Tuesday, July 22, 2008

New No-Fault Pharmacy Fee Schedule Effective July 7, 2008

The New York State Insurance Department today announced that the NYS Workers' Compensation Board has adopted a new Pharmacy Fee Schedule applicable to all prescription drugs dispensed on or after July 7, 2008. This fee schedule is also applicable to prescription drugs dispensed on or after July 7, 2008 to all No-Fault eligible injured parties.

The new fee is computed by using the Average Wholesale Price (AWP) minus 12% for brand plus the dispensing fee and the AWP minus 20% for generic plus the dispensing fee. The AWP means the average wholesale price of a prescription provided in the Red Book, Medi-Span Master Drug Database, Blue Book or other nationally recognized drug pricing index adopted by the Chair or Chair's designee.

To search the allowable reimbursement amounts for drugs prescribed in relation to either New York Workers' Compensation or No-Fault claims, go here.

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