The 2026 Regular Session concluded midnight Saturday, March 14. In total 306 bills (153 House Bills, 153 Senate Bills) completed legislative action. 

The WVHA advanced several bills improving provider enrollment, credentialing, and the behavioral health system, while protecting key budgetary items related to the hospital directed payment program (DPP), Medicaid and PEIA. The team also worked to shield hospitals and health systems from legislation that would have imposed significant financial, clinical, regulatory, and operational burdens. Along with our proactive agenda, defensive tactics were a primary focus this session, and none of it would have been possible without your grassroots support. Thank you.

Below is our Legislative Recap for the 2026 Regular Session. You’ll find an overview of the WVHA’s major legislative achievements, key defensive victories, and other notable healthcare bills—both those that successfully passed and those that did not move forward. If you have any questions about the bills featured or questions about the 2026 Session in general, please contact Tony Gregory.

SB 844 – Supplementary Federal Appropriation for Medicaid Services Passed March 13, 2026 | Effective Immediately | Approved by Governor March 19, 2026 

Overview: SB 844 authorizes more than $1.4 billion in supplemental federal funding for the Department of Human Services to support Medicaid services across West Virginia for the fiscal year ending June 30, 2026. This appropriation is critical to maintaining the stability of the state's healthcare system, preventing service disruptions, and ensuring the state can meet its financial obligations to hospitals and other providers.

Key Provisions:

Medical Services Funding: The bill increases the existing federal funds appropriation for Medicaid medical services by $1,373,097,966, providing essential resources to sustain coverage and reimbursement for healthcare services delivered to Medicaid beneficiaries across the state.

Administrative Costs Funding: An additional $37,000,000 in federal funds is appropriated for Medicaid administrative costs, supporting the operational infrastructure necessary to administer the program effectively.

Directed Payment Program Obligations: A key purpose of this supplemental appropriation is to enable the timely distribution of remaining funds owed to hospitals under the State Fiscal Year 2025 Directed Payment Program (DPP) — ensuring that hospitals receive payments already earned for services rendered to Medicaid managed care patients.

Executive Request: The appropriation was requested by the Governor following the establishment of available federal funds for expenditure in the current fiscal year, and takes effect immediately upon passage.

Impact on Members: This is among the most consequential pieces of legislation of the 2026 session for West Virginia hospitals. The $1.4 billion supplemental appropriation directly supports Medicaid reimbursement flows that hospitals depend on to sustain operations and serve patients. Most immediately, it clears the path for outstanding DPP payments owed to hospitals under SFY 2025 — funds that are critical to financial stability for many WVHA members. Hospitals should monitor the Department of Human Services and Bureau for Medical Services for guidance on the timing and distribution of these payments.

SB 650 – State-Designated Hospital Status for Forensic Psychiatric Facilities Passed March 9, 2026 | Effective Immediately

Overview: SB 650 makes a targeted but financially significant amendment to West Virginia's healthcare provider tax statute by clarifying the definition of "state-designated facility" to include certain private psychiatric hospitals that serve predominantly court-ordered forensic and civil involuntary commitment patients from state custody. The bill directly addresses a critical funding imbalance affecting Highland Clarksburg Hospital, which functions as an extension of the state hospital system but has faced unsustainable financial burdens under the current Directed Payment Program (DPP).

Key Provisions:

State-Designated Facility Definition Expanded: A licensed psychiatric hospital with an average annual inpatient census where more than 95 percent of patients are court-ordered forensic and civil involuntary commitments from state custody or from a state-owned hospital now qualifies as a "state-designated facility" for purposes of the healthcare provider tax.

Practical Effect – Tax Exclusion: Hospitals that qualify as state-designated facilities are excluded from the eligible hospital definition under the directed payment program provider tax. Qualifying psychiatric hospitals will no longer be subject to the additional healthcare provider tax imposed on eligible acute care hospitals, nor will they contribute to or benefit from the Eligible Facility Directed Payment Program Enhancement Account.

Impact on Members: While this bill is narrowly targeted at psychiatric facilities whose patient populations consist almost entirely of court-committed or state-transferred individuals, it carries a broader message for WVHA members about the importance of ensuring that provider tax structures account for hospitals with unique and specialized patient mixes. General acute care hospitals are not directly affected by this change.

HB 5459 – Managed Care Organization Healthcare Provider Tax Restructuring Passed March 11, 2026 | Effective June 9, 2026 (Tax Structure Change Effective July 1, 2027)

Overview: HB 5459 restructures the healthcare provider tax imposed on managed care organizations (MCOs) in West Virginia, transitioning from a tiered per-member-per-month assessment method to a uniform gross premium-based tax beginning July 1, 2027, subject to federal approval. The change is designed to create a broader, more consistent tax base across all MCOs operating in the state.

Key Provisions:

New Tax Rate and Structure: Beginning July 1, 2027, the MCO provider tax will be set at 2.5 percent of gross premiums written in West Virginia during each calendar quarter. Gross premiums are defined to include total premiums, capitation payments, or other consideration received by the MCO for providing or arranging healthcare services to enrollees in the state.

Uniform Application: The new tax rate applies uniformly to all certified HMOs regardless of their Medicaid, Medicare, commercial, or non-Medicaid membership mix — eliminating the previous tiered structure that differentiated tax rates based on member type or volume.

Exemptions: The tax does not apply to Medicare Advantage plans, PEIA health plans, or plans issued under the Federal Employees Health Benefits Act to the extent federal law preempts such taxation.

Transition Period: The existing tiered member-month tax structure remains in full force and effect until July 1, 2027, ensuring no gap in MCO tax collections during the transition period.

Federal Approval Requirement: The transition to the gross premium assessment method is contingent on CMS determining that the new structure constitutes a permissible broad-based healthcare-related tax eligible for federal financial participation under 42 C.F.R. §433.68. If CMS determines the tax is no longer permissible, it becomes automatically void.

Collection Trigger: No taxes may be collected under the new structure until the state receives written notice from CMS that proposed Medicaid rates have been approved as actuarially sound for the applicable tax year.

Impact on Members: While this tax is levied on MCOs rather than hospitals directly, the structure of MCO provider taxes has significant downstream implications for hospitals. MCO provider taxes serve as a key mechanism for generating the non-federal share of Medicaid funding that supports directed payment programs and other Medicaid reimbursement enhancements that flow to hospitals. The shift to a gross premium-based assessment is intended to create a more stable and predictable tax base, which should support more consistent Medicaid funding flows. WVHA members should monitor CMS approval of the new tax structure and its interaction with actuarial soundness determinations for Medicaid managed care rates, as these directly affect the financial environment in which hospital-MCO contracting occurs.

