Pharmacy Benefit Manager Regulation

West Virginia Legislative Events

Published March 14th, 2026

Detected April 8th, 2026

Summary

West Virginia Governor signed HB5430, regulating pharmacy benefit managers (PBMs). The bill requires annual pharmacy dispensing fee studies, limits charges by PBMs, prohibits certain PBM contracts with WV Medicaid and the Public Employees Insurance Agency, and mandates implementation of pharmacy cost containment tools. The bill passed unanimously in both chambers.

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What changed

HB5430 establishes comprehensive regulation of pharmacy benefit managers operating in West Virginia. The bill mandates annual pharmacy dispensing fee studies to establish fair reimbursement rates, imposes limits on amounts charged by PBMs, and prohibits certain PBM contract arrangements with state healthcare programs including WV Medicaid and the Public Employees Insurance Agency.

For affected parties, the legislation creates significant new compliance obligations for PBMs doing business with West Virginia state programs. Healthcare providers and pharmacies may benefit from improved reimbursement transparency and reduced PBM interference. State agencies administering Medicaid and public employee benefits must revise contracting processes and implement the required cost containment tools. The unanimous legislative support suggests strong political backing for enforcement of these new requirements.

What to do next

PBMs must review and adjust operations to comply with new charge limitations
State Medicaid and Public Employees Insurance Agency must implement new contracting restrictions with PBMs
Monitor for implementing regulations and agency guidance on cost containment requirements

Source document (simplified)

ChangeBridge / West Virginia / HB5430 Signed by Governor HB5430 House Bill Signed by Governor 2026-03-14

Relating to pharmaceutical benefits

The purpose of this bill is to is to regulate pharmacy benefit managers and state pharmacy purchasing by requiring an annual pharmacy dispensing fee study, limiting amounts charged by pharmacy benefit managers, prohibiting certain pharmacy benefit manager contracts with West Virginia Medicaid and the West Virginia Public Employees Insurance Agency, and requiring implementation of a pharmacy cost containment tool.

Bill Details

State West Virginia

Session 2026 Regular Session

Chamber House

Official Source www.wvlegislature.gov/BillStatus/Billshi...

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Action History

2026-04-01 H Approved by Governor 4/1/2026 2026-03-14 H Approved by Governor 4/1/2026 - House Journal 2026-03-14 S Approved by Governor 4/1/2026 - Senate Journal 2026-03-25 H To Governor 3/25/26 2026-03-14 S To Governor 3/25/2026 - Senate Journal 2026-03-14 S House Message received 2026-03-13 H Completed legislative action 2026-03-13 H Communicated to Senate 2026-03-13 H Effective from passage (Roll No. 505) 2026-03-13 H House concurred in Senate amendment and passed bill (Roll No. 504) 2026-03-13 H House received Senate message 2026-03-10 S Senate requests House to concur 2026-03-10 S Effective from passage (Roll No. 413) 2026-03-10 S Title amendment adopted 2026-03-10 S Passed Senate (Roll No. 412) 2026-03-10 S Read 3rd time 2026-03-10 S On 3rd reading 2026-03-09 S Committee amendment as amended adopted (Voice vote) 2026-03-09 S Amendment to committee amendment adopted (Voice vote) 2026-03-09 S Committee amendment reported 2026-03-09 S Read 2nd time 2026-03-09 S On 2nd reading 2026-03-06 S Read 1st time 2026-03-06 S Immediate consideration 2026-03-06 S Reported do pass, with amendment 2026-02-21 S To Health and Human Resources 2026-02-21 S To Health and Human Resources 2026-02-21 S Introduced in Senate 2026-02-20 H Communicated to Senate 2026-02-20 H Passed House (Roll No. 153) 2026-02-20 H Read 3rd time 2026-02-20 H On 3rd reading, Special Calendar 2026-02-19 H Amendment adopted (Voice vote) 2026-02-19 H Amendment reported by the Clerk 2026-02-19 H Read 2nd time 2026-02-19 H On 2nd reading, Special Calendar 2026-02-18 H Read 1st time 2026-02-18 H On 1st reading, Special Calendar 2026-02-17 H By substitute, do pass 2026-02-12 H Markup Discussion 2026-02-11 H To House Health and Human Resources 2026-02-11 H Introduced in House 2026-02-11 H To Health and Human Resources 2026-02-11 H Filed for introduction

Votes

2026-02-20 Passed House (Roll No. 153) Yea: 95 Nay: 0 2026-03-10 Passed Senate (Roll No. 412) Yea: 34 Nay: 0 2026-03-10 Effective from passage (Roll No. 413) Yea: 34 Nay: 0 2026-03-13 House concurred in Senate amendment and passed bill (Roll No. 504) Yea: 97 Nay: 0 2026-03-13 Effective from passage (Roll No. 505) Yea: 97 Nay: 0

Committee Referrals

2026-02-11 H Health & Human Resources 2026-02-21 S Health and Human Resources

Amendments

2026-02-18 hb5430 hfa worrell 2-18 _1 2026-02-18 hb5430 hfa worrell 2-18 _1 adopted Adopted 2026-03-02 hb5430 s hhr am _ 3-2 2026-03-09 hb5430 sfat helton _ 3-9 2026-03-09 hb5430 sfa helton _ 3-9 adopted Adopted 2026-03-09 hb5430 sfa helton _ 3-9 2026-03-02 hb5430 s hhr am _ 3-2 as amended 2026-03-02 hb5430 s hhr am _ 3-2 adopted Adopted 2026-03-09 hb5430 sfat helton _ 3-9 adopted Adopted