The PBM must provide an adequate and accessible pharmacy network that meets the requirements of West Virginia Code §33-51-8(d). Applicants need to submit the following documents electronically to our office. The portal is under-construction and expected to be completed in the next 60 days. Please do not mail the templates, you will receive an email when the portal is ready. Send an email to OICPBM@wv.gov to request portal instructions once the portal is available to receive templates.
The Network Template will identify each unique network the PBM uses in West Virginia and the Network Service Area.
The Provider Template is required for each Network. This template lists each participating pharmacy and their identifying information.