SB 570 – Supplementary Federal Appropriation for Rural Health Transformation Passed March 13, 2026 | Effective Immediately | Approved by Governor March 17, 2026

Overview: SB 570 is a supplementary appropriation bill that directs newly available federal funds to the West Virginia Department of Health for rural health transformation initiatives in the current fiscal year. For a summary, please visit here.

Key Provisions:

Federal Funds Appropriation: The bill appropriates $199,476,099 in federal funds to the Department of Health Central Office for the fiscal year ending June 30, 2026. The funds are designated specifically for the Rural Health Transformation Program.

Executive Request: The appropriation was requested by the Governor following the establishment of available federal funds for expenditure in the current fiscal year, and takes effect immediately upon passage.

Impact on Members: This is a significant federal investment in rural healthcare delivery in West Virginia. While the bill does not specify programmatic details, the scale of the appropriation suggests meaningful potential for hospitals and health systems — particularly those serving rural communities — to benefit from related program funding, initiatives, or partnerships. WVHA members should monitor how the Department of Health structures and deploys these funds, and engage early with the department to understand eligibility and participation opportunities.

HB 4740 – Purchasing Exemption for Rural Health Transformation Program Passed February 19, 2026 | Effective Immediately | Approved by Governor February 27, 2026

Overview: HB 4740 exempts the Department of Health from the state's standard purchasing and procurement requirements specifically for implementation of the federally funded Rural Health Transformation Program, enabling faster and more flexible deployment of awarded funds in compliance with federal requirements.

Key Provisions:

Procurement Exemption: The Department of Health is exempt from West Virginia's standard purchasing division statutes for all activities related to implementing the Rural Health Transformation Program. This allows the department to bypass normal state procurement processes where federal program requirements may conflict or where standard timelines would impede compliant use of funds.

Legislative Findings – Federal Program Context: The Legislature explicitly recognizes that West Virginia's application for Rural Health Transformation Program funding was submitted to CMS on November 5, 2025, and that an award was granted on or about December 29, 2025. The findings acknowledge that CMS requires rapid, targeted deployment of funds within rigid timeframes, and that failure to comply could trigger clawbacks of current and future awards.

Compliance Imperative: The exemption is framed as necessary to ensure the state meets CMS monitoring and compliance requirements, not as a general loosening of procurement oversight.

Impact on Members: This bill is closely connected to the $199.5 million federal appropriation in SB 570 and signals that the state is moving quickly to stand up the Rural Health Transformation Program. The procurement flexibility granted here should allow the Department of Health to contract with hospitals, health systems, and other providers more nimbly than standard state processes would permit. WVHA members should actively engage with the Department of Health to understand contracting opportunities and program timelines as implementation begins.

HB 4982 – Make West Virginia Healthy Act of 2026 Passed February 20, 2026 | Effective May 21, 2026 | Approved by Governor February 28, 2026

Overview: HB 4982 reestablishes and significantly expands West Virginia's statewide healthy lifestyles infrastructure, creating new programs addressing nutrition, physical fitness, and chronic disease prevention. The bill is closely tied to the Rural Health Transformation Program and introduces a "Food Is Medicine" initiative within Medicaid.

Key Provisions:

Food Is Medicine – Medicaid Authorization: The Bureau for Medical Services is directed to permit and encourage Medicaid managed care organizations to offer Food Is Medicine services for members with nutrition-related chronic diseases. Covered services include medically tailored meals, produce prescriptions, nutrition counseling, grocery provisions, and nutrition case management. MCOs are encouraged to partner with community-based organizations and prioritize locally grown West Virginia food.

Office of Healthy Lifestyles – Reestablished: The Office of Healthy Lifestyles is formally reestablished within the Department of Health, with expanded authority to coordinate wellness initiatives across state agencies. A 13-member Healthy Lifestyle Coalition must be appointed by July 1, 2026, and will meet monthly to align public health and private sector approaches to wellness.

Healthy Lifestyles Fund: A dedicated special revenue fund is continued in the State Treasury to support program activities, funded through legislative appropriations, grants, gifts, and other sources. Fund balances do not revert to the General Revenue Fund at year end.

Cross-Agency Coordination: The Office of Healthy Lifestyles is tasked with coordinating efforts across multiple state agencies, including the Departments of Education, Agriculture, and Human Services, with specific directives to develop a Farm-to-School program, map food desert zones, study the health impacts of food additives and dyes, and identify local food vendors.

Physical Education Requirements in Schools: The bill strengthens physical education mandates, requiring 30 minutes of PE at least three days per week in elementary schools, one full period per day for one semester in middle school, and one full course credit for high school graduation. Schools may not use restriction from physical activity as an academic or behavioral penalty.

Section 1115 Waiver – Medicaid Demonstration: The Office of Healthy Lifestyles is directed to work with the Bureau for Medical Services to develop a Section 1115 demonstration waiver to the federal government documenting the impact of the Food Is Medicine program, with results reported to the Legislative Oversight Committee.

County Grant Program: A new grant program is established to help counties advance healthy lifestyle goals, with priority given to schools seeking to expand Farm-to-School participation.

Annual Reporting: The Office of Healthy Lifestyles must report annually by December 1st to the Legislative Oversight Commission on Health and Human Resources Accountability, covering outcomes across education, agriculture, Medicaid, and SNAP coordination efforts.

Impact on Members: This bill has direct relevance for hospitals and health systems, particularly those serving Medicaid populations in rural areas. The Food Is Medicine authorization within Medicaid creates new opportunities for providers and MCOs to integrate nutrition-based interventions into care management. Hospitals should monitor how the Bureau for Medical Services structures Food Is Medicine guidance and standards for MCOs, and consider how community health and care management programs may align with these new initiatives.

HB 4951 – Nutrition Education Requirement for Physician Continuing Medical Education Passed March 14, 2026 | Effective June 12, 2026

Overview: HB 4951 makes a targeted but meaningful addition to continuing medical education requirements for physicians in West Virginia, mandating that nutrition education be included as part of the CME that physicians must complete to renew their licenses. The requirement applies to allopathic physicians, podiatrists, and osteopathic physicians and surgeons.

Key Provisions:

Nutrition CME Requirement – Allopathic Physicians and Podiatrists: The existing requirement of 50 hours of continuing medical education per two-year renewal period is amended to explicitly include completion of medical education in nutrition as part of the CME requirement. The bill does not specify a minimum number of nutrition-specific hours, leaving the scope and content standards to the West Virginia Board of Medicine.

Nutrition CME Requirement – Osteopathic Physicians: The same nutrition education requirement is added to the biennial 32-hour CME renewal requirement for osteopathic physicians and surgeons licensed under the West Virginia Board of Osteopathic Medicine, with the same flexibility on specific hour requirements.

