This bill aims to amend the Code of West Virginia by introducing a new article focused on protecting patient access to clinician-administered medications. 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 provider's choice of pharmacy, imposing additional fees on patients, or interfering with a patient's right to choose their 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 of these provisions, categorizing them as unfair methods of competition and unfair practices under the Unfair Trade Practices and Consumer Protection Law. It further stipulates that any contract provisions contradicting these new regulations will be deemed null and void in the state. Overall, the legislation seeks to enhance patient access to necessary medications while ensuring fair practices among health insurance providers.

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