SB 645 West Virginia Senate · 2026 Regular Session

Prohibiting surprise billing of ground emergency medical services by nonparticipating providers

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.

Issues: ✓ Healthcare

Bill status signed all 5 stages cleared

Introduction

Jan 2026

Committee Review

Mar 2026

Senate Passage

Mar 2026

House of Delegates Passage

Mar 2026

Signed into Law

Jun 2026

Introduced Jan 28, 2026 Signed Jun 25, 2026

Maddy AI version diff · 5 comparisons

What changed between versions

sb645 hfa statler am 3-11 _3 adopted adopted.htm → sb645 hfat worrell 3-12 _1 adopted.htm · 3 edits

MINOR

The bill was renumbered and the amendment process was altered. The amendment previously proposed by Delegate Statler, which sought to change a specific dollar amount from 150 to 200, was removed. A new amendment was introduced by Delegate Worrell to replace the bill's title with a comprehensive description covering out-of-network ambulance services, rate establishment, payment procedures, and claims denial notices.

Scope change

The bill's scope is now explicitly defined in the new title to cover out-of-network ambulance services, establishing rates, payment procedures, exceptions, and written notice requirements for denied claims.

REQUIREMENT

The amendment to change the rate threshold from 150 to 200 was removed from the legislative record.

A new title was added that formally outlines the bill's intent to regulate out-of-network ambulance services, set rates, and require written notices for denied claims.

TECHNICAL

The bill identifier was updated from version 3-11 to version 3-12, reflecting a new amendment cycle.

Floor votes · Senate Feb 11, 2026 · House of Delegates Mar 12, 2026

How they voted

31–0

Passed · 2 other

Total votes 33

Feb 11, 2026

D Democratic2

2 Yea

100% Yea

R Republican31

29 Yea 2

93% Yea

Vote distribution

All Yea All Nay Mixed No data

Full legislative history

Actions timeline

Total actions

Key actions

Committee

Amendments

Apr 1, 2026

Signed into law

Approved by Governor 4/1/2026

upper

Mar 14, 2026

Signed into law

Approved by Governor 4/1/2026 - House Journal

lower

Mar 14, 2026

Signed into law

Approved by Governor 4/1/2026 - Senate Journal

upper

Mar 13, 2026

Upper · Passed

Senate concurred in House amendments and passed bill (Roll No. 601)

upper

Mar 12, 2026

Lower · Passed

Title amendment adopted (Voice vote)

lower

Mar 12, 2026

Lower · Passed

Passed House (Roll No. 435)

lower

Mar 12, 2026

Amended

Amendment rejected (Voice vote)

lower

Mar 12, 2026

Lower · Passed

Amendment adopted (Voice vote)

lower

Mar 12, 2026

Introduced

Amendment reported by the Clerk

lower

Mar 12, 2026

Introduced

Motion to reconsider amendment (Roll No. 434)

lower

Mar 12, 2026

Lower · Passed

Motion for previous question adopted (Roll No. 433)

lower

Mar 12, 2026

Amended

Motion to table motion to reconsider amendment rejected (Roll No. 432)

lower

Mar 11, 2026

Amended

Committee amendment rejected (Voice vote)

lower

Mar 11, 2026

Introduced

Amendment reported by the Clerk

lower

Mar 10, 2026

Lower · Passed

With amendment, do pass

lower

Feb 12, 2026

Committee

To House Health and Human Resources

lower

Feb 12, 2026

Committee

To Health and Human Resources

lower

Feb 12, 2026

Introduced

Introduced in House

lower

Feb 11, 2026

Upper · Passed

Passed Senate (Roll No. 67)

upper

Feb 6, 2026

Upper · Passed

Reported do pass

upper

Jan 28, 2026

Introduced

Introduced in Senate

upper

Jan 28, 2026

Committee

To Health and Human Resources

upper

1 primary · 0 co-sponsors