Alignment with Broader Health Policy Goals: The bill is consistent with and complementary to the Make West Virginia Healthy Act (HB 4982) and the Food Is Medicine provisions enacted this session, reflecting a broader legislative emphasis on nutrition as a cornerstone of chronic disease prevention and health improvement in West Virginia.

Impact on Members: Hospitals and health systems should be aware that physicians on their medical staffs will now be required to include nutrition-focused education in their CME portfolios at the time of license renewal. While the requirement does not mandate a specific number of nutrition hours, CME program administrators and medical staff offices may wish to ensure that nutrition-related educational offerings are available and clearly documented for physicians seeking to satisfy this requirement. This change also presents an opportunity for hospitals to offer or promote nutrition-focused CME programming as part of broader workforce development and wellness initiatives.

HB 4335 – Medicaid Provider Enrollment & Credentialing Reform Passed February 20, 2026 | Effective Immediately with internal effective dates | Approved by Governor February 28, 2026

Overview: HB 4335 modernizes and streamlines the Medicaid provider enrollment and credentialing process in West Virginia, establishing firm timelines, standardized forms, and electronic submission requirements effective July 1, 2026.

Key Provisions:

Expedited Enrollment: The Department of Human Services (or its fiscal agent) must complete Medicaid provider enrollment determinations within 5 business days of receiving a completed application. Incomplete applications must be flagged electronically within 2 business days with specific guidance on missing materials.

Credentialing Timelines for MCOs: Medicaid managed care organizations (MCOs) must complete provider credentialing within 60 calendar days of a clean and complete application, with a possible one-time 30-day extension upon written justification. MCOs that miss deadlines face penalties including corrective action plans, monetary sanctions, or credentialing-by-default.

Standardized Credentialing Forms: The Office of the Insurance Commissioner will prescribe a uniform CAQH-based electronic credentialing form. MCOs must use this standard form and may not require providers to submit additional information beyond what it requests.

Mandatory Electronic Submission: All enrollment and credentialing applications, renewals, and supporting documents must be submitted electronically only beginning July 1, 2026.

Cleanup of Existing Law: The bill repeals the now-redundant uniform credentialing statutes under Chapter 16, Article 1A (§16-1A-1 through §16-1A-10).

Impact on Members: This legislation should meaningfully reduce administrative burden for hospitals and health systems by accelerating provider enrollment, standardizing credentialing paperwork, and eliminating duplicative processes — helping providers join Medicaid networks and begin serving patients more quickly.

SB 741 – Involuntary Commitment Pilot Program Expansion Passed March 12, 2026 | Effective June 10, 2026 | Approved by Governor March 18, 2026

Overview: SB 741 expands West Virginia's existing involuntary commitment pilot program to additional counties, while preserving existing safeguards and collaborative oversight structures established under prior law.

Key Provisions:

Expanded Pilot Geography: The involuntary commitment pilot program is extended to Hampshire, Morgan,  Raleigh, and Wood counties (in addition to the existing counties of Cabell, Berkeley, and Ohio), allowing the Supreme Court of Appeals, mental health facilities, law enforcement, the Department of Human Services, and the Department of Health Facilities to participate.

Alternative Transportation Safeguards: No alternative transportation provider may be used in the commitment process until formal standards — covering role, scope, regulation, and training — have been developed and implemented, consistent with the evaluation process outlined in existing law.

Mental Health Center Obligations: Mental health centers must make licensed evaluators available for prompt commitment evaluations, conducted in person when possible or by videoconference when in-person would cause substantial delay. Evaluators must also explain the commitment process, identify alternative treatment options, and communicate necessary information to state hospitals to facilitate timely admissions.

Ongoing Audit Process: The Department of Human Services is required to conduct retrospective quarterly audits of involuntary civil commitment applications to assess clinical justification and compliance, with findings kept confidential.

Impact on Members: The bill reinforces the importance of prompt clinical evaluations and clear communication with state hospital staff to ensure orderly patient transitions.

SB 742 – Involuntary Hospitalization Process Modifications Passed March 14, 2026 | Effective June 12, 2026

Overview: SB 742 streamlines the involuntary hospitalization process for hospital emergency departments by expanding physician authority to act independently and extending the deadline for filing mental hygiene petitions.

Key Provisions:

Expanded Physician Authority: An authorized staff physician may now order up to 72 hours of involuntary hospitalization without first contacting a list of enumerated individuals, provided the physician believes — following an examination — that the patient is mentally ill or addicted and, because of his or her mental illness or addiction, is likely to cause serious harm to themselves or others. The physician must sign a written statement attesting to the decision.

Extended Mental Hygiene Petition Deadline: If longer-term involuntary treatment is needed, the deadline to file a mental hygiene petition has been extended from 24 to 72 hours from the time of involuntary hospitalization, giving physicians and hospital staff more time to complete the necessary documentation before a formal hearing is triggered.

Treatment During Holds: Patients may receive treatment during the involuntary hold period, with consent, or during a medical or psychiatric emergency. Hospitals and physicians are required to assess existing medical needs and provide necessary care, including previously prescribed medications.

Payment Protections: Hospitals and physicians are to be reimbursed at negotiated insurer rates. For uninsured patients, providers may file a claim with the West Virginia Legislative Claims Commission.

Liability Protections: Authorized staff physicians and hospital employees acting in good faith, within the scope of their duties, and consistent with the standard of care are protected from liability for their actions.

No Adjudication Effect: An involuntary hold instituted under this section does not constitute a legal adjudication of mental incompetence for the individual and cannot be construed  to satisfy firearms disability requirements under state law.

Impact on Members This bill directly affects hospital emergency departments by giving authorized staff physicians or designated employees clearer, more independent authority to initiate involuntary holds and providing additional time to complete mental hygiene filings. Hospitals should update policies, ensure staff are familiar with the new documentation requirements and expanded timelines, and confirm they have current contact information for mental hygiene commissioners in their county.

SB 200 – Enhanced Penalties for Assault on Healthcare Workers and Other Protected Persons Passed March 13, 2026 | Effective June 11, 2026 | Approved by Governor March 25, 2026

Overview:  SB 200 strengthens criminal penalties for assault, battery, and related offenses committed against healthcare workers, government representatives, law enforcement, emergency service personnel, utility workers, and correctional employees. It also consolidates and enhances protections for law enforcement animals into the criminal code.

Key Provisions:

Enhanced Penalties for Assault on Healthcare Workers: The bill explicitly includes healthcare workers — defined as nurses, nurse practitioners, physicians, physician assistants, and technicians employed by or under contract to hospitals, health departments, long-term care facilities, physician offices, clinics, or outpatient facilities — among the protected class of individuals covered by elevated criminal fines and penalties, including:

• Malicious assault (intent to maim, disfigure, disable, or kill): felony, 3–15 years imprisonment
• Unlawful assault: felony, 2–5 years imprisonment
• Battery: felony, 1-3 years for a first offense, escalating to up to 10 years for a third offense
• Assault: felony, 1–3 years imprisonment and/or fines up to $200

Repeat Offender Escalation: Battery convictions carry escalating penalties for repeat offenders, with fines increasing from $500 for a first offense up to $2,000 for a third offense, and prison terms increasing accordingly.

