In addition to other provisions of this article, the division is authorized, on behalf of the Public Employees Insurance Agency, the schools of medicine of the state colleges and universities, the department of vocational rehabilitation and the Department of Health and Human Resources, to negotiate and enter into agreements directly with manufacturers and distributors whose prescription drug products are sold in the state for sole-source and multiple-source drugs to be paid for under a state program for eligible recipients. Such agreements shall provide for a rebate of a negotiated percentage of the total product cost to be paid by the manufacturer or distributor of a specific product. Each agency is authorized to establish, either singularly or together with other agencies, a drug formulary.
Prescription drug products are included in the drug formulary only upon completion of the application to and approval of the division. Those products for which a rebate is successfully negotiated are automatically included in the drug formulary for a period of time coterminous with the negotiated rebate.
If there has been a failure to negotiate or renew a rebate agreement for a specific prescription drug product, the pharmaceutical manufacturer of that product shall disclose to the division its most favorable pricing arrangements available to state and nonstate government purchasers. If the division determines that the product needs to be included in the drug formulary, with the approval of the agency the division shall establish the amount to be reimbursed for the product based upon the price information provided by the manufacturer. The determination as to whether a product should be included in the drug formulary is based on the product's efficiency, cost, medical necessity and safety. Any rebate returns, as a result of the provisions of this section regarding prescription drugs, shall be deposited in the General Revenue Fund.
It is expressly recognized that no other entity may interfere with the discretion and judgment given to the single state agency that administers the state's Medicaid program. Therefore, the Department of Health and Human Resources is authorized to negotiate rebates as provided for in this section.
Structure West Virginia Code
Chapter 5A. Department of Administration
Article 3. Purchasing Division
§5A-3-1. Division Created; Purpose; Director; Applicability of Article; Continuation
§5A-3-1a. Prescription Drug Products
§5A-3-2. Books and Records of Director
§5A-3-3. Authority of Director of Purchasing
§5A-3-3a. Additional Exemptions From Purchasing Requirements
§5A-3-6. Purchasing Section Standard Specifications -- Advisers From Spending Units
§5A-3-8. Facilities of Division Available to Local Governmental Bodies
§5A-3-9. Examination and Testing of Purchases; Report Required
§5A-3-10b. Best Value Procurement
§5A-3-10c. Direct Award Procurement
§5A-3-10e. Prequalification Agreement; Agency-Delegated Bidding
§5A-3-11a. Negotiation When All Bids Exceed Budget in Requisition
§5A-3-11b. Discussion and Final Offers
§5A-3-13. Contracts to Be Approved as to Form; Filing
§5A-3-15. Emergency Purchases in Open Market
§5A-3-16. Special Fund; Purposes; How Composed
§5A-3-17. Purchases or Contracts Violating Article Void; Personal Liability
§5A-3-18. Substituting for Commodity Bearing Particular Trade Name or Brand
§5A-3-19. Purchases From Federal Government and Other Sources
§5A-3-20. Spending Units to Submit Lists of Expendable Commodities
§5A-3-29. Penalty for Violation of Article
§5A-3-31. Corrupt Actions, Combinations, Collusions or Conspiracies Prohibited; Penalties
§5A-3-32. Power of Director to Suspend Right to Bid; Notice of Suspension
§5A-3-33. Review of Suspension by Secretary
§5A-3-33d. Grounds for Debarment
§5A-3-33e. Debarment Procedure
§5A-3-33f. Effects of Debarment
§5A-3-34. Authority Over Inventories and Property
§5A-3-35. Submission of Annual Inventories
§5A-3-36. Inventory of Removable Property
§5A-3-37. Reciprocal Preference; Preference for Resident Vendors for Certain Contracts
§5A-3-43. State Agency for Surplus Property Created
§5A-3-44. Authority and Duties of State Agency for Surplus Property
§5A-3-46. Warehousing, Transfer, etc., Charges
§5A-3-47. Department of Agriculture and Other Agencies Exempted
§5A-3-48. Travel Rules; Exceptions
§5A-3-50. Acquiring and Disposing of Vehicles and Aircraft
§5A-3-51. Maintenance and Service to Vehicles and Aircraft
§5A-3-53. Enforcement of Travel Management Regulations
§5A-3-57. Buy American Task Force; Study; Report
§5A-3-58. Creation of the Purchasing Improvement Fund
§5A-3-59. Small, Women and Minority-Owned Businesses