Bill > SB1055

This bill mandates that the Bureau for Medical Services (the "Bureau"), which is the state agency responsible for administering Medicaid, must use a data-informed methodology when reviewing and setting reimbursement rates for substance use disorder services, which include various forms of treatment like residential care, withdrawal management, outpatient services, and medication-assisted treatment. This approach requires the Bureau to consider factors such as provider costs, workforce expenses, service utilization, geographic considerations, patient needs, inflation, and regional benchmarks when conducting a "rate study," which is defined as an analysis of the costs, usage, and delivery of these services. The bill also requires the Bureau to involve stakeholders, such as service providers and consumer representatives, in this process and to publicly share summaries of rate study findings and the general methodology used, while also submitting an annual report to a legislative oversight commission detailing current rates, utilization trends, and access to care indicators.

Health and Social Services

http://www.wvlegislature.gov/Bill_Status/Bills_history.cfm?input=1055&year=2026&sessiontype=RS&btype=bill