Mental Health and Substance Use Disorders Insurance Coverage Protection Act

HB 2861, the Mental Health and Substance Use Disorders Insurance Coverage Protection Act, requires most health insurance policies issued or renewed on or after January 1, 2026, to cover medically necessary treatment for mental health and substance use disorders. The bill mandates that insurers follow generally accepted clinical standards when determining coverage and prohibits policies from using discretionary clauses that limit such coverage. It directly affects health insurance providers and policyholders in West Virginia by expanding required benefits for behavioral health care. The law creates new regulatory standards under West Virginia Code §33-57A-1 et seq. and applies to individual, group, hospital, and health maintenance organization plans. This proposal is currently pending in the House Health and Human Resources Committee.