Providing for administration of cost-sharing calculations

SB 832 (West Virginia Senate Bill 832) requires health insurers and pharmacy benefits managers to adjust cost-sharing calculations for insured individuals. It mandates that insurers provide credit toward in-network cost-sharing when a person pays a discounted cash price below the insurer’s average allowed amount for a service. The bill also prohibits insurers from discriminating against individuals who pay cash for in-network services referred by out-of-network providers. These changes apply to all health insurance plans in West Virginia, effective January 1, 2026, and aim to simplify cost-sharing transparency for consumers.