The bill amends the Code of West Virginia to establish a health care provider tax on managed care organizations (MCOs), specifically certified health maintenance organizations (HMOs). Starting July 1, 2027, a tax of two and one-half percent will be levied on the gross premiums written by these certified HMOs in the state during each calendar quarter. This tax will apply uniformly to all certified HMOs, regardless of their membership composition, but will not apply to Medicare Advantage plans, certain health plans issued by the West Virginia Public Employees Insurance Agency, or plans under the Federal Employees Health Benefits Act if preempted by federal law.

Additionally, the bill outlines the transition from a tiered member-month tax structure to a gross premium assessment method, contingent upon federal approval that the new tax structure qualifies as a permissible health care-related tax eligible for federal financial participation. The tax will not be collected until the state receives written notice of approval from the federal Centers for Medicare and Medicaid Services regarding the actuarial soundness of proposed Medicaid rates for the applicable taxable year. The bill also includes provisions for the tax to be voided if it is determined by federal authorities that it is no longer permissible.

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