This bill amends the Code of West Virginia to adjust the tax rates imposed on health maintenance organizations (HMOs) operating within the state. Specifically, it establishes new tax rates for the period from July 1, 2025, through June 30, 2026, which include $78.75 for each Medicaid member month under 250,000, $45.00 for each Medicaid member month between 250,000 and 500,000, and $2.25 for each Medicaid member month greater than 500,000. Additionally, it sets rates for non-Medicaid member months at 56.04 cents for those under 150,000 and 23.0 cents for those of 150,000 or more. The bill also introduces a mechanism for maintaining these rates by applying a uniform multiple to ensure compliance with federal regulations.

Furthermore, the bill removes previous provisions that mandated annual increases to the tax rates based on the average West Virginia Medicaid Managed Care capitation rate changes. Instead, it establishes a process for the West Virginia Bureau for Medical Services to certify adjusted tax rates necessary to maintain compliance with federal law, which will be published by the Tax Commissioner annually. The effective date of the tax is contingent upon federal approval, and it will be voided if the Centers for Medicare and Medicaid Services determines it is no longer permissible.

Statutes affected:
Introduced Version: 11-27-10a
Committee Substitute for the Committee Substitute: 11-27-10a
Committee Substitute: 11-27-10a
Engrossed Committee Substitute: 11-27-10a