been available, substitution of a generic drug product will not be required. If the generic drug product is not available and a medical emergency situation, which for purposes of this section is defined as any condition requiring alleviation of severe pain or which threatens to cause disability of take life if not promptly treated, exists, then the pharmacist may dispense the brand name product at his regular price.
In such instances the pharmacist must record the date, hour and nature of the medical emergency on the back of the prescription and keep a copy of all such prescriptions. (b) The prescriber shall inform the patient whether he or she has prescribed a brand name or its generic equivalent drug product. (c) The provisions of this subdivision shall not apply to a hospital as defined in article twenty-eight of the public health law. (d) No prescriber shall be subjected to civil liability arising solely from authorizing, in accordance with this subdivision, the substitution by a pharmacist of a drug product pursuant to paragraph (o) of subdivision one of section two hundred six of the public health law.”
Please refer to the New York State Workers’ Compensation website to check the latest Pharmacy and Durable Medical Goods Fee Schedules. If you are unsure of your Worker’s Compensation coverage or how this applies to you in the case of specialty prescription medication, please contact us.