Public Safety Animal Protections: The bill moves protections for law enforcement animals out of the agriculture code and into the criminal code, establishing misdemeanor and felony penalties for injuring or killing a public safety animal on duty. Willfully causing death of a public safety animal carries fines of $2,000–$5,000 and up to 10 years imprisonment.

Impact on Members This bill is directly relevant to hospitals and health systems. By explicitly naming healthcare workers as a protected class subject to enhanced assault and battery penalties, it sends a clear signal that violence against clinical and support staff will carry serious criminal consequences. Hospital administrators and security teams may wish to communicate these updated protections to staff and review any related workplace safety and incident reporting policies.

HB 5458 – Medical Practice Act Revisions and Genetic Counselors Practice Act Passed March 9, 2026 | Effective June 7, 2026

Overview: HB 5458 makes broad updates to the West Virginia Medical Practice Act, streamlines and consolidates special license types, and establishes a new licensing framework for genetic counselors under the newly created Genetic Counselors Practice Act.

Key Provisions:

Genetic Counselors Practice Act – New Licensure Framework: Effective July 1, 2026, genetic counselors must hold a valid license issued by the West Virginia Board of Medicine to practice in the state. Licensure requires a master's degree from an accredited genetic counseling program and current certification from the American Board of Genetic Counseling (ABGC) or the American Board of Medical Genetics and Genomics (ABMG). Licenses expire biennially and require 30 hours of continuing education for renewal.

Active Candidate Status (ACS) Permits: Individuals who have attained Active Candidate Status with the ABGC but have not yet passed the certification exam may obtain a one-year ACS permit to practice genetic counseling under the supervision of a qualified supervisor — either a licensed genetic counselor or a licensed physician.

Scope of Practice: Licensed genetic counselors may obtain and evaluate patient and family medical histories, coordinate genetic laboratory testing, communicate risk factors, and provide counseling and anticipatory guidance. Genetic counselors may not diagnose or treat disease, and must refer patients requiring diagnosis or treatment to a licensed physician. Genetic counselors may provide telehealth services. Notably, genetic counselors are explicitly prohibited from recommending that an expectant mother obtain an elective abortion.

Insurance Reimbursement Parity: Genetic counselors are designated as providers and may not be reimbursed at rates lower than other providers rendering similar services by health insurers or state health plans.

Healthcare Facility Reporting: Hospitals and healthcare facilities must report to the Board of Medicine within 60 days of completing any formal disciplinary action against a licensed genetic counselor, including revocation, restriction, or termination of practice privileges.

Criminal Penalty for Impersonating a Physician: Any genetic counselor or ACS permittee who represents themselves as a licensed physician is guilty of a felony, punishable by 1–2 years imprisonment and/or a fine up to $2,000.

Medical Practice Act Housekeeping: The bill consolidates and modernizes several existing provisions, including codifying special license types (restricted licenses in extraordinary circumstances, medical school faculty licenses, and summer camp licenses), authorizing electronic signatures on licenses, creating separate complaint files distinct from a licensee's historical record, and repealing several outdated and duplicative provisions.

Criminal Background Checks: Genetic counseling applicants are added to the list of health professions subject to criminal background check requirements under "Lynette's Law," requiring fingerprint-based state and federal criminal history checks for all first-time applicants

Impact on Members: Hospitals and health systems that employ or credential genetic counselors should prepare for the new licensure requirement taking effect July 1, 2026. Credentialing staff will need to verify Board of Medicine licensure for genetic counselors as part of standard privileging processes. The new facility reporting requirement also places an affirmative obligation on hospitals to notify the Board within 60 days of any formal disciplinary action involving a genetic counselor on staff. Additionally, the reimbursement parity provision may affect contract negotiations with MCOs and insurers for genetic counseling services.

HB 4089 – Jessica Huffman's Law: Scalp Cooling Coverage for Cancer Patients Passed March 10, 2026 | Effective June 8, 2026 (Coverage Requirement Effective January 1, 2027)

Overview: HB 4089, designated "Jessica Huffman's Law," requires health insurers across all major coverage categories in West Virginia to provide coverage for scalp cooling systems used by cancer patients undergoing chemotherapy to prevent or reduce hair loss. The coverage mandate takes effect for all policies issued or renewed on or after January 1, 2027.

Key Provisions:

Scalp Cooling Coverage Mandate: Any insurer that covers cancer chemotherapy treatment must also cover scalp cooling systems — defined as devices designed and intended for repeated use to cool the human scalp for the purpose of preventing or reducing chemotherapy-related hair loss, consistent with CMS definitions. Standard cost-sharing provisions such as deductibles, copayments, and coinsurance may apply, consistent with other benefits in the policy.

Broad Coverage Scope: The mandate applies across all major insurance product types in West Virginia, including individual accident and sickness policies, group insurance plans, hospital and medical service corporations, healthcare corporations, health maintenance organizations, public employees insurance, and Medicaid managed care plans.

Effective Date for Coverage: While the bill takes effect 90 days from passage, the actual insurance coverage requirement applies to policies issued or renewed on or after January 1, 2027, giving insurers and health plans time to update their benefit structures accordingly.

Impact on Members: Hospitals and cancer centers that offer scalp cooling services should anticipate increased insurance coverage for this treatment beginning in 2027, which may expand patient access and reduce financial barriers for chemotherapy patients seeking scalp cooling therapy. Oncology programs may wish to review their current scalp cooling capabilities and billing practices in advance of the January 1, 2027 effective date to ensure they are positioned to support patients in accessing this newly mandated benefit.

SB 231 – Value-Based Payment Requirements for Addiction Care Passed March 14, 2026 | Effective June 12, 2026

Overview: SB 231 establishes a framework to transition West Virginia's Medicaid addiction care system from a fee-for-service model to a value-based payment structure tied to measurable long-term recovery outcomes. The Legislature finds that the current addiction care system is fragmented and not aligned to outcomes, and this bill directs the Bureau for Medical Services to build the data infrastructure, outcome measures, and payment models necessary to incentivize coordination and accountability across the full continuum of substance use disorder care.

Key Provisions:

Standard Billing Codes: By October 1, 2026, the Bureau for Medical Services (BMS), in conjunction with managed care organizations, must establish standard billing codes for all substance use disorder services across the continuum of care, with providers required to use those codes by January 15, 2027.

