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WV HB5266
Bill
Status
2/5/2026
Primary Sponsor
Mike Pushkin
Click for details
AI Summary
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Requires all West Virginia Medicaid managed care organizations to contract with any willing hospital, doctor, behavioral health provider, or other provider in a Medicaid region who accepts the same payment rates and terms as comparable providers
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Establishes "any willing provider" requirements, meaning MCOs cannot exclude qualified providers from their networks if those providers agree to standard contract terms
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Providers must meet Medicaid enrollment requirements, hold proper professional and business licenses, have a Medicaid provider number, and satisfy MCO credentialing standards to qualify
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Disqualifies providers who are excluded from participating in Medicare or Medicaid programs
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Adds new section §9-5-34 to the West Virginia Code under Article 5 (Miscellaneous Provisions) of the state Medicaid program
Legislative Description
Requiring West Virginia Medicaid managed care organizations to contract with any otherwise qualified provider
Health
Last Action
To House Health and Human Resources
2/5/2026