State of Legislation

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Legislature Status: Adjourned sine die March 7.

• West Virginia Department of Health & Human Resources coronavirus resource page.
• April 13, 2020 – The West Virginia National Guard, in collaboration with researchers from West Virginia University, academia, and business and industry leaders, announced a coordinated effort to address personal protective equipment (PPE) shortages.
• April 10, 2020 – The Governor announced a hero pay grant in the amount of $100,000 to each county to distribute at discretion to reward front line workers.
• April 10, 2020 – The Governor added four counties (Cabell, Ohio, Wayne and Wood) to the Emergency Order enabling counties to further tighten social distancing measures and tighten rules surrounding essential services.

Legislation

• HB 2263 Established requirements for pharmacy benefit manager reimbursements for pharmacy services, requires pharmacy benefits managers to report some aggregate costs data, and prohibits pharmacy benefits managers and health insurers from taking certain discriminatory actions against willing pharmacies. Enacted.

West Virginia Regulatory Updates  04/22/2024

HB 2032 – Relating to the Occupational Pneumoconiosis Board

Issues: Workers’ Compensation (General)

Summary For 01/17/2023

This measure entitles a claimant to obtain an evaluation from the Occupational Pneumoconiosis Board regardless of time limitations

Most Recent Update:

03/09/2024 – This measure failed upon adjournment of the legislature on March 9.  This measure is ineligible for further consideration.

HB 2190 – Relating to Eligibility For Workers’ Compensation Benefits By Requiring Blood Test After Traumatic Injury to Determine Intoxication

Issues: Workers’ Compensation (General)

Summary For 01/19/2023

This measure specifies that a medical provider for a person who has suffered a traumatic personal injury within 12 hours of presenting for treatment may require the person to undergo a blood test to determine whether they were under the influence of alcohol or drugs at the time. The test must be carried out within 12 hours of the injury’s occurrence and before to the administration of medicine or the use of other drugs.

This measure specifies that:

• a person must be notified in writing and verbally that refusal may prohibit the individual and his or her dependents from receiving benefits for the injury;
• the refusal is regarded official after 15 minutes: however, the applicant may retract his or her refusal within 15 minutes of the denial and be given the option of taking the exam again;
• following a refusal to take the test, the medical practitioner is under no responsibility to give the individual another chance, and the denial is irrevocable; and
• when the person’s refusal to take the test becomes final, his or her right to benefits under this chapter as compensation for the harm is forfeited and terminated.

Most Recent Update:

03/09/2024 – This measure failed upon adjournment of the legislature on March 9.  This measure is ineligible for further consideration.

Additional Outlook: This measure was introduced to amend current law by adding a new section related to eligibility for workers’ compensation benefits by persons who suffer a traumatic personal injury; requiring blood tests of persons being treated for a traumatic personal injury by the medical provider to determine whether the person is intoxicated under certain circumstances; testing requirements; circumstances when a blood test may not be a requirement; and circumstances when a blood test may not be a requirement.

HB 2524 – Repealing the Law Which Makes Prime Contractors Liable For the Failure of Subcontractors to Make Proper Payments For Workers’ Compensation

Issues: Workers’ Compensation (General)

Summary For 01/16/2023

This measure repeals the law which makes prime contractors liable for the failure of subcontractors to make proper payments for workers’ compensation coverage.

Most Recent Update:

03/09/2024 -This measure failed upon adjournment of the legislature on March 9. This measure is ineligible for further consideration.

HB 4216 – To Reaffirm and Enhance the Workers Compensation Exclusive Remedy Rule or Doctrine

Issues: Workers’ Compensation (General)

Summary For 01/11/2024

This measure enhances the “exclusive remedy” nature of workers’ compensation. It reasserts that the remedies under workers’ compensation are exclusive of other legal remedies, including under common law. It also removes a number of the exemptions and additional conditions relating to employer negligence, liability, and the nature of the injury.

Most Recent Update:

03/09/2024 -This measure failed upon adjournment of the legislature on March 9. This measure is ineligible for further consideration.

HB 4310 – Relating to Eligibility For Workers’ Compensation Benefits By Requiring Blood Test After Traumatic Injury to Determine Intoxication

Issues: Workers’ Compensation (General)

Summary For 01/15/2024

This measure requires workers’ compensation treatment for an individual with traumatic personal injury presenting within 12 hours of the injury to include a blood test for intoxication. An individual may refuse the test, but this disqualifies them from benefits under workers’ compensation. An individual’s refuse may be revoked until it becomes final after being warned of this and 15 minutes after the initial refusal.  It takes effect July 1, 2024

Most Recent Update:

03/09/2024 – This measure failed upon adjournment of the legislature on March 9.  This measure is ineligible for further consideration.

