West Virginia House Bill HB5266

West Virginia 2026 Regular Session

• Introduced: 2/5/26
• Refer: 2/5/26

Caption

Requiring West Virginia Medicaid managed care organizations to contract with any otherwise qualified provider

Summary

HB5266 would add a new section to West Virginia law governing Medicaid managed care. The bill requires all West Virginia Medicaid managed care organizations to contract with any hospital, physician, behavioral health provider, or other provider that is otherwise qualified and willing to accept the same reimbursement and terms offered to comparable providers. In effect, it creates an “any willing provider” requirement for Medicaid managed care networks. To be eligible for inclusion, a provider must meet all applicable Medicaid enrollment requirements, professional and business licensing rules, have a Medicaid provider number, satisfy the managed care organization’s credentialing standards for similar providers, and not be excluded from Medicare or Medicaid. The bill applies to providers serving a Medicaid region and is intended to ensure that qualified providers are not excluded from managed care networks solely because of network contracting decisions.

Impact

The bill would expand access to Medicaid managed care networks by limiting the ability of managed care organizations to selectively contract with providers. It would affect West Virginia Medicaid MCOs, hospitals, physicians, behavioral health providers, and other licensed providers who meet enrollment and credentialing standards. The practical legal effect is to require network participation for any willing and qualified provider at comparable payment and contract terms, potentially reducing network exclusivity and increasing provider participation in Medicaid services.

Sentiment

Based on the bill text and available context, the measure appears to be framed as a provider-access and network-fairness bill rather than a controversial program overhaul. The stated purpose is straightforward: to ensure qualified providers can join Medicaid managed care networks if they accept the same terms as comparable providers. No committee debate or recorded votes were provided, so there is no documented opposition or support in the available materials beyond the bill’s sponsor-driven introduction.

Contention

The main point of contention likely centers on managed care organizations’ ability to control their provider networks and negotiate differentiated rates versus providers’ desire for open access to Medicaid patients. Supporters would likely emphasize patient choice, provider fairness, and access to care, especially in behavioral health and rural areas. Opponents, if any, would likely argue that an any-willing-provider mandate could limit MCO network management, reduce contracting flexibility, and potentially increase costs or administrative burden. No specific objections or named opponents appear in the provided record.