Treatment Authorizations & Variances Requests

The New York State Workers’ Compensation Board recently implemented a Prescription Drug Formulary, which lists the medications eligible for reimbursement under a claimant’s workers' compensation medical coverage. Beginning December 5, 2019, all new prescriptions for injured workers must comply with the requirements of the Formulary. Beginning June 5, 2020, all refills and renewals must comply with the Formulary.

Over the next several months, claimants should discuss each of their medications with their health care providers to determine if their medication is reimbursable under their workers’ compensation medical coverage and make appropriate changes as necessary. Health care providers have been notified of the new drug formulary and should be anticipating the discussions with their patients. For more information, visit the WCB Formulary website.

Medical providers should submit their Attending Doctor's Request for Authorization (C-4Auth) requests and Medical Treatment Guideline (MTG) Variance Requests, forms MG-2 and MG-2.1, to the MTG teams in their respective NYSIF business offices. Please note your respective NYSIF business office email, fax and claim unit numbers provided below:

NYSIF Medical Treatment Authorization and Variance Request Teams

Office MTG Shared Email Box MTG Fax Claim Units
All Offices NYSIF-MG2-C4Auth@nysif.com (212) 587-7540 All Units except 271 and 272
CorVel Claims Processing GM-SYNY-Claims@corvel.com (866) 727-5573   272
York Claims Processing MG2@wellcomp.com (614) 717-6152  271

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