SB 828 is a procedural bill that allocates unspent funds from the Department of Human Services' Medicaid State Share Fund (Fund 5090) for fiscal year 2026. It directs $174,483,090 already designated for "Medical Services" to cover ongoing Medicaid provider payments, using money remaining unappropriated after the fiscal year began. This bill does not create new policy or change eligibility - it simply ensures existing unspent Medicaid funds are used for medical services as intended. It directly affects Medicaid providers in West Virginia by securing payment for covered services.
This bill establishes a value-based payment system for West Virginia's Medicaid addiction care services, shifting from fee-for-service to rewarding providers based on patient recovery outcomes. It directly affects Medicaid providers treating substance use disorders by requiring them to use standardized billing codes starting in 2027 and report on five specific outcome metrics: housing stability, sobriety, avoidance of criminal justice involvement, self-sufficiency (employment/education), and provider transition plans. The bill mandates data collection and analysis by the Bureau for Medical Services to develop these metrics, with value-based payments requiring implementation by 2028. The goal is to create a coordinated care system focused on long-term recovery success rather than fragmented service volume.
West Virginia Senate Bill 645 prohibits non-network ambulance services from charging patients extra fees beyond standard insurance cost-sharing. It requires insurers to pay non-participating ambulance providers directly at 400% of the Medicare rate (or the provider’s billed amount, whichever is lower) within 30 days of a clean claim. Patients cannot be billed for amounts beyond their standard copayments, coinsurance, or deductibles, and insurers must provide written denial notices with specific reasons. This applies to ground ambulance services covered under health insurance policies issued on or after January 1, 2027.
This bill (SB 570) allocates $199,476,099 in unspent federal funds to the West Virginia Department of Health's "Rural Health Transformation Program" for fiscal year 2026. It adds a new funding line (Fund 8802, Org 0506) under the Department's Central Office to support this specific program. The funds are designated for rural health initiatives and directly affect the Department of Health's ability to implement these programs. This is a procedural funding measure, not a policy change, using existing federal funds without new tax implications.
HB 4626 establishes a West Virginia grant program to fund U.S. Food and Drug Administration (FDA) drug development trials using ibogaine, a substance being studied for treating opioid use disorder and other neurological/mental health conditions. The program requires applicants (e.g., pharmaceutical companies or research organizations) to demonstrate capacity to conduct FDA trials, secure approval for ibogaine as a medication, and commit to establishing a state presence, securing insurance coverage, and ensuring treatment access for uninsured patients. Applicants must submit detailed trial designs, safety protocols, and plans for intellectual property rights and post-approval implementation, with grants administered through a state selection committee. The bill does not approve ibogaine but aims to accelerate its development pathway through state-funded trials.
SB 778 amends West Virginia law to allow nurse practitioners and physician assistants, alongside physicians, to certify students with disabilities as eligible for homebound educational services. This change directly affects families of exceptional children who require homebound instruction due to injury or health conditions. The key provision removes the previous restriction requiring certification only by physicians, expanding who can authorize this service. The bill aims to streamline access to homebound education by broadening the pool of qualified medical professionals who can make this determination.
Senate Bill 956 removes requirements that physician assistants (PAs) in West Virginia must work under direct physician supervision or collaboration. It allows PAs to own medical businesses, practice independently without mandated supervision, and be held to the same standard of care as other licensed healthcare providers. The bill amends specific sections of West Virginia law (§30-3-14, §30-3-15, §31B-13-1301) and adds a new section (§30-3E-21) to formalize these changes, including classifying PAs as a "professional service" under business law. This directly affects PAs by expanding their scope of practice and business ownership opportunities.
SB 1012 amends West Virginia law to permit the development of 60 additional inpatient substance use disorder treatment beds specifically for youth aged 17 or younger in Cabell County. The bill modifies certificate of need requirements that previously restricted new beds in counties with over 250 existing substance abuse treatment beds, making an exception for Cabell County's juvenile beds. This policy change directly affects minors in Cabell County seeking inpatient treatment for substance use disorders by removing a regulatory barrier to expanding specialized care. The provision is limited to inpatient treatment beds exclusively for individuals 17 years or younger.
SB 954 prohibits health insurers in West Virginia from denying coverage, increasing premiums, or canceling sickness, disability, or long-term care insurance policies solely because someone is a living organ donor. The bill applies to policies issued or renewed after July 1, 2026, and specifically bans insurers from: (1) refusing coverage based on donor status, (2) requiring donors to stop donating to maintain coverage, or (3) otherwise discriminating against donors in policy terms. It directly affects living organ donors and insurers regulated under West Virginia's health insurance laws. The legislation ensures donors cannot face financial penalties for their altruistic act through their health insurance.
SB 580 updates West Virginia's licensing rules for medical imaging and radiation therapy professionals, directly affecting radiologic technologists, MRI technicians, radiation therapists, and nuclear medicine technologists. Key changes include allowing radiation therapists to earn licensure through direct degree programs (without prior radiography training), restricting denial of licensure to only healthcare-related criminal convictions, and aligning their scope of practice with national standards. The bill also eliminates six-month temporary licenses, transfers oversight of radiologist assistants from the Board of Medicine to the Medical Imaging Board, and adds new definitions to clarify regulations. These updates aim to modernize licensing requirements while maintaining public safety standards.