SB 994
Relating to Medicaid reimbursement rates for certain mental health procedures
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- Passed Senate
- Passed House of Delegates
- To Governor
- Became Law
Bill overview
This bill aims to align West Virginia Medicaid reimbursement rates for certain mental health services, specifically outpatient psychiatry and psychology, with Medicare rates. It directs the state’s Medicaid enhancement board to review and propose increases in reimbursement rates for these services provided in licensed behavioral health centers, ensuring they are at least equivalent to Medicare Part B rates. The board will also work to improve communication between providers and the Department of Human Services.
Key provisions
- Directs the Medicaid enhancement board to review and propose increases in reimbursement rates for outpatient psychiatry and psychology services.
- Requires these rates to be equivalent to Medicare reimbursement rates.
- Sets a deadline of July 1, 2026, for the board to develop a proposal for increased rates.
- Mandates that reimbursement rates for these services cannot be lower than those paid to Medicare Part B providers.
- Requires the board to meet and confer with medical specialty representatives to ensure equitable reimbursement.
- Authorizes the board to assist in communication between providers and the Department of Human Services.
- Requires the board to review reimbursements for early and periodic screening, diagnosis, and treatment.
- Establishes a process for the single state agency to review and adjust the fee schedule quarterly.
Who is affected
- West Virginia Medicaid recipients
- Outpatient psychiatry and psychology providers
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