The proposed bill aims to enhance patient access to clinician-administered medications in West Virginia by introducing a new article to the state code. It defines key terms such as "covered individual" and "clinician-administered drug," and outlines prohibited practices for health insurance issuers and pharmacy benefit managers. Specifically, the bill prohibits these entities from denying authorization or payment for clinician-administered drugs based on the source of the drugs, imposing additional fees on patients, or interfering with a patient's choice of provider. It also clarifies that while differing copayments may be established, the location of drug administration cannot be a factor in determining medical necessity.

Additionally, the bill establishes penalties for violations, categorizing them as unfair competition and practices under the Unfair Trade Practices and Consumer Protection Law. It further stipulates that any contract provisions contradicting the new regulations will be deemed null and void. Overall, the legislation seeks to ensure that patients have equitable access to necessary medications administered by healthcare professionals without undue restrictions or financial burdens.

Statutes affected:
Introduced Version: 33-64-1, 33-64-2, 33-64-3, 33-64-4