West Virginia legislation · 2026 Regular Session
West Virginia SB645: Prohibiting surprise billing of ground emergency medical services by nonparticipating providers
Status: Signed into law, April 1, 2026
What the bill says
An act to amend the Code of West Virginia, 1931, as amended, by adding five new sections, designated §33-15-24, §33-16-20, §33-24-46, §33-25-23, and §33-25A-37, relating to out-of-network ambulance services; establishing rates; establishing payment procedures; providing exceptions; and requiring written notices for denied claims. ARTICLE 15. ACCIDENT AND SICKNESS INSURANCE. §33-15-24. Prohibiting surprise billing of ground emergency medical services by nonparticipating providers. For a health insurance policy issued by an insurer on or after January 1, 2027: (1) Payment by an insurer to a non-.
From the enrolled text, March 13, 2026:
AN ACT to amend the Code of West Virginia, 1931, as amended, by adding five new sections, designated §33-15-24, §33-16-20, §33-24-46, §33-25-23, and §33-25A-37, relating to out-of-network ambulance services; establishing rates; establishing payment procedures; providing exceptions; and requiring written notices for denied claims. ARTICLE 15. ACCIDENT AND SICKNESS INSURANCE. §33-15-24. Prohibiting surprise billing of ground emergency medical services by nonparticipating providers. For a health insurance policy issued by an insurer on or after January 1, 2027: (1) Payment by an insurer to a non-participating emergency medical services agency for covered ambulance services provided under the provisions of §16-4C-1 et seq. of this code, excluding air ambulance services as defined in §16-4C-3(a) of this code, to a covered enrollee in accordance with subdivision (2) of this and (B) The non-participating emergency medical services agency is prohibited from billing the covered individual for any additional amount for the ambulance services provided, except for any copayment, coinsurance, deductible, and other cost-sharing amounts that the insurer requires the covered enrollee to pay. (2) The insurer shall provide direct payment to a non-participating emergency medical services agency for covered ground ambulance services provided to a covered or E(B) According to the non-participating emergency medical services agency's billed charges, whichever is less. (3) The copayment, coinsurance, deductible, and other cost-sharing amounts that an insurer requires a …