HB5365

Relating to the regulation of pharmacy benefit managers providing services to the Public Employees Insurance Agency.

Introduced·2/9/26
Intr Text

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.

Included in complete analysis

  • Overview
  • Core Provisions
  • Implementation
  • Impact
  • Legal Framework
  • Critical Issues

See what it does, who it affects, and the critical issues in plain language. Free, 30 seconds.

Where it stands

Current
Banking & Insurance Committee
Next
Committee decision

Sponsors

0
9
RRRRRRRRR
Democratic CaucusRepublican Caucus

History

Feb 16

House

To House Banking and Insurance

Feb 9

House

Filed for introduction

Feb 9

House

To Finance