WV| IB 25-01 outlines the impact of West Virginia’s prescription drug rebate law, enacted through House Bill 2263 in 2021, on commercial health insurance rates. Effective January 1, 2022, the law requires that rebates received for prescription drugs be passed through to reduce the cost-sharing for covered individuals at the point of sale and contribute to lowering health insurance premiums. The West Virginia Offices of the Insurance Commissioner (OIC) mandated insurers to report the effect of these rebates on rate filings starting in 2023, with data reviewed by contracted actuaries. Insurers such as Aetna, Highmark Blue Cross Blue Shield, UnitedHealthcare, and others have complied, showing varying reductions in premium rates due to the pass-through rebate provision.
Key Points:
- Pass-Through Rebate Requirement: Prescription drug rebates must reduce individual cost-sharing at the point of sale and be applied to lower health insurance premiums, ensuring transparency and affordability.
- Impact on Premium Rates: Insurers reported significant reductions in rate increases due to rebates, ranging from -0.15% to -14%, depending on plan type and insurer-specific data.