§33-55-9. Rulemaking
The commissioner shall propose a rule for legislative approval in accordance with the provisions of 29A-3-1 et seq. of this code to implement the provisions of this article.
§33-54-4. Health Benefit Plan Issuer Reporting Requirements
No later than March 1 of each calendar year, each health benefit plan issuer shall submit to the Auditor a report providing the following information for the immediately preceding calendar year: Provided, That nothing in this article should be construed as to requiring a health benefit plan issuer to disclose confidential health information protected by […]
§33-54-5. Auditor S Searchable Pharmaceutical Transparency Website Created
(a) By July 1, 2021, the Auditor shall create a searchable pharmaceutical price transparency website, containing the information specified in §33-54-3 and §33-54-4 of this code, available to the public at no cost, and presented in a consumer-friendly, searchable format. (b) Effective July 1, 2021, the Auditor shall update the information displayed on the searchable […]
§33-55-1. Definitions
For purposes of this article: “Authorized representative” means: (A) A person to whom a covered person has given express written consent to represent the covered person;
§33-55-2. Applicability and Scope
(a) Except as provided in subsection (b) of this section, this article applies to all health carriers that offer network plans. (b) The following provisions of this article do not apply to health carriers that offer network plans that consist solely of limited scope dental plans or limited scope vision plans: (1) 33-55-3(a)(2) of this […]
§33-55-3. Network Adequacy
(a)(1) A health carrier providing a network plan shall maintain a network that is sufficient in numbers and appropriate types of providers, including those that serve predominantly low-income, medically underserved individuals, to assure that all covered services to covered persons, including children and adults, will be accessible without unreasonable travel or delay. (2) Covered persons […]
§33-54-3. Drug Manufacturer Reporting Requirements
(a) Not later than January 15 of each calendar year, a drug manufacturer shall submit a report to the Auditor stating the following information for each brand-name, specialty, and generic drug manufactured by the drug manufacturer and sold in the state directly by the drug manufacturer or a wholesale drug distributor: Provided, That the requirements […]
§33-53-7. Enforcement, Penalties and Rulemaking
(a) The Commissioner of Insurance shall examine and investigate the activities of any person that the commissioner reasonably believes has been or is engaged in an act or practice prohibited by this article. (b) The commissioner may enforce the provisions of this article by any means permissible in this chapter, including by issuing orders to […]
§33-54-1. Short Title
This article shall be known and cited as the Requiring Accountable Pharmaceutical Transparency, Oversight, and Reporting Act.
§33-54-2. Definitions
For the purpose of this article: “Auditor” means the State Auditor of West Virginia, by himself or herself, or by any person appointed, designated, or approved by the State Auditor to perform the service. “Brand-name drug” means a prescription drug approved under 21 USC 355(b) or 42 USC 262. “Drug” or “prescription drug” refers to […]