Health and Human Resources

HB 5582 extends the expiration date of West Virginia's program requiring drug screening for adult applicants seeking Temporary Assistance for Needy Families (TANF) benefits. The program, originally set to end December 31, 2026, will now operate until December 31, 2030. Under this program, applicants who test positive for drugs must complete substance abuse treatment and job skills programs to continue receiving TANF benefits, though they may keep benefits while participating. The bill does not change existing screening requirements or treatment rules - it only extends the program's authorization period.

HB 5004 requires Medicaid and private health insurance plans in West Virginia to cover medically necessary diagnosis and treatment for Pediatric Acute-Onset Neuroimmune Disorders (PANS and PANDAS), as defined by the National Institutes of Health. This directly affects Medicaid enrollees and patients with these conditions, ensuring coverage for diagnostic testing, medications, immune-related treatments, and behavioral services when ordered by a physician and supported by medical evidence. The bill mandates coverage parity for behavioral symptoms, preventing insurers from restricting care solely due to psychiatric manifestations. It also requires the state health department to educate providers on recognizing PANS/PANDAS symptoms, including acute onset, association with strep infections, and neurological symptoms. The legislation applies to all health benefit plans subject to West Virginia's insurance laws.

This bill requires physicians and osteopathic doctors in West Virginia to complete continuing education credits specifically in nutrition as part of their biennial license renewal process. The law mandates that medical professionals earn a minimum of fifty hours of continuing medical education every two years, with osteopathic physicians required to complete thirty-two hours including nutrition training, and these credits must be approved by relevant medical boards. The bill amends existing state code sections to make nutrition education a mandatory component of the continuing education requirement for license renewal.

HB 5430 regulates pharmacy benefit managers (PBMs) for West Virginia's Public Employees Insurance Agency (PEIA), directly affecting state employees covered by PEIA, PBMs, and pharmacies providing services to them. The bill requires PBMs to submit detailed quarterly reports on claim payments, including costs charged to PEIA versus amounts paid to pharmacies, and prohibits certain PBM contracts that limit transparency. It also mandates PBMs to implement a cost containment tool and requires a study on pharmacy pricing. The law aims to increase transparency in pharmacy billing and control costs for state health insurance programs.

HB 4335 requires West Virginia's Medicaid program to process provider enrollment applications within 5 business days of receipt and mandates managed care organizations to complete provider credentialing within 60 days. The bill establishes a unified electronic platform for all Medicaid provider applications, renewals, and documentation, eliminating paper submissions starting July 1, 2026. It also sets penalties for managed care organizations that miss deadlines, including monetary sanctions or "credentialing-by-default" by the Department of Human Services. This bill directly affects Medicaid providers (like doctors and clinics), managed care organizations, and the Department of Human Services.