HB 4687 – Repealing the Law Which Makes Prime Contractors Liable For the Failure of Subcontractors to Make Proper Payments For Workers’ Compensation

Issues: Workers’ Compensation (General)

Summary For 01/17/2024

This measure removes prime contractor liability for a subcontractor’s failure to pay for workers’ compensation coverage.

Most Recent Update:

03/09/2024 – This measure failed upon adjournment of the legislature on March 9.  This measure is ineligible for further consideration.

Additional Outlook: This measure was introduced to amend current law by adding a new section related to eligibility for workers’ compensation benefits by persons who suffer a traumatic personal injury; requiring blood tests of persons being treated for a traumatic personal injury by the medical provider to determine whether the person is intoxicated under certain circumstances; testing requirements; circumstances when a blood test may not be a requirement; and circumstances when a blood test may not be a requirement.

SB 286 – Relating to Time Limitation For Filing Occupational Pneumoconiosis Claims

Issues: Workers’ Compensation (General)

Summary For 01/22/2024

This measure clarifies that a workers’ time to claim an evaluation from the Occupational Pneumoconiosis Board is not time limited.

Most Recent Update:

03/09/2024 -This measure failed upon adjournment of the legislature on March 9. This measure is ineligible for further consideration.

HB 5554 – Modifying the Occupational Pneumoconiosis Award Categories For Worker’s Compensation

Issues: Workers’ Compensation (General)

Summary For 02/13/2024

This measure establishes payment guidelines for workers with pulmonary massive fibrosis without current pulmonary impairment. This measure aims to address future impairments that may occur outside the typical timeframe for filing a complaint​.

This measure specifies that no employee or dependent is entitled to compensation for injury or death caused by self-inflicted injury or intoxication of the employee. Employers may require employees to undergo blood tests to determine evidence of intoxication under specific circumstances​​.

This measure establishes specific compensation guidelines for claimants with pulmonary massive fibrosis who do not currently have pulmonary impairment. It categorizes the compensation into three groups: Category A (10%), Category B (20%), and Category C (30%)​​.

This measure specifies that the commission may collaborate with the Office of Miners’ Health Safety and Training and the State Division of Labor to promote safety programs and formulate rules for hazardous employments.

This measure specifies that if an employee is injured or dies due to the employer’s deliberate intention to cause such injury or death, the employee, or in the case of incompetency, the employee’s conservator or guardian, may seek recovery under the chapter. This allows for a cause of action against the employer for damages exceeding the amount received or eligible to be received in a claim for benefits.

This measure specifies that an employee or their representative can seek additional compensation beyond what is covered by standard workers’ compensation benefits.

This measure specifies that if an employee’s death results from the employer’s deliberate intention to cause injury or death, the representative of the employee’s estate is entitled to recover under the chapter and can bring a cause of action against the employer for excess damages.

Most Recent Update:

03/09/2024 -This measure failed upon adjournment of the legislature on March 9. This measure is ineligible for further consideration.

West Virginia Regulatory Updates 3/6/2023

HB 3270 – To Amend the Deliberate Intent Statute to Limit Noneconomic Damages to $250,000

Issues: Workers’ Compensation (General)

Summary:

This measure removes occupational pneumoconiosis from compensable injuries under deliberate intent. It also limits noneconomic loss damage awards under workers’ compensation to $250,000 and caps attorney fees to 20% of the award amount.

Most Recent Update:

2/24/2023 -This measure has been scheduled for a hearing on February 24 in the House Committee on Judiciary, chaired by Delegate Moore Capito (R). The sponsor does not sit on the committee of referral.

The West Virginia legislature is meeting in person for the 2023 legislative session. Anyone wishing to testify may do in person or by submitting written testimony to the committee Chair. A vote may occur at the discretion of the Chair. The measure may be referred to multiple committees.

SB 648 – Amending Deliberate Intent Exception to Immunities Provided Under Workers’ Compensation

Issues: Workers’ Compensation (General)

Summary:

This measure provides that supervisors and managers who are responsible for providing safe working conditions and whose job duties include eliminating or ameliorating that condition giving rise to liability are not employees.  The measure removes provisions requiring an employee suffering from occupational pneumoconiosis to submit written certification by a board-certified pulmonologist that the employee is suffering from complicated pneumoconiosis or pulmonary massive fibrosis.
The measure provides that the maximum amount recoverable for any action regarding compensatory damages for noneconomic loss may not exceed $250,000 for each occurrence. The measure reduces compensatory damages for economic losses for payments from collateral sources for the same injury by a plaintiff. This measure takes effect on July 1, 2023.

