Relating to financial assistance available for a prescription drug

HB 3092 requires health insurers and pharmacy benefit managers in West Virginia to include all cost-sharing payments (by patients or others) when calculating out-of-pocket costs for prescription drugs. It applies an annual cap on out-of-pocket expenses to all health plans sold in the state and prohibits insurers from changing coverage terms based on the availability of financial assistance for specific drugs. Violations can result in civil penalties up to $10,000 per incident, with restitution required for affected patients. The law takes effect for health plans beginning on or after January 1, 2026.