VA INS PBM Rebate Report Guidance

Updated on: Feb 12, 2025

Latest Event


  • Jan. 2025 VA INS Updated Guidance
  • On Jan. 29, 2025, VA INS issued memo with updates to general guidance, reporting forms and instructions, following statutory changes to rebate reporting requirements.
  • Updated guidance, reporting forms and instructions under the Reporting tab on the Pharmacy Benefits Management webpage, State Corporation Commission’s website.
  • Also, noted that the report for calendar year 2024 is due on or before Mar. 31, 2025.
  • Document dated Jan. 29, 2025, received from VA INS Feb. 7, summarized on Feb. 12.

On Dec. 5, VA INS issued notice of updated PBM rebate report.

  • VA INS issued memo, Notice of pending updates to pharmacy benefits management (PBM) rebate report including forms, instructions, and guidance for Virginia insurers.
  • Follows Ch. 329/626 expansion of PHB rebate reporting requirements, see #203947.
  • Rebate Report Updates
  • Pharmacy benefits management rebate reporting requirements were expanded and codified in subsection B of VA INS 38.2-3468, Virginia Administrative Code.
  • Bureau plans to issue updated forms, instructions, and guidance on or before Jan. 17, 2025, for use with rebate reports for calendar year 2024, due on/before Mar. 31, 2025.
  • Updated materials will be posted on the State Corporation Commission’s Pharmacy Benefits Management webpage at Virginia SCC - Pharmacy Benefits Management.
  • Jan. 2025 VA INS Updated Guidance
  • On Jan. 29, 2025, VA INS issued memo with updates to general guidance, reporting forms and instructions, following statutory changes to rebate reporting requirements.
  • Updated guidance, reporting forms and instructions under the Reporting tab on the Pharmacy Benefits Management webpage, State Corporation Commission’s website.
  • Also, noted that the report for calendar year 2024 is due on or before Mar. 31, 2025.
  • Document dated Jan. 29, 2025, received from VA INS Feb. 7, summarized on Feb. 12.
Regulators
VA INS
Entity Types
Ins
Reference
Memo, 1/29/2025; Memo, 12/5/2024; Citation: VA INS 38.2-3468;
Functions
Compliance; Legal; Operations; Product Administration; Reporting
Countries
United States of America
Category
State
N/A
Products
Insurance; Insurance-Health; PBM
Rule Type
Final
Regions
Am
Rule Date
Dec 5, 2024
Effective Date
Mar 31, 2025
Rule ID
236243
Linked to
Reg. Last Update
Jan 29, 2025
Report Section
US Insurance