This bill amends the Code of West Virginia to increase and maintain the tax rates imposed on health maintenance organizations (HMOs) operating within the state. Specifically, it establishes new tax rates for various tiers based on Medicaid member months and non-Medicaid member months, with the rates set to increase on July 1 of each year based on the average West Virginia Medicaid Managed Care capitation rate change. The bill outlines the specific rates for each tier for the periods from July 1, 2022, through June 30, 2025, and introduces new rates for the period from July 1, 2025, through June 30, 2026. Additionally, it mandates that the tax rates be adjusted annually to maintain revenue at six percent of the cost of care, in compliance with federal regulations.

The bill also includes provisions for the certification of these rates by the West Virginia Bureau for Medical Services to the Tax Commissioner, ensuring that the tax remains permissible under federal law. It specifies the definitions of key terms related to managed care organizations and outlines the effective date of the tax, which is contingent upon federal approval. The tax will be automatically voided if it is determined by the Centers for Medicare and Medicaid Services that it is no longer permissible. Overall, the bill aims to ensure a stable funding mechanism for health care services provided through HMOs in West Virginia.

Statutes affected:
Introduced Version: 11-27-10a