Relating to setting the rate the Public Employees Insurance Agency shall pay for services
Maddy summaryHB 2130 sets reimbursement rates for healthcare providers serving West Virginia public employees and retirees through the Public Employees Insurance Agency. It requires the Agency to pay hospitals at least 110% of Medicare rates for inpatient care (excluding Medicare primary retiree plans) and mandates an 80% employer/20% employee cost-sharing structure for premiums. The bill also requires annual financial plans to be reviewed by an independent actuary, includes public hearings on proposed plans, and allows subsidies for retired employees based on factors like employment length. This directly affects state employees, retirees, and healthcare providers participating in the state insurance program.
Budget & TaxesSupports Budget & TaxesSets reimbursement rates and mandates actuarial reviews to manage healthcare spending within budget constraints, promoting fiscal responsibility.
HealthcareSupports HealthcareMandates 110% of Medicare rates for hospital reimbursement (above standard), increasing provider funding for public employee healthcare coverage and strengthening access to services.
Labor & EmploymentSupports Labor & EmploymentSets higher reimbursement rates (110% Medicare) and 80/20 cost-sharing for public employee healthcare, expanding benefits and reducing employee financial burden.
In committee Feb 12, 2025
0 co-sponsors