HB 5290 adds $250,000 to "Personal Services and Employee Benefits" and $250,000 to "Equipment" within the Department of Health's Laboratory Services Fund (Fund 5163) for fiscal year 2026. This supplemental appropriation reallocates unspent funds from the current fiscal year to cover specific lab staffing and equipment costs. The bill directly affects the Department of Health’s laboratory services operations by providing additional funding for existing budget categories. It does not create new programs or policies but adjusts spending within an existing fund for the 2026 fiscal year. The bill was introduced on February 6, 2026, and referred to the House Finance Committee.
HB 5483 requires health insurers and pharmacy benefits managers (PBMs) to include all cost-sharing payments (like copays or deductibles) made by patients or others when calculating a patient's total out-of-pocket costs for prescription drugs. It applies annual cost-sharing limits to all health plans sold in West Virginia and prohibits insurers or PBMs from altering coverage terms based on whether a patient has financial assistance for a drug. The bill directly affects patients using prescription drugs, insurers, PBMs, and third-party administrators, ensuring their coverage terms remain unchanged regardless of available drug financial help. Violations carry civil penalties up to $10,000 per incident, with restitution required for affected patients. The law takes effect for new plans on or after January 1, 2027.
HB 5071, the "Oral Health and Cancer Rights Act," requires all health insurance plans in West Virginia (including public employee, medical, and group plans) issued or renewed after January 1, 2026, to cover oral health procedures necessary as side effects of cancer treatments. These procedures include evaluations, medications, dental devices, and rehabilitation services needed to restore functions like eating, swallowing, or speaking affected by cancer therapies such as chemotherapy or radiation. The bill mandates that insurers cover these services as part of cancer treatment, directly affecting cancer patients and their insurance providers. One year after implementation, the Public Employees Insurance Agency and Bureau of Medical Services must report the cost of these coverage changes to the Joint Committee on Government and Finance.
HB 5407 requires West Virginia's child welfare department to share medical, dental, and mental health records of children in abuse/neglect cases with their school counselors within 30 days of placement. This directly affects the department, mental health providers, school counselors, and children involved in juvenile court cases. The key mechanism is a mandatory record-sharing process to improve collaboration among professionals supporting the child's well-being. The bill aims to streamline information flow without changing existing court procedures or standards of care. It is a procedural amendment to existing child welfare law, not a new substantive policy.
HB 5109 updates West Virginia's regulations for pharmacy benefit managers (PBMs) by clarifying key definitions and duties in the Pharmacy Audit Integrity Act. The bill directly affects pharmacies, PBMs, health benefit plans, and patients by standardizing terms like "pharmacy benefits management" (which includes claims processing, network management, and rebate administration) and defining "affiliate" relationships to prevent conflicts of interest. Key mechanisms include requiring clear disclosure of how PBMs determine reimbursement rates (like "maximum allowable cost") and restricting certain ownership ties between PBMs and pharmacies. The changes aim to increase transparency in prescription drug pricing and billing practices without altering coverage rules. This is a definitional update, not a new benefit or funding measure.
HJR 36 is a constitutional amendment proposal (not a regular bill) that would add a new section to West Virginia's Constitution guaranteeing reproductive rights. It states that every individual has the right to make decisions about contraception, fertility treatment, pregnancy, miscarriage care, and abortion, with the state prohibited from interfering unless using the least restrictive means for health. The amendment allows abortion restrictions after fetal viability (when a fetus can survive outside the womb with medical care) only if a physician determines it's necessary to protect the patient's life or health. This proposal requires voter approval in the 2026 general election to become part of the state constitution.
HB 5054 requires counties participating in West Virginia's QMHP Pilot Program to ensure every public school in the county has at least one qualified mental health professional (QMHP). A QMHP is defined as a registered mental health professional (including school counselors, who are automatically classified as QMHPs under the bill) who collaborates with schools but does not practice independently. This mandate applies only to schools in counties that join the pilot program, aiming to guarantee student access to mental health support. The bill does not alter existing school counselor duties but formalizes their role in meeting the QMHP requirement.
HB 5573 creates a new Rural Medical Residency Program focused specifically on obstetrics and gynecology (OB/GYN) for rural hospitals in West Virginia. The bill directs the Rural Health Initiative to fund this program using existing Rural Health Initiative resources or other legislative appropriations. It prioritizes OB/GYN care - a critical need in rural "health care deserts" where access is limited - as part of the state’s strategy to address shortages of primary care physicians. The program will operate within rural hospitals and align with the Rural Health Initiative Act’s goals to improve health care accessibility in underserved areas.
HB 5547 requires healthcare providers to obtain specific written consent from parents before conducting newborn genetic screening, which cannot be fulfilled by general consent forms signed at hospital admission. It limits blood collection to only what's necessary for screening and mandates destruction of blood samples after three weeks unless parents give additional written consent for retention. The bill also prohibits using newborn blood samples for research, law enforcement, or other purposes without separate consent from parents or the adult who was a minor when the sample was taken. Healthcare facilities must provide written information about screening options and the right to opt out during pregnancy.
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.
