This bill aims to amend the Code of West Virginia by introducing a new article, designated as Article 64, which focuses on protecting patient access to physician-administered medications. It defines key terms such as "covered individual" and "physician-administered drug," and establishes that health insurance issuers and pharmacy benefit managers cannot refuse to authorize or pay for these medications when provided by participating providers. Additionally, the bill prohibits insurers from denying coverage based on the source of the physician-administered drugs, as long as medical necessity criteria are met, and mandates that patients should not incur additional fees beyond their designated cost-sharing amounts.

Furthermore, the bill outlines that any actions taken in violation of these provisions are considered unfair practices, subjecting violators to penalties under the Unfair Trade Practices and Consumer Protection Law. It also states that any contractual provisions contrary to this section will be deemed null and void in West Virginia. Overall, the legislation seeks to ensure that patients have reliable access to necessary medications administered by their physicians without facing undue financial burdens or restrictions.

Statutes affected:
Introduced Version: 33-64-1