WV HB4335

Requires the Department of Human Services or its fiscal agent to complete Medicaid provider enrollment determinations within 5 business days of receiving a completed application, with notification of missing materials within 2 business days

Mandates Medicaid managed care organizations (MCOs) complete provider credentialing within 60 calendar days, with only one possible 30-day extension allowed upon written justification

MCOs failing to meet credentialing timelines face penalties including corrective action plans, monetary sanctions, or credentialing-by-default at the department's discretion

Requires all Medicaid enrollment, credentialing applications, renewals, and supporting documents to be submitted exclusively by electronic means beginning July 1, 2026

Establishes the CAQH (Council for Affordable Quality Healthcare) credentialing form as the mandatory standard, prohibiting contracting entities from requiring additional information beyond this form