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WV HB4965
Bill
Status
Enrolled
3/12/2026
Primary Sponsor
Laura Kimble
Click for details
AI Summary
- Allows PEIA patients with prior authorization for a covered treatment to receive an alternative treatment for the same condition without obtaining new prior authorization
- Alternative treatment must be medically appropriate for the same diagnosed condition and cannot exceed the allowed cost of the originally authorized treatment
- Requires licensed healthcare providers to document in medical records that the alternative treatment is medically appropriate for the same diagnosed condition
- Prohibits PEIA from requiring new prior authorization or imposing administrative requirements that unreasonably delay access to qualifying alternative treatments
- Does not apply to treatments for new or unrelated diagnoses, non-covered benefits, or cases involving fraud, waste, or abuse
Legislative Description
Relating to patient-centered treatment flexibility within the Public Employees Insurance Agency
Insurance
Last Action
House received Senate message
3/13/2026
Committee Referrals
Health and Human Resources3/5/2026
Health & Human Resources1/29/2026
Full Bill Text
No bill text available