West Virginia 2023 Regular Session

West Virginia House Bill HB2785

Introduced
1/18/23  

Caption

Relating to PEIA reimbursement

Impact

If enacted, HB 2785 would directly affect the existing structure of the PEIA by creating a safeguard for its enrollees who might otherwise face financial hardship due to the unwillingness of some healthcare facilities to accept their insurance. This measure aims to bulletproof users against sudden healthcare cost burdens arising from provider policy changes, with the intention of promoting consistent access to necessary medical services for the state employees and other eligible members enrolled in PEIA.

Summary

House Bill 2785 proposes to amend the West Virginia Public Employees Insurance Act (PEIA) by introducing a new provision that mandates the reimbursement of individuals for healthcare costs incurred at medical facilities that have ceased to accept PEIA. This legislative action intends to protect the financial interests of PEIA participants who find themselves with outstanding medical bills due to changes in healthcare providers' acceptance of their insurance. The bill seeks to ensure timely reimbursement—within seven days upon receipt of an invoice—for individuals who provide proof of their owed medical bills to PEIA.

Sentiment

The sentiment around HB 2785 appears to be largely supportive among those concerned about healthcare accessibility and financial protection for insured individuals. Advocates argue that the bill plays a vital role in shielding families from unforeseen medical expenses, while also emphasizing the need for financial stability in healthcare coverage. Nonetheless, there may be some opposition or concerns raised regarding the implications for hospitals and healthcare facilities that may need to manage the financial impacts of the bill.

Contention

Notably, discussions surrounding HB 2785 could revolve around the sustainability of reimbursing individuals for medical bills, especially in light of budgetary constraints faced by the state. There might also be discussions about the obligations of medical facilities and whether there needs to be a broader systemic solution to ensure continued acceptance of PEIA by a range of healthcare providers. Balancing the interests of the insured with those of healthcare entities is likely to be a point of contention if the bill progresses.

Companion Bills

No companion bills found.

Previously Filed As

WV SB677

Relating to funding for supplementing PEIA reimbursements up to Medicare rate

WV SB127

Relating to reimbursement of hospital inpatient rates by PEIA

WV SB706

Relating to PEIA reimbursement of inpatient hospital rates

WV SB676

Requiring report on Medicaid fees and managed care provider reimbursements compared to PEIA, Medicare, and surrounding states

WV SB268

Relating to PEIA

WV SB607

Requiring PEIA reimbursement rates be no less than Medicare

WV HB3186

Relating to PEIA inpatient rates

WV HB3420

Relating to the reimbursement of sexual assault forensic medical examinations

WV SB453

Requiring pricing and payment transparency from pharmacy benefits managers contracting with PEIA

WV SB292

Allowing doula services be covered by Medicaid and PEIA

Similar Bills

No similar bills found.