Outcome-Based Performance Measures: By July 1, 2026, BMS — in consultation with the Bureau for Behavioral Health, West Virginia University, Marshall University, providers, individuals in recovery, law enforcement, and other stakeholders — must develop outcome-based performance measures for each level of addiction treatment and recovery care. Key metrics include housing stability, sobriety, criminal justice and child welfare avoidance, self-sufficiency, and provider transition planning.

Baseline Data Collection: Beginning no later than July 1, 2027, a one-year baseline period will be established during which performance data on cost, quality, utilization, and outcomes will be collected and analyzed to set benchmarks. Providers will receive benchmark data during the baseline year to allow for performance improvement before payment adjustments take effect.

Value-Based Payment Implementation: By July 1, 2028, BMS must require MCOs to implement value-based payments aligned with the approved outcome measures and billing codes. The model will include enhanced payments for providers that meet or exceed outcome benchmarks and reduced payments for those that fall short.

Provider Accountability: Providers who fail to meet established outcome measures for three consecutive quarters are subject to de-certification, code blocking, termination, or exclusion from the Medicaid program.

Data Reporting: BMS must submit annual reports to the Legislative Oversight Commission on Health and Human Resources Accountability beginning January 1, 2028, covering utilization trends and costs by provider type. Outcome data must be included beginning July 1, 2028, with comparisons to prior year data and national benchmarks, including neonatal abstinence syndrome rates and adult overdose deaths.

CMS Approval Required: BMS must submit a state plan amendment to CMS by October 1, 2026 to obtain necessary federal authority. The entire article has no force or effect if CMS does not approve the amendment.

Impact on Members: This bill has significant implications for hospitals and health systems that provide substance use disorder treatment services, including inpatient detoxification, medication-assisted treatment, and behavioral health services billed through Medicaid. The shift to value-based payment will require providers to invest in data tracking, outcome reporting, and care coordination infrastructure. Hospitals should engage early in the stakeholder process for developing outcome measures and billing codes, and begin assessing their current SUD program performance against the metrics outlined in the bill — particularly housing stability, sobriety, and care transition planning — ahead of the 2027 baseline year.

HB 5086 – Peer Support Programs for Healthcare Workers and First Responders Passed March 14, 2026 | Effective June 12, 2026

Overview: HB 5086 represents a critical step forward in supporting the mental health and well-being of West Virginia's healthcare workforce. The bill establishes clear standards for peer support programs, enabling hospitals and other providers to offer structured, confidential support to caregivers experiencing the stress and trauma inherent in their professions. By protecting caregivers from licensure discipline solely for seeking help and creating a testimonial privilege for peer support communications, the bill removes longstanding barriers to accessing care.

Key Provisions:

Broad Coverage of Healthcare Professionals: The bill defines "covered caregivers" broadly to include physicians, physician assistants, registered and practical nurses, osteopathic physicians, medical residents, psychologists, counselors, social workers, chaplains, pharmacists, first responders, and any other licensed or certified professional designated by a hospital's governing authority as a healthcare professional — ensuring the protections extend across the full spectrum of hospital staff.

Peer Support Program Standards: Employers and organizations may establish formal or informal peer support programs and appoint qualified advisors — including psychiatrists, psychologists, psychiatric-mental health nurse practitioners, licensed counselors, or licensed social workers — to ensure peer support team members are appropriately trained and providing proper services.

Training Requirements: To receive the bill's testimonial privilege protections, peer support team members must complete a minimum of eight hours of initial basic peer support training and participate in additional refresher training at least quarterly. Training must cover peer support skills, mental health risk factor identification, confidentiality, local resources, and communication techniques.

Licensure Discipline Protections: Licensing boards may not take disciplinary action against a caregiver solely because the caregiver voluntarily seeks or participates in peer support, counseling, or therapy. Boards are also prohibited from requiring disclosure of participation in peer support or mental health services unless required by federal law or necessary to determine current fitness to practice. Boards retain the authority to require participation in board-designated professional health programs.

Testimonial Privilege: Peer support team members may not be compelled to testify about communications received from or advice given to individuals who receive peer support services. Exceptions apply when communications indicate a clear and present danger, involve criminal acts, or when the individual receiving services consents to or voluntarily provides testimony. Past or present child abuse or neglect is explicitly designated as a clear and present danger for purposes of the privilege.

Impact on Members: This bill has direct and meaningful implications for hospitals and health systems. Hospitals that establish or expand peer support programs consistent with these new standards will be better positioned to support workforce well-being, reduce burnout, and retain clinical staff. The licensure protection and testimonial privilege provisions remove two of the most significant deterrents to help-seeking among caregivers. Hospital administrators and human resources teams should review existing peer support program structures and ensure they align with the training and designation requirements established by this legislation.

HB 5430 – Pharmacy Benefit Manager Reform and Cost Containment Passed March 13, 2026 | Effective Immediately

Overview HB 5430 makes significant reforms to how pharmacy benefit managers (PBMs) operate in West Virginia, strengthening consumer and provider protections, expanding PBM oversight to the Public Employees Insurance Agency (PEIA), prohibiting certain anti-competitive PBM ownership structures, and requiring new cost containment initiatives in both PEIA and Medicaid.

Key Provisions:

PEIA Subject to Pharmacy Audit Integrity Act: PBM contracts with the Public Employees Insurance Agency are now explicitly subject to the requirements of West Virginia's Pharmacy Audit Integrity Act and the jurisdiction of the Office of the Insurance Commissioner, closing a gap that previously left PEIA outside this oversight framework. Medicare-related provisions are expressly excluded from conflict.

PBM Reimbursement Floor: PBMs may not reimburse a West Virginia pharmacy or pharmacist for a prescription drug in an amount less than the national average drug acquisition cost plus a professional dispensing fee of $10.49. If national average drug acquisition cost data is unavailable, the wholesale acquisition cost plus the dispensing fee applies as the floor.

Prohibition on Self-Dealing: PBMs are explicitly prohibited from reimbursing a pharmacy or pharmacist less than the amount the PBM reimburses itself or an affiliate for the same drug or service — a direct prohibition on the spread pricing practices that have disadvantaged independent and hospital-based pharmacies.

340B Program Protections: PBMs may not reimburse 340B entities at rates lower than those paid to comparable non-340B pharmacies, assess additional fees or chargebacks on the basis of 340B participation, or discriminate against 340B entities in network participation. These protections explicitly apply to PEIA as well, a significant expansion for hospital 340B programs.

Rebate Pass-Through: At least 100 percent of all PBM rebates must be applied to reduce a covered individual's cost-sharing at the point of sale. For PEIA specifically, 100 percent of all rebates must be passed on to the plan to reduce premiums rather than retained by the PBM.

