PBM Reform

West Virginia Pharmacists Association advocates for healthcare reform that benefits patients and pharmacies together. From advocating and participating in the Federal Trade Commission investigation to passing one of the most progressive pharmacy reimbursement laws in the country, WVPA supports efforts in pharmacy benefit manager (PBM) reform and oversight on a state and federal level.

Below are the references to current WV Code for Pharmacy Audit Integrity Act. Should you know of any PBM or insurance company in violation of this code, WVPA encourages you to file a complaint (link below) with the Office of Insurance Commissioner to help enforce law we have advocated to pass for consumer and pharmacy protection. National Community Pharmacists Association has provided some tips on filing complaints here and materials to educate yourself and others here.

Reference of current WV Code

PBM licensure/registration requirement

WV Code 33-51-8

Prohibition against adjudication fees

WV Code 33-51-9

Fair pharmacy audit procedures

WV Code 33-51-4

Prohibition against anti-mandatory mail-order

WV Code 33-51-8

Any Willing Pharmacy

WV Code 33-51-11

Prohibitions against PBMs reimbursing PBM-affiliated pharmacies at higher rates than non-affiliated pharmacies

WV Code 33-51-9