About the Law
There are two issues at stake.
Issue 1: The Issue of Pharmacy Choice
Section 26 of the
Workers' Compensation Reform Bill
S. 3322/A. 6163
What it says:
"Notwithstanding any other provision of this chapter, if an employer or carrier has contracted with a pharmacy to provide prescribed medicine to claimants, then such employer or carrier may require claimants to obtain all prescribed medicines from the pharmacy with which it has contracted, except if a medical emergency occurs and it would not be reasonably possible to obtain immediately required prescribed medicine from the pharmacy with which the employer or carrier has a contract. An employer or carrier that requires claimants to obtain prescribed medicines from a pharmacy with which it has a contract must notify claimant of the pharmacy or pharmacies with which it has a contract. "
What it means:
Injured workers in need of prescriptions must go to the pharmacy that their insurance provider has contracted with.
If your claim is disputed, it's even worse. Until your claim is settled, your insurance company will not cover your medications. In the meantime, you'll be sent to a pharmacy where you will have to pay the full cost of the medication, out of your pocket.
The full text of the bill can be found here.
Issue 2: Choice of Diagnostic Testing Providers
S 29 Section 13a (7)
(same as Section 25 (7)(A) of the bill)
What it says:
"Notwithstanding any other provision of this chapter to the contrary, any insurance carrier authorized to transact the business of Workers' Compensation insurance in this state, self-insurer or the state insurance fund may contract with a network or networks, legally and properly organized, to perform diagnostic tests, X-ray examinations, magnetic resonance imaging, or other radiological examinations or tests with a provider or at a facility that is affiliated with the network or networks with which the carrier contracts, except if a medical emergency occurs requiring an immediate diagnostic test, X-ray examination, magnetic resonance imaging or other radiological examination or test or if the network with which the insurance carrier, self-insurer or that state insurance fund contracts does not have a provider or facility able to perform the examination or test within a reasonable distance from the claimant's residence or place of employment, as defined by the regulation of the board."
What it means:
Injured workers in need of diagnostic testing must go to the provider that their insurance provider has contracted with.
You will be forced to forfeit trusted relationships with providers and facilities, and the new assigned provider may be prejudiced in favor of the Workers' Compensation insurance carrier due to economic relationships.
You may be forced to go back to work while still injured and will use your private insurance to treat persistent work-related injuries. Your employer's and/or union's sponsored private health care cost will soar and your co-payment and deductibles will increase.
The full text of the bill can be found here.
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