Most Recent Update:

2/15/2023 – This measure has been introduced for the 2023 legislative session and referred to the Senate Judiciary Committee. The sponsor does not sit on the committee of referral. This measure is eligible for consideration in the committee of referral. Additional Outlook: This measure is similar to SB 685

SB 685 – Amending Deliberate Intent Exception to Immunities Provided Under Workers Compensation

Issues: Workers’ Compensation (General)

Summary:

This measure provides that supervisors and managers who are responsible for providing safe working conditions and whose job duties include eliminating or ameliorating that condition giving rise to liability are not employees. The measure removes provisions requiring an employee suffering from occupational pneumoconiosis to submit written certification by a board-certified pulmonologist that the employee is suffering from complicated pneumoconiosis or pulmonary massive fibrosis. The measure provides that the maximum amount recoverable for any action regarding compensatory damages for noneconomic loss may not exceed $250,000 for each occurrence. The measure reduces compensatory damages for economic losses for payments from collateral sources for the same injury by a plaintiff. This measure takes effect on July 1, 2023.

Most Recent Update:

2/28/2023 – On February 20, this measure was introduced and referred to the Senate Judiciary Committee. This measure is eligible for consideration in the committee of referral. Additional Outlook: This measure is similar to SB 648

West Virginia Regulatory Updates 2/7/2023

HB 2032 – Relating to the Occupational Pneumoconiosis Board

Issues: Workers’ Compensation (General)

Summary:

This measure entitles a claimant to obtain an evaluation from the Occupational Pneumoconiosis Board regardless of time limitations.

Most Recent Update:

1/11/2023 This measure has been introduced for the 2023 legislative session and referred to the House Health and Human Resources Committee. The sponsor does not sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

HB 2190 – Relating to Eligibility For Workers’ Compensation Benefits By Requiring Blood Test After Traumatic Injury to Determine Intoxication

Issues: Workers’ Compensation (General)

Summary:

This measure specifies that a medical provider for a person who has suffered a traumatic personal injury within 12 hours of presenting for treatment may require the person to undergo a blood test to determine whether they were under the influence of alcohol or drugs at the time. The test must be carried out within 12 hours of the injury’s occurrence and before to the administration of medicine or the use of other drugs.

This measure specifies that:

• a person must be notified in writing and verbally that refusal may prohibit the individual and his or her dependents from receiving benefits for the injury;
• the refusal is regarded official after 15 minutes: however, the applicant may retract his or her refusal within 15 minutes of the denial and be given the option of taking the exam again;
• following a refusal to take the test, the medical practitioner is under no responsibility to give the individual another chance, and the denial is irrevocable; and
• when the person’s refusal to take the test becomes final, his or her right to benefits under this chapter as compensation for the harm is forfeited and terminated.

Most Recent Update:

1/11/2023 This measure has been introduced for the 2023 legislative session and referred to the House Judiciary Committee. The sponsor does not sit on the committee of referral This measure is eligible for consideration in the committee of referral.

HB 2524 – Repealing the Law Which Makes Prime Contractors Liable For the Failure of Subcontractors to Make Proper Payments For Workers’ Compensation

Issues: Workers’ Compensation (General)

Summary:

This measure repeals the law which makes prime contractors liable for the failure of subcontractors to make proper payments for workers’ compensation coverage.

Most Recent Update:

1/12/2023 This measure has been introduced for the 2023 legislative session and referred to the House Committee on Workforce Development. The sponsor does sit on the committee of referral. This measure is eligible for consideration in the committee of referral.

West Virginia Regulatory Updates 4/11/2022

HB 2052 – Relating to Occupational Pneumoconiosis Claims

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure establishes that time limitations provided for filing occupational pneumoconiosis claims does not apply or limit a claimant to obtain an evaluation from the Occupational Pneumoconiosis Board. This measure provides that a claimant seeking to obtain an evaluation from the Occupational Pneumoconiosis Board is not limited to any time constraints of §23-4-15 Application for benefits.

Most Recent Update:

3/12/2022 The Legislature adjourned. In even years, legislation will not be carried over to the next session. This measure is ineligible to receive further consideration.

