WV SB231

Requires the Bureau for Medical Services to establish standard billing codes for all substance use disorder services by January 15, 2027, and implement a value-based payment model through Managed Care Organizations by July 1, 2028

Defines outcome measures for addiction treatment providers including housing stability, verified sobriety, avoidance of new arrests or child protective services investigations, and participation in employment or education programs

Mandates annual reporting to the Legislative Oversight Commission on Health and Human Resources Accountability starting January 1, 2028, covering utilization trends, costs, and outcomes by provider with comparisons to national rates

Authorizes penalties for providers failing to meet outcome measures, including decertification, code blocking, termination, or exclusion from Medicaid after three consecutive quarters of underperformance

Requires submission to the Centers for Medicare and Medicaid Services by October 1, 2026, to obtain necessary authority for implementing payment and coverage changes