WV SB832

Requires insurers and pharmacy benefits managers to count cost-sharing amounts paid by the insured or on their behalf by third parties toward deductibles, copayments, and annual out-of-pocket maximums

Allows patients who pay a discounted cash price below the insurer's average allowed amount to receive credit toward their in-network cost-sharing requirements as if the service was provided by an in-network provider

Prohibits insurers from discriminating in payment for covered in-network services solely because the patient was referred by an out-of-network provider

Defines "average allowed amount" as the average of all contractually agreed upon amounts paid to network providers, calculated over no more than one calendar year, with methodology approval by the Insurance Commissioner

Amendments apply to accident and sickness insurance, group insurance, hospital/medical/health service corporations, and HMOs, effective January 1, 2026 for policies delivered, issued, amended, or renewed after that date