Healthcare (Insurance)

This bill establishes mandatory Medicaid program requirements for West Virginia, directly affecting Medicaid enrollees including adults, children, and individuals receiving coverage under the Children’s Health Insurance Program. Key provisions include implementing a work requirement by January 1, 2027; prohibiting Medicaid use by undocumented residents starting October 1, 2026; requiring biannual eligibility verification; ending multi-state enrollment; removing deceased members quarterly; reducing error rates to 3% by 2028; and limiting retroactive eligibility to 30-60 days. The bill aligns West Virginia’s Medicaid program with federal requirements under the One Big Beautiful Bill Act (OBBBA), mandating the Bureau for Medical Services to seek necessary federal authority to implement these changes. It also requires Medicaid waivers to be budget neutral and amends specific taxes related to managed care and providers.

HB 4770 prohibits the use of AI companions (systems designed to simulate human relationships through personalized, ongoing emotional interactions) in delivering mental health therapy services. It requires explicit, written consent for any AI use in mental health care, banning such tools from diagnosing, treating, or claiming to treat conditions. The law applies to all health insurance policies issued or renewed after January 1, 2027, affecting mental health providers and insurers. Exceptions allow AI for administrative tasks (e.g., scheduling) but not for direct therapy or emotional engagement.

This bill (SB 35) limits employer liability when an employee's criminal record for drug addiction-related offenses or diseases is expunged. It requires the state to create a database tracking these expungements and mandates courts to check this database in cases involving such employees. Employers are not required to provide health insurance or cover health care costs related to drug addiction or addiction-related diseases if the employee's record was expunged. The law specifically applies to employees participating in "return to work initiatives" for recovering addicts and does not affect employers' obligations for non-addiction-related issues.