PEIA Cost Containment Vendor: By July 1, 2026, PEIA must issue a competitive bid for a pharmacy cost containment vendor — separate from any PBM contract — to engage prescribing providers with information on lowest net cost drug options and clinically appropriate polypharmacy reduction. Prescribers are not required to change their prescribing, but PEIA retains discretion to modify its formulary based on vendor recommendations.

Medicaid Pilot Program: By July 1, 2026, the Medicaid program must establish a one-year pilot program using a pharmacy cost containment vendor to present prescribers with cost and effectiveness data. The pilot may not increase state expenditures relative to projected savings, and if net savings are demonstrated, Medicaid may enter into a long-term contract with the vendor before the pilot concludes.

Medicaid PBM Self-Dealing Prohibition: Any PBM managing Medicaid pharmacy benefits may not reimburse a pharmacy less than it reimburses itself or an affiliate for the same drug or service.

Pharmacy Dispensing Fee Study: The Office of the Insurance Commissioner must conduct and submit a study of the cost to dispense outpatient prescriptions in West Virginia by December 1, 2026, with a presentation to legislative oversight committees by January 15, 2027, and biennially thereafter.

Impact on Members: This bill has meaningful implications for hospital systems with pharmacy operations, particularly those participating in the 340B drug pricing program. The explicit extension of 340B protections to PEIA and the prohibition on discriminatory PBM practices against 340B entities strengthens the ability of hospital pharmacies to participate in networks on equal footing. The self-dealing prohibition and reimbursement floor also benefit hospital outpatient pharmacies by ensuring more equitable and transparent reimbursement. Hospital pharmacy and finance teams should review their current PBM contract terms and 340B arrangements in light of these new protections, and monitor implementation guidance from the Office of the Insurance Commissioner.

HB 4196 – Long-Acting Reversible Contraception Requirements for Medication-Assisted Treatment Programs Passed February 20, 2026 | Effective May 21, 2026 | Approved by Governor February 27, 2026

Overview: HB 4196 amends the Medication-Assisted Treatment Program Licensing Act to require MAT programs to offer long-acting reversible contraception (LARC) to patients recovering from addiction. The bill establishes specific standards for contraceptive counseling and medical assessment, while emphasizing patient autonomy and non-coercive care.

Key Provisions:

LARC Offering Requirement: All licensed medication-assisted treatment programs must offer long-acting reversible contraception to patients as part of their treatment protocols. The requirement applies to both male and female patients and is embedded within the broader patient protocol and treatment planning requirements that MAT programs must follow.

Non-Coercive Contraceptive Counseling: MAT programs must provide shared decision-making contraceptive counseling that is non-coercive and tailored to the patient's lifestyle, health needs, and personal preferences. Counseling must ensure informed choice and include medical eligibility screening for potential contraindications.

Provider Qualification Requirements: A MAT program may not place or insert a LARC device unless it has a licensed, trained healthcare provider on staff to perform the procedure. Programs that lack a qualified provider or necessary equipment must establish a referral system to direct patients to a licensed healthcare provider or clinic capable of delivering the full range of contraceptive services.

Referral Network Obligation: The referral requirement ensures that even programs without in-house LARC capability cannot simply decline to offer the service — they must actively connect patients to appropriate outside providers, preserving patient access to contraceptive care.

Broader MAT Program Context: The bill is part of a broader update to MAT program operational requirements, which also include existing provisions around medical director qualifications, controlled substance monitoring, drug testing, buprenorphine dosing documentation, telehealth, and tapering schedule compliance.

Impact on Members: Hospitals and health systems that operate or are affiliated with medication-assisted treatment programs should review their current protocols and provider capacity to ensure compliance with the new LARC offering and counseling requirements by May 21, 2026. Programs without qualified on-site providers for LARC insertion will need to establish formal referral arrangements with OB/GYN providers or family planning clinics ahead of the effective date. This bill also reinforces the importance of integrating reproductive health services into addiction care — an area where hospitals are well-positioned to support comprehensive, coordinated treatment for patients in recovery.

HB 5168 – Emergency Medical Services Funding and Data Center Fee Obligations Passed March 14, 2026 | Effective June 12, 2026

Overview: HB 5168 establishes new dedicated funding streams for emergency medical services across West Virginia, drawing on State Lottery net profits to support EMS salary enhancement, crisis response, mental health treatment, and county-level EMS operations. The bill also clarifies that certified microgrid districts and high impact data centers are obligated to pay county fire and ambulance fees, closing a potential gap in local EMS funding as large-scale data center development expands in the state.

Key Provisions:

Lottery-Funded EMS Appropriations: Following the end of each fiscal year, the State Lottery Commission must allocate up to $12 million annually from remaining net profits to three EMS-related funds, distributed as follows:

• $6 million to the Emergency Medical Services Crisis Response and Mental Health Treatment Fund
• $3 million to the new County Emergency Medical Services Fund (for counties with existing EMS levies or dedicated fees)
• $3 million to the new All-County Emergency Medical Services Fund (distributed to all counties based on population)

All allocations are subject to availability of remaining lottery net profits and are reduced pro rata if insufficient funds exist.

EMS Crisis Response and Mental Health Treatment Fund: The existing EMS Salary Enhancement Fund is renamed and expanded to include crisis response and mental health treatment as authorized uses. The first $1 million of lottery transfers each year must be used specifically for mental health training and treatment for EMS personnel, including Crisis Intervention Team training, peer support programs, Adult Mental Health First Aid, Life Coach training, and Critical Incident Stress Management training. Counties receiving lottery-sourced distributions must provide a 30 percent match from county or other funds.

County EMS Fund – Targeted Support: The new County Emergency Medical Services Fund distributes funds exclusively to counties that already have a countywide excess levy or dedicated fee for EMS, with distributions proportional to each qualifying county's share of the aggregate population of all qualifying counties.

All-County EMS Fund – Universal Support: The new All-County Emergency Medical Services Fund distributes funds to all counties on a population-proportional basis, providing a baseline funding stream for EMS operations regardless of whether a county has an existing EMS levy.

Data Center and Microgrid Fee Obligations: The bill explicitly clarifies that certified high impact data centers and certified microgrid districts — which enjoy broad exemptions from local zoning and regulatory requirements — are nonetheless required to pay all applicable county and municipal fire, ambulance, and other service fees. They are entitled to receive fire and police protection in return, but may not be required to pay both county and municipal fire fees simultaneously.

Annual Reporting: The Office of Emergency Medical Services must report annually by July 1 to the Legislative Oversight Commission on Health and Human Resources Accountability, providing a county-by-county accounting of fund distributions, EMS worker salary enhancements, and recommendations for continued funding.

