West Virginia has made progress in healthcare price transparency on several fronts, including implementing an APCD, passing legislation easing access to medical records, and creating annual financial disclosure requirements for facilities in order to determine the reasonableness of healthcare costs among providers. West Virginia also closely regulates hospital prices, requiring hospitals to submit all changes and amendments to hospital charges for approval. However, competition in the insurance market is weak, as only one carrier issues qualified health plans on the individual insurance market and premiums for employer-sponsored plans are some of the highest in the country.
In the 2017 legislative session, West Virginia Governor Jim Justice signed HB 2459, which exempts financially distressed hospitals in acquisition proceedings from going through the traditional Certificate of Need process. In the 2018 legislative session, West Virginia enacted legislation to regulate pharmaceutical costs and transparency. West Virginia passed the Pharmacy Audit Integrity and Transparency Act (SB 46), which provides that a pharmacy may inform consumers of lower cost alternatives and cost share to assist health care consumers, and penalizes any pharmacy benefit managers that attempt to prohibit such disclosure. West Virginia joins a growing number of states that aim to reduce the cost of prescription drugs by increasing transparency around pricing. Additionally, the state also passed HB 4524, which mandates that pharmacists substitute biological prescriptions with lower-costing generic biological drugs.
The State Database
The Source tracks state activities impacting healthcare price and competition in both legislation and litigation in a searchable database to help stakeholders at the state level understand their legal and regulatory environment as they make efforts to improve access, quality, and efficiency, and reduce costs in healthcare. We currently cover bills from the 2017-2018 legislative term and key statutes from each state. Search the database for specific bills, statutes or cases by using keyword, key issue category, and/or jurisdiction.