SB621 H H&HR AM #1 3-7
The Committee on Health and Human Resources moved to amend the
bill on page two, following the enacting section, by striking the
remainder of the bill and inserting in lieu thereof the following:
ARTICLE 4. GENERAL PROVISIONS.
§33-4-21. Format for preferred drug lists; rule-making authority.
(a) The commissioner, in consultation with the Secretary of
the Department of Health and Human Resources, the Director of the
Public Employees Insurance Agency and the Board of Pharmacy, shall
propose rules for legislative approval in accordance with the
provisions of article three, chapter twenty-nine-a of this code to
develop a standardized format for all preferred drug lists or drug
formularies used in West Virginia. To the extent jurisdiction
exists, the rules apply to all entities regulated by the Insurance
Commissioner as set forth in this chapter, the Bureau for Medical
Services within the Department of Health and Human Resources, the
Public Employees Insurance Agency within the Department of
Administration, all pharmacy benefit managers registered or
licensed pursuant to the provisions of this chapter and any other
entity that routinely utilizes a preferred drug list or drug
formulary for outpatient pharmaceuticals.
(b) The rules required in subsection (a) of this section shall reflect an understanding that entities may have multiple preferred
drug lists or drug formularies; that purchasers may change
entities, preferred drug lists or drug formularies; and that
entities may have preferred drug lists or drug formularies used in
multiple states and shall provide:
(1) For a requirement that all preferred drug lists and drug
formularies use a standard format;
(2) As authorized under federal law, that the preferred drug
list or drug formulary submitted by an entity may be amended, if
new medications become available on the market, medications become
available generically, treatment warnings are issued by agencies of
the federal government or nationally recognized health experts,
agencies of the federal government allow for additional treatments
by the use of previously approved medications, or the purchaser or
employer requests the amendment; and
(3) That the preferred drug list or drug formulary is made
available electronically on the internet and changes to the
preferred drug list or drug formulary are reflected timely.
(c) Nothing in this section permits the commissioner to
require what substances are included upon any individual preferred
drug list or drug formulary.
(d) No rule promulgated pursuant to the provisions of this
section shall be in conflict with the standards developed by the
federal government in regard to the Medicare Pharmacy Part D Program.
(e) Any rule promulgated pursuant to the provisions of this
section shall be consistent with standards developed by nationally
recognized entities engaged in the establishment of national
standards for pharmaceutical point of sale transactions.