HB 2292 – Including Three Types of Cancer For Which Rebuttable Presumption of Injury from Employment Exists For Firefighters

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure includes bladder cancer, mesothelioma, and testicular cancer as a rebuttable presumption for firefighters. This measure, if enacted, will take effect 90 days following enrollment. This measure has a sunset of July 1, 2025.

Most Recent Update:

3/12/2022 The Legislature adjourned. In even years, legislation will not be carried over to the next session. This measure is ineligible to receive further consideration.

HB 4598 – Relating Generally to Occupational Pneumoconiosis

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure relates to disability benefits for pneumoconiosis under workers’ compensation. This bill applies to employers and workers’ compensation insurers. This measure amends state code to to provide disability benefits to employees with pneumoconiosis. The measure allows that if the commissioner determines that an employee has occupational pneumoconiosis, but without measurable pulmonary impairment therefrom, the employee shall be awarded and paid 20 weeks of benefits at the same benefit rate as herein provided. The measure further provides that in all cases before the Occupational Pneumoconiosis Board and where there has been an X2 ray diagnosis of pulmonary massive fibrosis or complicated pneumoconiosis without impairment, the claimant shall be granted a 25 percent permanent partial disability award by the commissioner. The measure asserts that the 25 percent shall be offset from any future permanent partial disability award recommended by the Occupational Pneumoconiosis Board and granted by the commissioner.

Most Recent Update:

3/12/2022 The Legislature adjourned. In even years, legislation will not be carried over to the next session. This measure is ineligible to receive further consideration.

SB 177 – Adding Certain Cancers As Rebuttable Presumption For Certain Injuries and Diseases For Professional Firefighters

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure expands the types of occupational diseases for professional firefighters. This measure applies to professional firefighters. This measure adds skin, lung, esophageal, colon, testicular, prostrate, brain, breast or cervical cancers as well as mesothelioma and non-Hodgkin’s lymphoma to the least of occupational diseases for professional firefighters. This amendment expires on July 1, 2027, unless extended by the legislature. No effective date provided.

Most Recent Update:

3/15/2022 The Legislature adjourned on March 15. This measure is ineligible for further consideration.

West Virginia Regulatory Updates 2/3/2022

HB 2052 – Relating to Occupational Pneumoconiosis Claims

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure establishes that time limitations provided for filing occupational pneumoconiosis claims does not apply or limit a claimant to obtain an evaluation from the Occupational Pneumoconiosis Board. This measure provides that a claimant seeking to obtain an evaluation from the Occupational Pneumoconiosis
Board is not limited to any time constraints of §23-4-15 Application for benefits.

Most Recent Update:

1/12/2022 This measure has been introduced and referred to the House Judiciary Committee, chaired by Moore Capito (R). This measure is eligible for a hearing in the House Judiciary Committee. A timeline for consideration will be established at the discretion of the Chair.

HB 2292 – Including Three Types of Cancer For Which Rebuttable Presumption of Injury from Employment Exists For Firefighters

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure includes bladder cancer, mesothelioma, and testicular cancer as a rebuttable presumption for firefighters. This measure, if enacted, will take effect 90 days following enrollment. This measure has a sunset of July 1, 2025.

Most Recent Update:

1/12/2022 This measure has been requested for a refile by the sponsor. It has been referred to the House Fire Departments and Emergency Medical Services Committee chaired by Delegate Joe Statler (R) with a subsequent referral to the House Judiciary Committee. This measure awaits committee consideration.

SB 177 – Adding Certain Cancers As Rebuttable Presumption For Certain Injuries and Diseases For Professional Firefighters

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure expands the types of occupational diseases for professional firefighters. This measure applies to professional firefighters. This measure adds skin, lung, esophageal, colon, testicular, prostrate, brain, breast or cervical cancers as well as mesothelioma and non-Hodgkin’s lymphoma to the least of occupational diseases for professional firefighters. This amendment expires on July 1, 2027, unless extended by the legislature. No effective date provided.

Most Recent Update:

1/12/2022 This measure was introduced and referred to the Senate Banking and Insurance Committee and the Senate Finance Committee, chaired by Senator Michael Azinger (R) and Senator Eric Tarr (R) respectively. This measure is eligible for consideration in the committees of referral.

