The proposed bill seeks to enhance mental health parity in West Virginia by requiring the Public Employees Insurance Agency and other health insurance providers to offer coverage for behavioral health, mental health, and substance use disorders that is equivalent to coverage for physical illnesses. It introduces new sections to the West Virginia Code, including sections 5-16-7h, 33-15-4y, 33-16-3ii, 33-24-7z, 33-25-8w, and 33-25A-8z. Key provisions include definitions of relevant disorders, mandates for comprehensive coverage and reimbursement for screenings and treatments, and adherence to federal regulations regarding treatment limitations. The bill also requires the Public Employees Insurance Agency to submit annual reports on compliance with mental health parity, detailing claims data and medical necessity determination processes.

Additionally, the bill outlines specific requirements for insurance carriers, such as ensuring that coverage for mental health services is no less extensive than that for physical health services, compliance with treatment limitations, and the establishment of procedures for treatment with nonparticipating providers. It mandates that any denial of reimbursement for mental health services must include language informing covered persons of their rights. The Insurance Commissioner is tasked with submitting annual reports starting June 1, 2025, to the Joint Committee on Government and Finance, detailing compliance with parity requirements. The provisions of this bill will take effect for policies beginning on or after January 1, 2026.

Statutes affected:
Introduced Version: 5-16-7h, 33-15-4y, 33-16-3ii, 33-24-7z, 33-25-8w, 33-25A-8z