A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto a new article, designated §33-62-1, all relating to protecting patient access to physician-administered medications; and prohibiting certain actions.
(b) A health insurance issuer, pharmacy benefit manager, or their agent may not refuse to authorize, approve, or pay a participating provider for providing covered physician-administered drugs and related services to covered persons.

(c) A health insurance issuer may not condition, deny, restrict, refuse to authorize or approve, or reduce payment to a participating provider for a physician-administered drug when all criteria for medical necessity are met, because the participating provider obtains physician-administered drugs from a pharmacy that is not a participating provider in the health insurance issuer’s network. The drug supplied shall meet the supply chain security controls and chain of distribution set by the federal Drug Supply Chain Security Act, 29 Pub. L. 113-54, as amended. The payment shall be at the rate set forth in the health insurance issuer’s agreement with the participating provider applicable to such drugs, or if no such rate is included in the agreement, then at the wholesale acquisition cost.