WEST VIRGINIA
Offices of the Insurance Commissioner
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Allan L. McVey
Insurance Commissioner
Pharmacy Benefit Managers and Auditing Entities

The West Virginia  Pharmacy Audit Integrity Act applies to pharmacy benefit managers that perform pharmacy benefit management for covered entities and persons or companies that perform pharmacy audits.

List of Licensed PBM's as of 5/31/22 

Licensing Requirements

West Virginia's Pharmacy Audit Integrity Act was enacted by the 2019 legislature.  The Act requires that effective October 1, 2020,  Pharmacy Benefit Managers (PBM) and Auditing Entities must be licensed in order to operate within the state of West Virginia.

Here are the steps to apply for licensure as a PBM:

  1. Complete the PBM Licensing application.
  2. See the Network Adequacy's information below.
  3. West Virginia PBM Bond Form.
  4. Include an initial application fee of $5,000, payable to: WVOIC with the completed application and bond form.  Mail to:  WVOIC, PO Box 50540, Charleston, WV  25305-0540

Apply for licensure as an Auditing Entity:

 

Annual Report

Here are the steps to renew your licensure as a PBM:

  • Complete the PBM Renewal Application.
  • West Virginia PBM Bond Form.
  • Remit a renewal application fee of $5,000 (payable by check or via our online payment portal). Applications can be mailed to: WVOIC, PO Box 50540, Charleston, WV 25305-0540.
Reporting Forms and Changes

Required Reporting for PBMs.

PBM corporate change information should be reported within 30 days of change.