In response to staffing and other changes put in place related to the COVID-19 pandemic, the Workers’ Compensation Board is updating some processes to ensure timely continuity of programs within the workers’ compensation system.
Health care providers have been instructed to submit prior authorization requests for medical procedures to their insurance carrier’s designated email contact as posted on the Board’s website, rather than a fax number. Fax submissions may not be able to be reviewed in a timely manner because many insurer staff members are working remotely. Prior authorization requests for non-formulary medications should continue to be submitted through the medical portal.
All insurance carriers, self-insured employers, and third-party administrators should forward their fax number to their designated email contact to ensure that these non-formulary prior authorization requests are received and acted upon accordingly.
The Board will only issue Orders of the Chair (OOC) for emailed prior authorization requests listed below that are not responded to in a timely manner. An OOC will not be issued for a faxed prior authorization request.
These instructions pertain to the following forms:
The NY Workers’ Compensation Drug Formulary Prior Authorization process will continue to be used for prescriptions that require prior authorization.
We also ask that your Medical Treatment Guidelines administrator verify your designated email contact and update it if necessary.
Thank you for your cooperation. Please contact the Board at WCBMedicalDirectorsOffice@wcb.ny.gov if you have any questions.
