West Virginia HB5365 regulates pharmacy benefit managers for the Public Employees Insurance Agency.

West Virginia HB5365 mandates that pharmacy benefit managers disclose detailed information about contracting, reimbursement, networks, rebates, fees, and health-related services. It requires these managers to report quarterly on total charges, reimbursements, and claims processed. The bill also prohibits managers from reimbursing pharmacies less than the national average drug acquisition cost and from imposing certain conditions on beneficiaries. The Public Employees Insurance Agency is authorized to recover benefits paid fraudulently and to terminate contracts for non-compliance.

West Virginia HB5365 regulates pharmacy benefit managers for the Public Employees Insurance Agency.

West Virginia HB5365 mandates that pharmacy benefit managers disclose detailed information about contracting, reimbursement, networks, rebates, fees, and health-related services. It requires these managers to report quarterly on total charges, reimbursements, and claims processed. The bill also prohibits managers from reimbursing pharmacies less than the national average drug acquisition cost and from imposing certain conditions on beneficiaries. The Public Employees Insurance Agency is authorized to recover benefits paid fraudulently and to terminate contracts for non-compliance.