The Virginia General Assembly enacted legislation (Chapter 304 of the 2021 Acts of Assembly, Special Session I) requiring health insurance carriers, pharmacy benefits managers and pharmaceutical manufacturers to annually report on specific prescription drug pricing information. In any case in which the data reported is insufficient, the Virginia Department of Health may require wholesale distributors to report certain data about prescription drug costs. In response to this new legislative mandate, the State Board of Health approved emergency regulations (12VAC5-219-10 et seq.) at its September 2021 meeting. These emergency regulations became effective on January 17, 2022. The emergency regulations are currently scheduled to expire on July 16, 2023. The Virginia Department of Health has initiated a regulatory action to make these regulatory requirements permanent.
Reporting requirements vary depending on the organization type, and submitter specific data submission manuals are available for each entity type.
This prescription drug price transparency reporting requirement, administered by the Virginia Department of Health through a nonprofit data services organization (Virginia Health Information) pursuant to § 32.1-23.4, Code of Virginia, as further set forth in 12VAC5-219, should not be confused with a similar reporting requirement being administered by the State Corporation Commission's Bureau of Insurance pursuant to § 38.2-3468, Code of Virginia.A 1-page overview of this report and the initial data collection process can be found here. Definitions for each of the fields within the report are available by hovering over each column heading.