SB 1028
Relating to financial assistance available for prescription drug
Take action
Record your position on this measure.
Sign in to record your position, submit testimony, or contact your legislator.
Sign in to take action- Introduced
- Passed Senate
- Passed House of Delegates
- To Governor
- Became Law
Bill overview
This bill aims to improve access to prescription drugs in West Virginia by regulating how health plans and pharmacy benefit managers handle cost-sharing. Specifically, it requires these entities to include any cost-sharing amounts paid by insured individuals or others when calculating their contribution to prescription drug costs. The bill also establishes an annual limit on cost-sharing and prohibits insurers and related parties from adjusting plan terms based on the availability of financial assistance. It includes provisions for civil penalties and restitution for violations.
Key provisions
- Requires pharmacy benefit managers to include cost-sharing amounts paid by insureds or others when calculating their contribution to prescription drug costs.
- Establishes an annual limit on cost-sharing for all health plans in the state.
- Prohibits insurers, pharmacy benefit managers, and third-party administrators from changing plan terms based on financial assistance availability.
- Defines key terms related to cost-sharing and health plans.
- Authorizes civil penalties of up to $10,000 per violation for non-compliance.
- Provides for restitution to individuals harmed by violations of the bill.
- Requires the commissioner to propose rules for implementation.
Who is affected
- Insured individuals
- Health insurers
- Pharmacy benefit managers
- Third-party administrators
- West Virginia residents
Notable changes
Arguments in favor
Reasons to support this legislation.
No arguments in favor have been submitted.
Submit yoursArguments opposed
Reasons to oppose this legislation.
No arguments opposed have been submitted.
Submit yours