West Virginia legislation · 2026 Regular Session
West Virginia HB5556: Creating an external reference pricing pilot program for prescription drugs.
Status: Introduced, February 16, 2026
What the bill says
To amend the Code of West Virginia, 1931, as amended, by adding a new section, designated §9-5-29b, relating to the Department of Human Services establishing an external reference pricing pilot program for prescription drugs. ARTICLE 5. MISCELLANEOUS PROVISIONS. §9-5-29b. External reference pricing pilot program. (a) The Department of Human Services may establish a pilot program applying external reference pricing for selected high-cost prescription drugs purchased or reimbursed under the state Medicaid program. (b) For purposes of this section, "external reference pricing" means settin.
From the introduced text, February 16, 2026:
A BILL to amend the Code of West Virginia, 1931, as amended, by adding a new section, designated §9-5-29b, relating to the Department of Human Services establishing an external reference pricing pilot program for prescription drugs. ARTICLE 5. MISCELLANEOUS PROVISIONS. §9-5-29b. External reference pricing pilot program. (a) The Department of Human Services may establish a pilot program applying external reference pricing for selected high-cost prescription drugs purchased or reimbursed under the state Medicaid program. (b) For purposes of this section, "external reference pricing" means setting a maximum reimbursement rate for a prescription drug based on the lowest price paid for the same or therapeutically equivalent drug in one or more comparable industrialized nations, or as established through a federally recognized most-favored-nation pricing methodology. (c) The pilot program (2) Exclude drugs for which no appropriate international price comparison exists; (3) Preserve beneficiary access to medically necessary medications. (d) The department (2) Establish exceptions or alternative reimbursement rates when necessary to prevent drug shortages or access disruptions; and (3) Coordinate pricing methodologies with federal prescription drug pricing initiatives when available. (e) The pilot program shall be implemented for a period not to exceed three years, unless extended by the Legislature. (f) No later than December 1 of each year during the pilot period, the department shall submit a report to the Joint …