This bill aims to amend the Code of West Virginia by introducing a new article focused on value-based payment requirements for addiction care recovery outcomes. It establishes legislative intent, defines key terms, and outlines the creation of value-based measures to improve the state's fragmented addiction care system. The bill emphasizes the need for a coordinated continuum of care that includes prevention, treatment, and recovery support, while shifting the payment model from fee-for-service to one that rewards providers based on patient health outcomes and experiences.

Key provisions include the establishment of standard billing codes for substance use disorder services, the collection and analysis of data to determine utilization trends and costs, and the development of outcome-based performance measures by July 1, 2026. The Bureau for Medical Services is tasked with implementing a value-based payment model by July 1, 2028, which will incentivize providers based on their ability to meet specified outcome measures. Additionally, the bill outlines the authority of the Bureau to seek necessary approvals from the Centers for Medicare and Medicaid Services (CMS) to implement these changes effectively.

Statutes affected:
Introduced Version: 16-67-1, 16-67-2, 16-67-3, 16-67-4, 16-67-5