Healthcare

signed · West Virginia · House of Delegates Jun 29, 2026

HB 5459: Relating to a tax on managed care organizations

HB 5459 imposes an annual tax on certified health maintenance organizations (HMOs) operating in West Virginia that provide Medicaid services. It establishes tiered tax rates based on Medicaid member months (with higher rates for larger volumes) and non-Medicaid member months, adjusting annually using West Virginia's Medicaid capitation rate changes. Starting July 1, 2027, the tax shifts to a flat 2.5% of each HMO's gross premiums in the state, applying uniformly regardless of membership type. The bill exempts Medicare Advantage plans and certain government health plans as specified in federal law.

Topics ✓ Budget & TaxesSupports Budget & TaxesImposes tax on HMOs to generate state revenue for Medicaid programs, directly increasing government funding under Budget & Taxes.95% confidence ✓ HealthcareSupports HealthcareTax on Medicaid-providing HMOs generates revenue tied to Medicaid capitation rates, potentially funding public health programs per bill's structure.90% confidence

Sub-Topics Medicaid Medicare

in committee · West Virginia · House of Delegates Feb 9, 2026

HB 5343: Establish a medical Adult day care pilot program in Fayette County.

HB 5343 establishes a three-year medical adult day care pilot program in Fayette County for older adults and adults with disabilities who need daytime medical supervision but don’t qualify for nursing home care. The program, funded with $750,000-$1.25 million, provides licensed medical oversight, health monitoring, therapeutic activities, and daily support during weekday hours at a community facility. It targets individuals with chronic conditions, cognitive impairments, or those at risk of needing long-term care, aiming to reduce hospital visits, ease caregiver burden, and delay nursing home placement. If successful, the program could expand statewide after evaluation of outcomes like health stability and cost-effectiveness.

Topics ✓ HealthcareSupports HealthcareBill establishes a funded medical adult day care program providing health monitoring and support for vulnerable adults, expanding access to healthcare services and increasing state healthcare funding.90% confidence

Sub-Topics Hospitals Long-Term Care

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in committee · West Virginia · Senate Feb 19, 2026

SB 994: Relating to Medicaid reimbursement rates for certain mental health procedures

SB 994 requires West Virginia Medicaid to set reimbursement rates for outpatient mental health services at the same level as Medicare Part B rates. It directly affects mental health providers in licensed behavioral health centers who offer services like psychotherapy, medication management, and psychiatric evaluations for adults, children, and families. The bill mandates a state board to develop a proposal for these rate increases by July 1, 2026, ensuring Medicaid rates never fall below Medicare rates for identical services. This change aims to improve payment equity for mental health care providers participating in Medicaid.

Topics ✓ HealthcareSupports HealthcareMandates Medicaid reimbursement rates for mental health services to match Medicare Part B rates, increasing provider payments and improving access to care.95% confidence

Sub-Topics Medicaid Medicare Mental Health

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signed · West Virginia · Senate Jun 25, 2026

SB 828: Supplemental Appropriation to Department of Human Services, fund 5090

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.

Topics ✓ HealthcareSupports HealthcareDirects unspent Medicaid funds to cover ongoing medical provider payments, maintaining current healthcare funding without defunding services.92% confidence

Sub-Topics Medicaid

in committee · West Virginia · House of Delegates Feb 3, 2026

HB 5121: To mandate county boards of education to provide feminine hygiene products in all public elementary, middle, and high schools for female students

HB 5121 requires all West Virginia public elementary, middle, and high schools to provide free tampons and pads to female students. County boards of education must ensure these feminine hygiene products are available at no cost in school facilities. The bill directly affects every public school in the state and its female students by mandating access to these essential items. This policy change replaces any existing requirements with a statewide standard for free provision of such products.

Topics ✓ EducationSupports EducationMandates free feminine hygiene products in all public K-12 schools, directly improving student access to essential items and supporting attendance/participation in education.95% confidence ✓ HealthcareSupports HealthcareMandates free access to feminine hygiene products in schools, improving essential health access for female students as a public health measure.95% confidence

Sub-Topics Student Health

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in committee · West Virginia · House of Delegates Feb 2, 2026

HB 5034: Relating to biometric privacy

HB 5034, the West Virginia Genomic Information Privacy Act of 2026, requires medical facilities, research organizations, and companies collecting genetic data to inform West Virginia residents about how their genetic information is gathered, used, and shared. The bill prohibits these entities from selling, transferring, or using genetic data for foreign adversaries (as defined by federal law) and mandates secure storage of such information. It also establishes a private right of action, allowing individuals to sue if their genetic privacy is violated.

