Relating to financial or product assistance for prescription drugs

HB 5470 requires pharmacy benefits managers to include all cost-sharing amounts paid by patients or others when calculating their out-of-pocket costs for prescriptions. It applies annual cost-sharing limits to all health plans sold in West Virginia and prohibits insurers or pharmacy managers from changing coverage terms based on the availability of drug assistance programs. The bill directly affects insured patients and health plans by preventing hidden cost-shifting and ensuring transparency in how deductibles and copays are calculated. Violations carry civil penalties up to $10,000 per incident, and the provisions take effect for plans issued on or after January 1, 2027.