WV HB5349

Requires the Public Employees Insurance Agency and private health insurers to provide coverage for behavioral health, mental health, and substance use disorders that is no less extensive than coverage for physical illnesses, including mandatory screenings for alcohol use, substance use, and depression.

Prohibits insurers from applying treatment limitations (both quantitative and nonquantitative) to mental health and substance use benefits that are more restrictive than those applied to medical and surgical benefits within the same classification.

Mandates that insurers authorize treatment with out-of-network providers at in-network cost-sharing rates when covered mental health services are not available within established time and distance standards.

Requires annual reporting to the Joint Committee on Government and Finance beginning June 1, 2026, documenting parity compliance data, medical necessity criteria, and analyses of treatment limitations.

Applies to policies delivered, issued, amended, or renewed on or after January 1, 2027, covering the Public Employees Insurance Agency, individual and group accident/sickness insurance, hospital/medical service corporations, and health maintenance organizations.