Topics ✓ HealthcareSupports HealthcareProtects genetic data privacy in healthcare settings, strengthening patient rights and data security per medical facility requirements.95% confidence ✓ TechnologySupports TechnologyBill mandates privacy protections for genetic data, requiring transparency and secure handling, directly advancing data privacy safeguards in technology policy.90% confidence

Sub-Topics Consumer Data Protection

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in committee · West Virginia · House of Delegates Feb 16, 2026

HB 5593: Making ivermectin available over the counter in West Virginia

HB 5593 would allow pharmacists in West Virginia to sell ivermectin to consumers without a doctor's prescription. The bill directly affects pharmacies, pharmacists, and anyone purchasing ivermectin for personal use. It adds a new section to state law (§60A-2-204a) specifically permitting over-the-counter sales, dispensing, and possession of ivermectin. This changes current requirements by removing the need for a prescription, making the drug accessible without a healthcare provider's authorization. The bill does not address medical uses or safety considerations, only the regulatory framework for its sale.

Topics ✓ HealthcareSupports HealthcareRemoves prescription requirement for ivermectin, improving patient access to the drug under state law without healthcare provider authorization.90% confidence

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in committee · West Virginia · House of Delegates Feb 13, 2026

HB 5498: Relating to liability protection of a multidisciplinary team member.

HB 5498 clarifies that members of county child abuse investigative teams cannot be personally liable for actions taken during investigations of child sexual assault, abuse, or neglect - such as prosecutors, law enforcement, child protective services workers, health care providers, and mental health professionals. The bill specifically protects team members from liability for routine work in these investigations, but does not shield them from claims arising from gross negligence, willful misconduct, or intentional harm. This amendment to West Virginia law directly affects the 8 permanent team member roles listed in the bill and ensures they can participate without personal legal risk for standard investigative actions. The change aims to strengthen team collaboration by removing personal liability concerns during sensitive child abuse cases.

Topics ✓ HealthcareSupports HealthcareProtects healthcare providers and mental health professionals from liability during child abuse investigations, enabling their participation in care teams without fear of personal liability.95% confidence

Sub-Topics Mental Health

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in committee · West Virginia · House of Delegates Feb 3, 2026

HB 5149: Establishing the West Virginia Prescription Drug Affordability Board

HB 5149 establishes the West Virginia Prescription Drug Affordability Board to address high prescription drug costs for residents and health systems. The board will review pricing for all prescription drugs - including brand name, generic, biologic, and biosimilar drugs - and require transparency from manufacturers about drug costs. It directly affects West Virginia residents, state/local governments, health plans, healthcare providers, and pharmacies by creating a formal process to evaluate affordability challenges. The bill mandates the board to conduct cost studies, require manufacturer disclosures, and issue reports, aiming to reduce financial burdens on patients and the healthcare system.

Topics ✓ HealthcareSupports HealthcareCreates board to lower drug costs via transparency, improving patient access and affordability in healthcare coverage95% confidence

Sub-Topics Prescription Drugs

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in committee · West Virginia · House of Delegates Feb 10, 2026

HB 5103: Relating to requiring the Office of Health Facility Licensure and Certification to inspect office-based medication-assisted treatment programs at least every 24 months

HB 5103 requires the West Virginia Office of Health Facility Licensure and Certification to inspect office-based medication-assisted treatment programs (which provide opioid addiction treatment using medication) at least once every 24 months. These inspections must include reviewing patient records to ensure compliance with licensing rules and may involve a pharmacist and law enforcement officer. The bill mandates formal inspections every two years, in addition to unannounced complaint inspections already allowed. It directly affects opioid treatment programs operating in medical offices across West Virginia.

Topics ✓ HealthcareSupports HealthcareMandates regular inspections for MAT programs to ensure compliance with licensing rules, strengthening oversight of opioid addiction treatment services and patient care standards.92% confidence

Sub-Topics Medical Licensing Substance Abuse

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