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 7/11/22 

The PBM Portal is no longer available. 

All PBM correspondence should be directed to: OICPBM@wv.gov.

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. Complete the West Virginia PBM Bond Form.
  3. Complete the PBM Pharmacy Provider Location Template and the PBM Network Template.
  4. Remit an initial application fee of $5,000 (by check payable to WVOIC or via our online payment portal). 
  5. Mail the completed application and bond form to: WVOIC, PO Box 50540, Charleston, WV 25305-0540
  6. The templates may be submited by email to: OICPBM@wv.gov

Apply for licensure as an Auditing Entity:

Renewal Application

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

  1. Complete the PBM Renewal Application.
  2. Complete the West Virginia PBM Bond Form.
  3. Complete the PBM Pharmacy Provider Location Template and the PBM Network Template.
  4. Remit a renewal application fee of $5,000 (by check payable to WVOIC or via our online payment portal).
  5. Applications can be mailed to: WVOIC, PO Box 50540, Charleston, WV 25305-0540.
  6. The templates may be submitted by email to: OICPBM@wv.gov.

Renewal filings and templates will also be accepted electronically via SERFF. Detailed filling instructions are forthcoming.

Reporting Forms and Changes

Required Reporting for PBMs.

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