CVS Health Corp and Walmart, Inc. have agreed to pay $147.5 million to settle West Virginia's claims over their alleged roles in the state's opioid crisis. According to the state, CVS agreed to pay $82.5 million and Walmart agreed to pay approximately $65 million. The state had accused the pharmacy chains of fueling the deadly opioid epidemic through their allegedly lax oversight of prescription pills sold in the state. West Virginia’s per capita opioid mortality rate is three times the national average.
On March 30, 2022, West Virginia Gov. Jim Justice approved a powerful patient choice bill, HB 4112. The bill gives patients greater authority to choose which in-network pharmacy they want to fill their prescriptions and addresses the arbitrary “specialty” designation that PBMs use to steer patients to PBM-owned pharmacies. The passage of this law marks a big win for West Virginia pharmacists and the profession as a whole. HB 4112 goes into effect on June 10, 2022.
West Virginia Legislature
The West Virginia Offices of the Insurance Commissioner is holding pharmacy benefit managers (PBMs) accountable for unlawful actions. The Office posted a bulletin notice for PBMs and health benefit plans that enforces a freedom of consumer choice law prohibiting requiring a patient to use a mail order pharmacy. It enforces that a PBM's network cannot only consist of mail order pharmacies, but instead must have a mix of physical stores as well within a reasonable distance from the patient's home. Failure to comply may result in severe consequences such as losing their license.
West Virginia Offices of the Insurance Commissioner
HB 2263 positively impacts locally-owned pharmacies and their patients by protecting their freedom of choice. It requires transparency in drug rebates and premiums, and regulates fair reimbursement for all pharmacies. Overall, it limits the current practices of PBMs that interfere in pharmacies' ability to deliver affordable and necessary patient care.
West Virginia Pharmacists Association