West Virginia HB5430: Relating to pharmaceutical benefits

What the bill says

An act to amend and reenact §5-16-9, §33-51-3, and §33-51-9 of the Code of West Virginia, 1931, as amended; and to amend the code by adding two new sections, designated §9-5-34 and §33-51-14, relating to pharmaceutical benefits; making the Public Employees Insurance Agency subject the Pharmacy audit Integrity Act; providing exceptions; providing specific provisions shall not be applied to conflict with Medicare; requiring competitive bid solicitation for cost containment vendor; setting forth terms for cost containment vendor contract; requiring the Medicaid program to establish a time limited.

From the enrolled text, March 13, 2026:

AN ACT to amend and reenact §5-16-9, §33-51-3, and §33-51-9 of the Code of West Virginia, 1931, as amended; and to amend the code by adding two new sections, designated §9-5-34 and §33-51-14, relating to pharmaceutical benefits; making the Public Employees Insurance Agency subject the Pharmacy audit Integrity Act; providing exceptions; providing specific provisions shall not be applied to conflict with Medicare; requiring competitive bid solicitation for cost containment vendor; setting forth terms for cost containment vendor contract; requiring the Medicaid program to establish a time limited pilot program; defining terms; limiting amounts charged by pharmacy benefit managers; addressing Public Employees Insurance Agency rebate; prohibiting certain pharmacy benefit manager ownership structures; requiring a study; and requiring a report. ARTICLE 16. West Virginia PUBLIC EMPLOYEES INSURANCE ACT. §5-16-9. Authorization to execute contracts. (a) The director is given exclusive authorization to execute such contract or contracts as are necessary to carry out the provisions of this article. (b) The provisions of §5A-3-1 et seq. of this code, relating to the Division of Purchasing of the Department of Finance and Administration, shall not apply to any contracts for any insurance coverage or professional services authorized to be executed under the provisions of this article. Before entering into any contract for any insurance coverage, as authorized in this article, the director shall invite competent …

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