Impact on Members: While this bill is primarily directed at EMS funding rather than hospital operations, it has meaningful indirect relevance for WVHA members. Strengthening EMS capacity, compensation, and mental health support across West Virginia's counties directly affects the quality and timeliness of pre-hospital care and patient transport to hospital emergency departments. The mental health treatment provisions for EMS personnel also complement the broader workforce well-being initiatives enacted this session, including the peer support protections in HB 5086. Hospitals in rural counties with strained EMS systems may particularly benefit from the stabilizing effect of these new funding streams on local emergency response capacity.

SB 645 – Surprise Billing Protections for Ground Emergency Medical Services Passed March 13, 2026 | Effective June 11, 2026 (Applies to Policies Issued on or after January 1, 2027)

Overview: SB 645 extends surprise billing protections to ground emergency medical services by prohibiting insurers from passing excess costs on to patients when they receive care from a non-participating ambulance provider. The bill establishes a uniform payment rate for out-of-network ground ambulance services, requires direct payment to EMS providers, and mandates specific claims processing and denial notification procedures across all major insurance product types in West Virginia.

Key Provisions:

Prohibition on Balance Billing: Non-participating emergency medical services agencies are prohibited from billing covered individuals for any amount beyond their standard cost-sharing obligations — such as copayments, coinsurance, and deductibles — for ground ambulance services. The insurer's payment to the EMS agency constitutes payment in full for the services rendered.

Uniform Out-of-Network Payment Rate: Insurers must pay non-participating ground ambulance providers at the lesser of 200 percent of the current Medicare published rate for the same services in the same geographic area, or the provider's billed charges. This establishes a clear, standardized reimbursement floor for out-of-network EMS agencies.

Patient Cost-Sharing Parity: A covered individual's cost-sharing obligations for out-of-network ground ambulance services may not exceed what they would have paid had the services been provided by an in-network EMS agency, preventing patients from bearing extra financial burden solely because an in-network ambulance was unavailable.

Direct Payment Requirement: Insurers must remit payment directly to the non-participating EMS agency — not to the covered individual — within 30 days of receiving a clean claim, ensuring that EMS providers receive timely and direct reimbursement.

Claims Processing Timeline: Insurers must pay or deny a clean claim for out-of-network ground ambulance services within 30 days of receipt. Limited exceptions apply where another payor is responsible, benefits are being coordinated, the claim has already been paid, or fraud or material misrepresentation is involved.

Denial Notice Requirements: If an insurer denies a claim, it must provide written notice that acknowledges the date the claim was received, states the specific reason or reasons for the denial or partial payment, or identifies any additional information needed to process the claim.

Broad Coverage Scope: The protections apply across all major insurance product categories, including individual accident and sickness policies, group insurance plans, hospital and medical service corporations, healthcare corporations, and health maintenance organizations. Medicaid and CHIP insurers are explicitly exempt.

Air Ambulance Excluded: The bill applies exclusively to ground emergency medical services. Air ambulance services are explicitly excluded from coverage under this legislation.

Impact on Members: While this bill is primarily directed at EMS agencies rather than hospitals, it has meaningful indirect relevance for WVHA members. Hospital-based ground ambulance services — where they exist — will benefit from the guaranteed direct payment and standardized reimbursement rate provisions. More broadly, the bill strengthens the financial viability of the EMS system that delivers patients to hospital emergency departments, particularly in rural areas where out-of-network ambulance encounters are common. Hospitals should also be aware that patients arriving via non-participating ambulance services will face cost-sharing no greater than in-network rates, which may reduce financial barriers to seeking emergency care and support timely treatment.

HB 5015 – Respiratory Care Interstate Compact Passed March 14, 2026 | Effective June 12, 2026

Overview: HB 5015 enacts the Respiratory Care Interstate Compact, joining West Virginia to a multistate agreement designed to streamline licensure and expand the ability of respiratory therapists to practice across state lines. The compact is intended to increase public access to respiratory therapy services, reduce administrative burdens on providers, and help address workforce shortages — all priorities of direct relevance to West Virginia hospitals and health systems.

Key Provisions:

Interstate Practice Privilege: Licensed respiratory therapists in any member state may obtain a "compact privilege" to practice in other member states without obtaining a separate full license in each state. The compact privilege is valid as long as the therapist maintains an active, unencumbered home state license and meets the compact's requirements, including no adverse actions within the previous two years and payment of applicable fees.

Licensure Requirements for Compact Privilege: To practice under the compact in a remote state, a respiratory therapist must hold an active home state license, maintain a current National Board for Respiratory Care credential, meet any jurisprudence requirements of the remote state, and notify the interstate commission of their intent to practice in that state.

Criminal Background Check Requirement: West Virginia's Board of Respiratory Care Practitioners is authorized and required to conduct state and national criminal history record checks — including fingerprint-based FBI checks — for all new licensees at the time of initial licensure, a prerequisite for full participation in the compact.

Respiratory Care Interstate Compact Commission: Member states collectively establish a joint government agency — the Respiratory Care Interstate Compact Commission — to administer the compact, promulgate binding rules, maintain a shared data system of licensure and adverse action information, and oversee compliance. Each member state appoints one commissioner, and the commission meets at least annually.

Shared Data System: The commission maintains a centralized database of licensure status, adverse actions, and significant investigative information across all member states, allowing licensing authorities to monitor the standing of respiratory therapists practicing under compact privileges in their states.

Scope of Practice: A respiratory therapist practicing under a compact privilege in a remote state must practice within the scope of practice authorized by that remote state — not the scope of their home state. This ensures each state retains authority over what respiratory therapists may do within its borders.

Military Members and Spouses: Active military members and their spouses are not required to pay commission fees for a compact privilege, and remote states may choose to waive or reduce their own compact privilege fees for this population.

Adverse Action and Enforcement: Member states retain full authority to take disciplinary action against licenses they issue and against compact privileges exercised in their state. If a home state license is encumbered, the therapist loses compact privileges in all remote states until the license is restored and two additional years have passed.

Effective Date of Compact: The compact takes effect nationally when at least seven states have enacted it into law, at which point the commission is formally established.

Impact on Members: This bill has meaningful workforce implications for West Virginia hospitals and health systems, which frequently face shortages of respiratory therapists — a critical clinical role in ICUs, emergency departments, and pulmonary care settings. By enabling respiratory therapists licensed in other states to practice in West Virginia more easily, the compact expands the pool of available clinicians, supports travel and contract respiratory therapy staffing, and facilitates care delivery in rural and underserved areas. Hospital credentialing and medical staff offices should be prepared to verify compact privilege status as a valid authorization to practice and update privileging policies accordingly once the compact takes effect.

HB 4191 – Employer Child Care Tax Credits and Child Care Subsidy Reforms Passed March 13, 2026 | Effective July 1, 2026

Overview: HB 4191 takes a multi-pronged approach to addressing West Virginia's child care crisis by expanding employer tax incentives for providing or sponsoring child care, modernizing the child care subsidy system, and mitigating the "benefits cliff" that discourages workforce participation. For hospitals and health systems — among the state's largest employers — this legislation creates meaningful new financial incentives to invest in child care solutions for their workforce.

