On June 2, the Insurance Commission filed the Pharmacy Auditing Entities and Pharmacy Benefit Managers Rule with an effective date of July 1, 2022. This rule is pursuant to passage of HB (House Bill) 2263 of 2021. The new rule amends the current rule relating to Pharmacy Audits that was effective on April 1, 2021 and remains in effect. 

Also in West Virginia, The Insurance Commission has proposed a rule 114CSR99 to reflect changes to the WV Code because of the passage of Enrolled HB 4112 which was approved by Governor Justice on March 30, 2022. The rule will be considered by the Legislative Rule Making Review Committee during the 2022 legislative interims and put before the WV Legislature for approval in 2023. If you have comments, please email them to Jill McCormack before the close of business on June 23. Otherwise, you may email them to michael.n.malone@wv.gov of the Insurance Commission by 5pm on July 5, 2022. 

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

Governor Justice (R) has signed two bills aimed at the regulation of Pharmacy Benefit Managers (PBMs). SB 312 provides legislative approval for Rules promulgated by the Insurance Commission to enact HB 2263 of 2021, landmark legislation that sets a reimbursement floor and provides a level playing field for community pharmacy. HB 4112 provides for pharmacy freedom of choice for specialty drugs, addresses 340B programs and will be effective for policies executed, amended or renewed on or after Jan. 1, 2023.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Insurance Commissioner has issued Pharmacy Freedom of Choice and Pharmacy Reimbursement Bulletins based on the passage of HB 2263 in 2021. Please note the Bulletins include information or members wanting to report potential violations to the Insurance Commissioner.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Insurance Commissioner issued two Bulletins to underscore prohibited activities by PBMs because of the passage of HB 2263 of 2021. Specifically, the Bulletins address pharmacy Freedom of Choice and Pharmacy Reimbursement. The latter has an effective date of January 1, 2022.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Legislative Rule Making Review Committee adopted the PBM rule as currently written without any debate. The rule, based on the passage of HB 2263 or 2021, must now receive final approval by the Legislature during the 2022 session.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Legislative Rule Making Committee will be considering the PBM rule as approved by the agency on December 8. You can link to the agenda here. NACDS is currently analyzing the rule and will follow up with members operating in the state via email. In the meantime, please share any concerns you may have with the rule with Jill McCormack as soon as possible.

For more information, contact NACDS’ Jill McCormack at 717-592-8977.

The Insurance Commissioner recently released the Insurance Bulletin No. 21-07 regarding how recent legislation impacts the state’s network adequacy requirements. Of note, the bulletin emphasizes that any sub-networks for specialty drugs that consist of only mail order pharmacies violates the state’s network adequacy standards.  

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Board of Pharmacy launched a pharmacy workload survey that opened on July 7 and will close on August 17. The aggregate data will be used by the Board and a WV Pharmacy Workload Task Force to develop a list of recommended regulatory actions for the Board and the WV Legislature to consider. Individuals interested in participating on the WV Pharmacy Workload Task Force may complete an application by August 17 at 5:00 p.m.

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.

The Board of Pharmacy proposed amendments to regulations under 15 WVCSR 16 to reduce the biennial pharmacist license renewal fee to $50 for applicants aged 65 years or older. Comments are due July 15. 

For more information, contact NACDS’ Sandra Guckian at 703-774-4801.