Bill > HB4117

This bill aims to prevent "surprise billing" for ground ambulance services, meaning patients will no longer be unexpectedly charged by out-of-network providers for emergency medical transport. For health insurance policies issued on or after January 1, 2026, and January 1, 2027, depending on the specific insurance type, insurers will be required to pay nonparticipating emergency medical services agencies directly for covered ground ambulance services. This payment will be considered full payment for the service, except for the patient's usual copayment, coinsurance, deductible, and other cost-sharing amounts, which cannot be higher than what they would pay for in-network services. The insurer's payment to the nonparticipating agency will be either 400% of the Medicare rate for the same service in the same area or the agency's billed charges, whichever is less. Insurers must process "clean claims" (claims that are complete and accurate) within 30 days and either pay or deny them, providing specific reasons for denial if applicable.

Budget and Finance, Business and Industry

http://www.wvlegislature.gov/Bill_Status/Bills_history.cfm?input=4117&year=2026&sessiontype=RS&btype=bill