New York Codes, Rules and Regulations
Title 12 - DEPARTMENT OF LABOR
Chapter V - Workers' Compensation
Subchapter M - Pharmacy And Durable Medical Goods Fee Schedules And Appendices
Part 440 - Pharmacy Fee Schedule
Section 440.6 - Prescription drugs or medicines
Current through Register Vol. 46, No. 12, March 20, 2024
(a) When a brand name drug is prescribed to treat an injury for which a self-insured employer or insurance carrier is liable pursuant to Workers' Compensation Law Section 13, a generic drug equivalent, if a generic equivalent is available, shall be provided unless the prescribing physician obtains Prior Authorization pursuant to subdivision (m) of section 441.1.
(b) A billing statement submitted to a self-insured employer or carrier for a prescription drug that has been 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 maximum reimbursement (as set forth in subdivision of section 440.5 herein) of the prescription drug and the dispensing fee as applicable.
