(a) A health care corporation issuing a contract under the provisions of this article may not require any person covered under a contract which provides coverage for prescription drugs to obtain the prescription drugs from a mail-order pharmacy in order to obtain benefits for the drugs.
(b) A health care corporation may not violate the provisions of subsection (a) of this section through the use of an agent or contractor or through the action of an administrator of prescription drug benefits.
(c) The Insurance Commissioner may propose rules for legislative approval in accordance with the provisions of article three, chapter twenty-nine-a of this code to implement and enforce the provisions of this section.
Structure West Virginia Code
Article 25. Health Care Corporations
§33-25-1. Declaration of Policy
§33-25-3. Incorporation; Purposes; Name; Limitations
§33-25-5. Exemption From Taxes
§33-25-6. Supervision and Regulation by Insurance Commissioner; Exemption From Insurance Laws
§33-25-6a. Applicability of Insurance Fraud Prevention Act
§33-25-8a. Third Party Reimbursement for Mammography or Pap Smear or Human Papilloma Virus Testing
§33-25-8b. Third Party Reimbursement for Rehabilitation Services
§33-25-8c. Third Party Payment for Child Immunization Services
§33-25-8d. Coverage of Emergency Services
§33-25-8e. Third Party Reimbursement for Colorectal Cancer Examination and Laboratory Testing
§33-25-8f. Required Use of Mail-Order Pharmacy Prohibited
§33-25-8g. Third-Party Reimbursement for Kidney Disease Screening
§33-25-8h. Required Coverage for Dental Anesthesia Services
§33-25-8j. Deductibles, Copayments and Coinsurance for Anti-Cancer Medications
§33-25-8k. Eye Drop Prescription Refills
§33-25-8l. Deductibles, Copayments and Coinsurance for Abuse-Deterrent Opioid Analgesic Drugs
§33-25-8n. Coverage for Amino Acid-Based Formulas
§33-25-8o. Substance Use Disorder
§33-25-8p. Prior Authorization
§33-25-8q. Fairness in Cost-Sharing Calculation
§33-25-8r. Mental Health Parity
§33-25-8s. Incorporation of the Health Benefit Plan Network Access and Adequacy Act
§33-25-8t. Incorporation of the Coverage for 12-Month Refill for Contraceptive Drugs
§33-25-11. Rules and Regulations
§33-25-14. Advancement of Money to Corporation
§33-25-16. Disposition of Fees and Charges
§33-25-17. Bonds of Corporation Officers and Employees
§33-25-18. Annual Audited Financial Report
§33-25-19. Administrative Supervision
§33-25-20. Policies Discriminating Among Health Care Providers
§33-25-22. Assignment of Certain Benefits in Dental Care Insurance Coverage