This bill amends the Code of West Virginia to establish that the Public Employees Insurance Agency (PEIA) shall reimburse healthcare providers at a rate of 110% of the Medicare amount for services rendered. Specifically, it deletes the term "minimum" from the existing law regarding reimbursement levels, thereby setting a clear standard for the reimbursement rate. The bill also outlines the responsibilities of the finance board, including the requirement to retain an impartial actuary to assess the financial plans and ensure they are capable of meeting the agency's estimated costs.

Additionally, the bill mandates that the finance board prepare an annual financial plan that includes various cost-sharing measures between employers and employees, with a specified ratio of 80% for employers and 20% for employees. It emphasizes the need for public hearings to gather feedback on the proposed financial plans and allows for modifications based on the actuary's recommendations. The finance board is also tasked with quarterly reviews of the financial plan to ensure fiscal stability and may only increase costs to employees in the event of a true emergency.

Statutes affected:
Introduced Version: 5-16-5