W. Va. Code R. § 114-99-7

Current through Register Vol. XLI, No. 50, December 13, 2024

Section 114-99-7 - Examinations

7.1. The Commissioner may examine the affairs of a PBM for compliance with Article 51, Chapter 33 of the West Virginia Code or the requirements of this rule.

7.2. Any examination permitted under this section shall follow the examination procedures and requirements applicable to covered entities under W. Va. Code § 33-2-9, and the Commissioner may assess the costs of the examination or audit to the PBM.

7.3. A PBM shall not be regularly examined under the same time periods of insurers as required under W. Va. Code § 33-2-9; however, the Commissioner may examine the PBM, pursuant to this section, at any time in which he or she believes it reasonably necessary to ensure compliance with Article 51, Chapter 33 of the West Virginia Code or the provisions of this rule.

7.4. The information and data obtained by the Commissioner from a PBM under this section shall be considered proprietary and confidential by law and privileged, exempt from disclosure pursuant to Chapter 29B of the West Virginia Code as a "trade secret", is not open to public inspection, is not subject to subpoena, is not subject to discovery or admissible in evidence in any criminal, private civil or administrative action and is not subject to production pursuant to court order. The Commissioner is authorized to use the documents, materials or other information in the furtherance of any regulatory or legal action brought as part of the Commissioner's official duties.

W. Va. Code R. § 114-99-7