Relating to financial assistance available for a prescription drug

HB 5483 requires health insurers and pharmacy benefits managers (PBMs) to include all cost-sharing payments (like copays or deductibles) made by patients or others when calculating a patient's total out-of-pocket costs for prescription drugs. It applies annual cost-sharing limits to all health plans sold in West Virginia and prohibits insurers or PBMs from altering coverage terms based on whether a patient has financial assistance for a drug. The bill directly affects patients using prescription drugs, insurers, PBMs, and third-party administrators, ensuring their coverage terms remain unchanged regardless of available drug financial help. Violations carry civil penalties up to $10,000 per incident, with restitution required for affected patients. The law takes effect for new plans on or after January 1, 2027.