This bill amends the Code of West Virginia to mandate that health benefit plans provide coverage for habilitative and rehabilitative services specifically for the treatment of stuttering, effective January 1, 2026. Under this legislation, any policy, plan, or contract issued or renewed must cover these services without imposing deductibles, per visit charges, or copayments. The bill also defines "habilitative services" and "rehabilitative services," ensuring that coverage includes both in-person and telehealth options. Furthermore, it requires that if a plan covers habilitative or rehabilitative services, it must also include habilitative and rehabilitative speech therapy for stuttering, regardless of whether the stuttering is classified as developmental.

Additionally, the bill prohibits maximum annual benefit limits and restrictions based on the underlying cause of stuttering, as well as utilization management requirements like prior authorization. It emphasizes that telehealth services must meet or exceed the standards set for health benefit plans and must utilize compliant communication technologies in accordance with federal privacy provisions. This comprehensive approach aims to improve access to essential speech therapy services for individuals affected by stuttering.

Statutes affected:
Introduced Version: 5-16-8b, 33-15-24, 33-16-20, 33-24-15, 33-25-23, 33-25A-37
Committee Substitute: 5-16-8b, 9-5-34, 33-15-24, 33-16-20, 33-24-15, 33-25-23, 33-25A-37
Engrossed Committee Substitute: 5-16-8b, 9-5-34, 33-15-24, 33-16-20, 33-24-15, 33-25-23, 33-25A-37