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.