WEST VIRGINIA LEGISLATURE
2025 REGULAR SESSION
Introduced
House Bill 2728
By Delegates Crouse, Moore, Drennan, Hornby, Dean, Masters, Amos, and Petitto
[Introduced February 21, 2025; referred to the Committee on Finance then the Judiciary]
A BILL to amend the Code of West Virginia, 1931, as amended, by adding thereto five new sections, designated §33-15-4y, §33-16-3aaa, §33-24-7z, §33-25-8w and §33-25A-8z; relating to requiring insurers providing sickness or health care to provide coverage for biodentical hormones.
Be it enacted by the Legislature of West Virginia:
## ARTICLE 15. ACCIDENT AND SICKNESS INSURANCE.
Any insurer who, on or after January 1, 2025, delivers or issues a policy of group accident and sickness insurance in this state under the provisions of this article shall make available as benefits to all subscribers and members coverage on an expense-incurred basis and individual and group service or indemnity type contracts issued by a nonprofit corporation shall provide coverage for biodentical hormones when determined to be medically necessary and ordered by a licensed physician after making a thorough evaluation of the patient's symptoms, diagnostic test results, or response to treatment.
## ARTICLE 16. GROUP ACCIDENT AND SICKNESS INSURANCE.
Any insurer who, on or after January 1, 2025, delivers or issues a policy of group accident and sickness insurance in this state under the provisions of this article shall make available as benefits to all subscribers and members coverage on an expense-incurred basis and individual and group service or indemnity type contracts issued by a nonprofit corporation shall provide coverage for biodentical hormones when determined to be medically necessary and ordered by a licensed physician after making a thorough evaluation of the patient's symptoms, diagnostic test results, or response to treatment.
## ARTICLE 24. HOSPITAL SERVICE CORPORATIONS, MEDICAL SERVICE CORPORATIONS, DENTAL SERVICE CORPORATIONS AND HEALTH SERVICE CORPORATIONS.
A policy, provision, contract, plan, or agreement subject to this article, on or after January 1, 2025, shall provide coverage for biodentical hormones when determined to be medically necessary and ordered by a licensed physician after making a thorough evaluation of the patient's symptoms, diagnostic test results, or response to treatment.
##
## ARTICLE 25. HEALTH CARE CORPORATIONS.
Any health care corporation that, on or after January 1, 2025, delivers or issues a policy of sickness or health insurance in this state under the provisions of this article shall provide coverage for biodentical hormones when determined to be medically necessary and ordered by a licensed physician after making a thorough evaluation of the patient's symptoms, diagnostic test results, or response to treatment.
## ARTICLE 25A. HEALTH MAINTENANCE ORGANIZATION ACT.
A health maintenance organization issuing coverage in this state pursuant to the provisions of this article shall provide coverage for biodentical hormones when determined to be medically necessary and ordered by a licensed physician after making a thorough evaluation of the patient's symptoms, diagnostic test results, or response to treatment.
NOTE: The purpose of this bill is to require insurance coverage for biodentical hormones.
Strike-throughs indicate language that would be stricken from a heading or the present law and underscoring indicates new language that would be added.