SB 574 — Relating to WV PEIA

SB574SB SFAT574 TakuboText #1skip 2-24navigation Dellinger SENATE 7965PRESIDENT  SENATORS SenatorsCOMMITTEES TakuboVIDEO/AUDIO andDISTRICT PlymaleMAPS movedSENATE toCLERK amendSENATE theRULES billHOUSE bySPEAKER strikingDELEGATES outCOMMITTEES theVIDEO/AUDIO titleDISTRICT andMAPS substitutingHOUSE thereforCLERK aHOUSE newRULES title,HOUSE toSTAFF readJOINT asINTERIM follows:COMMITTEES LEGISLATIVE ADMINISTRATOR LEGISLATIVE SERVICES DIVISION PUBLIC INFORMATION LEGISLATIVE AUTOMATED SYSTEMS DIVISION LEGISLATIVE AUDITOR'S OFFICE PERFORMANCE EVALUATION & RESEARCH DIVISION POST AUDIT DIVISION BUDGET DIVISION REGULATORY AND FISCAL AFFAIRS DIVISION CLAIMS COMMISSION CRIME VICTIMS RULE-MAKING REVIEW SPECIAL INVESTIGATIONS JUDICIAL COMP.

Eng.COMMISSION JOINT RULES STAFF INFO BILL STATUS BILL STATUS BILL TRACKING STATE LAW WEST VIRGINIA CODE ACTS OF THE LEGISLATURE CODE OF 1931 WV CONSTITUTION US CONSTITUTION REPORTS AGENCY REPORTS AGENCY GRANT AWARDS PERFORMANCE EVALUATIONS POST AUDITS EDUCATIONAL CITIZEN’S GUIDE INTERNSHIP PROGRAM PAGE PROGRAM PUBLICATIONS PHOTO GALLERY CAPITOL HISTORY HOW A BILL BECOMES LAW CONTACT SENATE ROSTER HOUSE ROSTER PUBLIC INFO.

NEWS RELEASES HELPFUL LINKS SB574 SUB1 eng2 « Senate Bill 574—A574 BILLHistory toOTHER amendVERSIONS and —  reenactCommittee §5-16-20Substitute and(1) §5-16-25 |  ofEngrossed theVersion Code |  ofIntroduced WestVersion Virginia, |  1931, |  asEmail amended;Key:

Green = existing Code.

Red = new code to be enacted WEST virginia legislature regular session Second Engrossed Committee Substitute for Senate Bill 574 By Senators Maroney, Nelson, Takubo, and Weld [Originating in the Committee on Health and Human Resources;

reported on February 11, 2022]         A BILL to amend and reenact §5-16-20 and §5-16-25 of the Code of West Virginia, 1931, as amended;

 Be  it  enacted Adoptedby Rejectedthe  Legislature  of West Virginia:

ARTICLE 16.

WEST VIRGINIA PUBLIC EMPLOYEES INSURANCE ACT.

§5-16-20.

Expense fund.

The Legislature shall annually appropriate such sums as may be necessary to pay the proportionate share of the administrative costs for the state as an employer, and each division, agency, board, commission, or department of the state which operates out of special revenue funds or federal funds or both shall pay its proportionate share of the administrative costs of the insurance plan or plans authorized under the provisions of this article and such fund existing within the Public Employees Insurance Agency shall be known as the State Employee Insurance Plan.

All other employers not operating from the state General Revenue Fund shall pay their proportionate share of the administrative costs of the insurance plan or plans authorized under the provisions of this article and such fund existing within the Public Employees Insurance Agency shall be known as the Nonstate Employee Insurance Plan.

§5-16-25.

Reserve fund.

Upon the effective date of this section, the finance board shall establish and maintain a reserve fund for the purposes of offsetting unanticipated claim losses in any fiscal year and supplementing any reimbursements made to hospitals and emergency medical service providers or agencies in accordance with §5-16-30 of this code.

Beginning with the fiscal year 2002 plan and for each succeeding fiscal year plan, the finance board shall maintain the actuarily recommended reserve in an amount no less than 10 percent of the projected total plan costs for that fiscal year in the reserve fund, which is to be certified by the actuary and included in the final, approved financial plan submitted to the Governor and Legislature in accordance with the provisions of this article.

§5-16-30.

Hospital inpatient rates.

(a) By July 1, 2023, the plan shall reimburse any hospital that provides inpatient care to a beneficiary covered by the plan at a rate of 110 percent of the Inpatient Prospective Payment System Diagnostic Related Group assigned amount then in effect for the federal fee for service component of the Medicare program.

(b) By July 1, 2023, the plan shall reimburse any emergency medical services provider or agency as defined in §16-4C-1 et seq.

at a rate of 110 percent of the Medicare rate.

(c) Nothing in this section limits the authority of the director under §5-16-3(c) and §5-16-9 of this code, including, but not limited to, his or her authority to manage provider contracting and payments and to designate covered and noncovered services.  (d) This section does not limit the authority of the director, the plan, or the plans under §5-16-11 of this code.  (e) This section shall apply to all policies, contracts, plans, or agreements subject to this section that are delivered, executed, amended, adjusted, or renewed on or after July 1, 2023.

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