Key Provisions:

Employer Tax Credits – Capital Investment: Employers that invest in qualified child care property — including construction, expansion, improvement, or equipment for an on-site or employer-sponsored child care facility — may claim a tax credit equal to 50 percent of the cost, spread over five years at 20 percent per year. The credit applies to both personal income tax and corporate net income tax filers. Joint investments by multiple unaffiliated employers are permitted, with each employer claiming credit proportional to their investment.

Employer Tax Credits – Operating Costs: In addition to the capital investment credit, employers may claim a tax credit equal to 50 percent of the net operating costs of providing or sponsoring child care for employees, after subtracting any amounts paid by employees. This operating cost credit may be carried forward for up to five years. Combined capital and operating credits may not exceed 100 percent of the employer's tax liability in a given year.

Employer-Sponsored Facilities: The bill broadens the definition of qualifying child care arrangements to include employer-sponsored third-party facilities — licensed child care providers whose costs are financially supported by one or more employers through direct payments, contracts, or subsidies. These facilities are not subject to proximity requirements or employee usage thresholds, giving hospitals and health systems greater flexibility in how they structure child care support for staff.

Nonprofit Tax Credit Transferability: Nonprofit employers — including nonprofit hospitals organized under 501(c)(3) — that qualify for child care tax credits but have no tax liability may transfer, sell, or assign their credits to other taxpayers. The Tax Division must certify the transferable credit amount within 90 days of application, creating a meaningful financial benefit even for tax-exempt health systems.

Electronic Attendance Filing: The Department of Human Services must implement a system for the electronic filing of all child care attendance days billed by providers by July 1, 2026, after which electronic submission will be mandatory for all providers seeking reimbursement.

Subsidy Cliff Mitigation: The Department of Human Services is directed to adopt policies by January 1, 2027 that gradually phase out child care assistance as family income increases, rather than cutting it off abruptly. The department may expand sliding fee scales, raise exit eligibility thresholds, and implement transitional eligibility periods to encourage workforce participation and wage growth without penalizing families for earning more.

Enrollment-Based Subsidy Payments: Child care subsidies will be paid based on monthly enrollment rather than daily attendance, though families whose children attend fewer than an average of eight days per month may be made ineligible for subsidy on a quarterly review basis.

Impact on Members: This bill is directly relevant to hospitals and health systems grappling with workforce recruitment and retention challenges. Child care access is a well-documented barrier to healthcare employment, particularly for nurses and other clinical staff working non-traditional hours. The new employer tax credits — including the operating cost credit and the flexibility to sponsor off-site third-party facilities — give hospitals practical and financially attractive options to expand child care benefits for employees. Nonprofit hospital systems should pay particular attention to the transferable credit provision, which allows them to monetize child care investment credits despite their tax-exempt status. Hospital human resources and finance teams should consult with tax advisors to assess how these credits can be optimally structured and utilized.

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While many bills advanced this session, several measures that would have directly impacted hospital operations did not complete legislative action. Although Certificate of Need was not a major priority for the Legislature or Governor this session, we did have to manage HB 5096, which would have removed personal care and intellectual developmental disabilities services from the CON review process. The WVHA remained neutral on this bill throughout the session as amendments were proposed as the bill moved through the Legislature. Another Certificate of Need bill considered but not advanced was HB 4359, exempting  an existing hospital under certificate of need to move its facility up to 10 miles to a new location. No other CON bills advanced this session.

Other bills directly impacting hospitals that we played defense on and did not advance this session included measures related to hospital facility fee oversight (SB 946), electronic medical records (HB 5476), and several scope-of-practice bills. Additional proposals that did not pass would have required hospitals to report costs associated with caring for undocumented immigrants (HB 4059), established decision-making protocols for unconscious ICU patients (HB 4344), mandated trauma-informed care protocols(HB 4853), required patient notification upon turning 18 of their right to report adverse effects from childhood procedures (HB 4899), addressed communication assistance for deaf and hard-of-hearing patients (HB 5097), and granted patients the right to refuse treatment from residents during non-emergency appointments (HB 5333), among many other bills. 

A small sampling of other key bills not advancing:

• HB 4198 – E-Verify Safe Harbor Act
• HB 5021 - Limited circumstances in which a registered nurse may administer anesthetics
• HB 5563 - WV Timely Transplant Referral and Veteran Care Coordination Act.
• HB 4767 – To require the Bureau for Medical Services (BMS) to file a legislative rule
• HB 4772 –Verification of Medicaid enrollees
• SB 580 - Updates the practice act for the WV Medical Imaging and Radiation Therapy Technology Board
• SB 615 – Require persons with illegal immigration status to be turned over to ICE
• SB 729 – RHTP Oversight
• SB 956 – Grants physician assistants full practice authority
• SB 1012 - Permit the development of juvenile treatment beds in Cabell

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The Legislature completed work on the FY2027 general revenue budget (SB 250); Governor Morrisey signed the bill with several line-item vetoes and reductions but the Legislature chose not to take action to override. His objections ranged from reducing or fully vetoing fund transfers he believed would endanger specific state programs to cutting allocations for Marshall University, international trade offices, tourism, and court appointed special advocates. In a few minor cases, he also corrected outdated agency names and redundant language in the bill.

Key Provisions of the Final 2027 Budget

Medicaid: The budget includes an additional $28 million for Medicaid over the current fiscal year, bringing total funding to $284 million. Funding for aged and disabled waiver programs increased by $5 million, to $162.6 million.

Rural Health Transformation: The Department of Health budget includes almost $200 million for the federal dollars being allocated for the Rural Health Transformation Program (RHTP) to align with the passage of SB 570.

Personal Income Tax Cut: A 5% personal income tax cut — retroactive to January 1 — was approved, returning an estimated $125 million to taxpayers. Governor Morrisey had sought a full 10% cut; the Legislature agreed to half that amount. SB 392 aligns with the 5% tax cut.  

Workforce & Pay Raises: An average 3% pay raise was approved for teachers, school service personnel, State Police, and public employees ($78.4 million total).

Adoption & Foster Care: A $40 million increase over current funding levels was included for adoption and foster care services.

Hope Scholarship (Education Vouchers): $276 million allocated — a 400%+ increase from the current funding level — as the program expands to all WV students.

Roads: $125 million in additional transportation funding.

Flood Resiliency Trust Fund: $5 million dedicated for the first time to flood preparedness and recovery.

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If you have any questions about the Legislative Recap or questions about the 2026 Regular Session, please contact Tony Gregory.

www.wvha.org | 100 Association Drive, Charleston, WV  25311 | 304.344.9744

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