West Virginia Insurance Commissioner Allan McVey issued an $800,000 penalty on Navitus for violations of the state's pharmacy audit, pharmacy reimbursement, and rebate pass-through laws between Jan. 1, 2023 and June 1, 2024. Navitus did not allow audited pharmacies 30 days to respond to preliminary reports and rejected documents to validate pharmacy records. Rebates totaling $540,000 were kept by the PBM rather than passed through as required by law. Navitus also did not reimburse West Virginia pharmacies at the required rate of NADAC plus a $10.49 professional dispensing fee. This enforcement action is particularly notable because Navitus is considered a transparent PBM. The consent order and the OIC examination of Navitus can be found here.
NCPA
