This bill amends the Code of West Virginia to update the health care provider tax imposed on managed care organizations (MCOs), specifically transitioning from a tiered member-month tax structure to a gross premium assessment method. Beginning July 1, 2026, the tax will be set at two and one-half percent of each certified health maintenance organization's (HMO) gross premiums written in the state during each calendar quarter. This new tax rate will apply uniformly to all certified HMOs, regardless of their membership composition, and will exclude Medicare Advantage plans and certain other health plans as specified.

Additionally, the bill clarifies definitions related to managed care organizations and taxable health plans, ensuring that the language aligns with the new tax structure. It also stipulates that the tax will only be collected once the federal Centers for Medicare and Medicaid Services approves the proposed Medicaid rates as actuarially sound. The changes aim to ensure compliance with federal regulations regarding health care-related taxes, thereby securing federal financial participation.

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