State Compliance Pharmacy Network Designation
Pursuant to the New York State Workers’ Compensation Law and regulations of the New York State Workers’ Compensation Board (NYS-WCB), a carrier or self-insured employer may designate a pharmacy or group of pharmacies that injured workers must use to obtain outpatient prescription medications and medical supplies.
Certain clients have contracted with PMSI’s Tmesys retail pharmacy network and mail-order pharmacy for purposes of providing pharmacy services in New York in compliance with these network requirements. To ensure full compliance, Tmesys files updated information with the NYS-WCB on a regular basis as required. Additionally, these clients also send required notifications regarding protocols for utilizing a network pharmacy when receiving pharmacy care for work-related injuries to their employees as well as injured workers currently receiving workers’ compensation pharmacy care in New York. This notification includes information about participating network pharmacies, including a
locator tool for the Tmesys network.
Each pharmacy within the network is required, under Board regulations, to have a sufficient inventory such that it may service claimants without undue delay. Each designated pharmacy must also be either a remote pharmacy or be open for business hours that are regular and customary in the community. In addition, the pharmacy must list any designations it has received by carriers or self-insured employers under these network provisions where it posts lists of the insurance it accepts for any other purpose.
More information on these pharmacy network programs including specific regulatory compliance requirements – contained in Chapter V of Title 12 NYCRR Subchapter M Part 440 of the New York Regulations – can be viewed at the
NYS-WCB’s website.
Should you have any additional questions concerning this information, please contact us at:
TMESYS
4502 Woodland Corporate Blvd. Suite 105
Tampa, FL 33614
800.964.2531