2026 Regular Session
SB 1055
Conducting rate study for substance use disorder
In Committee
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- Passed Senate
- Passed House of Delegates
- To Governor
- Became Law
Bill overview
This bill directs the Bureau for Medical Services to conduct a rate study for substance use disorder services covered under Medicaid. The study will use data to evaluate costs, utilization, and service delivery, aiming to ensure transparency and program integrity. It requires stakeholder engagement and the publication of study findings and trends to the Legislative Oversight Commission.
Key provisions
- Requires the Bureau for Medical Services to conduct a rate study for substance use disorder services.
- Establishes a data-informed methodology for reviewing reimbursement rates.
- Includes consideration of provider costs, workforce costs, service utilization, and regional benchmarks.
- Mandates stakeholder engagement with providers, managed care organizations, and consumer representatives.
- Requires the Bureau to publish rate study findings and methodology.
- Requires an annual report to the Legislative Oversight Commission on Health and Human Resources Accountability.
- Defines key terms such as ‘Substance use disorder services’ and ‘Rate study’.
Who is affected
- Medicaid recipients
- Substance use disorder treatment providers
- Managed care organizations
- The Bureau for Medical Services
- The Legislative Oversight Commission on Health and Human Resources Accountability
Notable changes
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