Meeting at the Capitol today, Sunday, May 20, Senators and Delegates of the Legislature’s Select Committee on PEIA, Seniors and Long Term Care were told that the Public Employees Insurance Agency’s (PEIA) increased costs were primarily due to rising costs of prescription drugs.
They were also told that PEIA patients can find drug costs lower that what PEIA insurance charges.
“We succeeded in having legislation passed by the 2018 Legislature allowing pharmacists to disclose to their patients lower cost alternatives to prices being charged by their insurance. This new law not only applies to PEIA but other third party plans,” said Richard Stevens, West Virginia Pharmacists Association Executive Director. “In essence, this eliminated the so-called ‘gag clause’ which prohibiting pharmacists from informing patients of the prices of their medications,” added Stevens who attended the meeting Sunday.
Following the meeting, Stevens informed lawmakers of the experience his wife had at their local independent pharmacy recently. After presenting her prescription, Stevens’ wife was told by her pharmacist that she could pay $18.50 cash for her prescription instead of a $50.00 copay on the $140.00 charge by her insurance company. “Naturally, we paid the out-of-pocket loser cost,” Stevens told lawmakers.
Getting prior authorizations approved in a timely manner is a problem, according to the Task Force appearing before Select Committee today. Governor Jim Justice appointed the Task Force at the close of the 2018 session to find a viable, long-term solution to the issues facing PEIA. The agency contends it will need another $50 million increase next year to meet increasing healthcare expenditures.