SB 83 – Relating Generally to Occupational Pneumoconiosis

Issues: Workers’ Compensation (Medical Coverage and Reimbursement), Workers’ Compensation (General)

Summary:

This measure creates benefits eligibility for employees diagnosed with occupational pneumoconiosis without impairment. This measure applies to workers’ compensation. Under this measure, employees determined to have occupational pneumoconiosis without measurable pulmonary impairment are eligible for 20 weeks of benefits at the same rate as when impairment is measurable. The commissioner is required to grant 25% permanent partial disability award to claimants in cases where there has been an X-ray diagnosis of pulmonary massive fibrosis and/or complicated pneumoconiosis without impairment. The award is to be offset from any future permanent partial disability award. This measure takes effect 90 days after enactment.

Most Recent Update:

1/12/2022 This measure has been introduced and referred to the Senate Committee on Banking and Insurance, chaired by Michael Azinger (R). The sponsor does not sit on the committee of referral. This measure is eligible for a hearing in the Senate Committee on Banking and Insurance. A timeline for consideration will be established at the discretion of the Chair.

West Virginia Regulatory Updates 8/5/2021

HB 2263 – Labor; workers’ compensation; temporary partial disability; cost of living adjustment; appeals

Issues: Workers’ Compensation (Prescription Drug Formulary)

Summary:

This measure established requirements for pharmacy benefit manager reimbursements for pharmacy services, requires pharmacy benefits managers to report some aggregate costs data, and prohibits pharmacy benefits managers and health insurers from taking certain discriminatory actions against willing pharmacies. This measure is applicable to pharmacy benefits managers and health insurers. This measure requires pharmacy benefit managers to ensure network adequacy, including access to pharmacies within a reasonable distance. This measure requires pharmacy benefit managers to report quarterly to the agency the total amount charged to the agency for all claims processed, the overall total number of claims which were reimbursed for less than the amount charged to the agency for all claims processes, and the total amount paid to pharmacies per claim. The director, if necessary, may only use aggregated, nonproprietary data. This measure prohibits pharmacy benefit managers from reimbursing pharmacists or pharmacies amounts less than the national drug acquisition cost for a prescription drug plus a professional dispensing fee. If the national drug acquisition cost is unavailable, the pharmacy benefits manager must use the wholesale acquisition cost. This measure requires pharmacy benefit managers to file reimbursement methodologies with the insurance commissioner for use in determining maximum allowable cost appeals. These are confidential. Pharmacy benefit managers are required to use the national drug acquisition cost as a point of reference for the ingredient drug product component of a pharmacy’s reimbursement for drugs on the national drug acquisition cost list and provide a report every four months which will be provided to the commissioner and published on the pharmacy benefits manager’s website. Drugs that must be published are those with a reimbursement of 10% and below of the national drug acquisition cost list and those reimbursed at 10% and above the national drug acquisition cost list. The report must include the quantity and reimbursement rate of the drug. This measure prohibits pharmacy benefits managers from basing pharmacy reimbursement on patient outcomes, imposing point-of-sale or retroactive fees, or deriving revenue from a pharmacy or insured in connection with performing pharmacy benefit management services.

This measure requires cost-sharing for prescription drugs to be calculated at the point of sale based on a price that is reduced by an amount equal to at least 100% of all rebated received in connection with the dispensing or administration of the prescription drug. A pharmacy benefits manager will offer a health plan the option of charging the plan the same price for a prescription as the pharmacy does. A pharmacy benefits manager will report the aggregate amount difference between the pharmacy reimbursement and what was charged by the pharmacy benefits manager. This measure prohibits pharmacy benefits managers and health plans from prohibiting enrollees from choosing a pharmacist who has agreed to participate, deny a pharmacy the right to participate if  they have agreed to the terms and met the requirements, impose additional fees on services from contract providers, impose monetary benefits or penalties impacting an enrollee’s choice of pharmacies, reduce reimbursement due to choice of pharmacy, require an enrollee to use mail-order pharmacies, or impose a copayment or other condition or restriction that would not have been imposed if the enrollee had chosen a mail-order or other willing pharmacy. This measure prohibits pharmacy benefits managers from discriminating against 340b covered entities. This measure requires health plans to notify pharmacies of reimbursement that will restrict pharmacy participation at least 60 days prior to the start of the plan and offer participation. The health plan will then notify enrollees of the available participating pharmacies. A pharmacy benefits manager or health plan that does not comply with this measure will not be approved by the insurance commissioner. This measure will apply to plans issued, renewed, or amended on or after January 1, 2022.

Most Recent Update:

4/9/2021 This measure has been signed by Governor Jim Justice (R). This measure will apply to plans issued, renewed, or amended on or after January 1, 2022.

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